Coverage of Acute Malnutrition Treatment

Indicator Name

Indicator ID in PRIME

Definition

This indicator is a coverage indicator for community-based management of acute malnutrition (CMAM) and will calculate the proportion of children with acute malnutrition who receive therapeutic care. This is also known as treatment coverage.

Numerator

Coverage Survey:
Number of children under 5 with acute malnutrition, defined as having a weight-for-height or weight-for-length z-score more than 2 SD below the median of the WHO child growth standards or having nutritional oedema, who received community management of acute malnutrition in the project area.

For program/project data recording: If Coverage survey is not available then proxy coverage can be calculated using:
Number of children under 5 with acute malnutrition, defined as having a weight-for-height or weight-for-length z-score more than 2 SD below the median of the WHO child growth standards or having nutritional oedema, admitted for community management of acute malnutrition over a specified period in the project area.

Denominator

Coverage Survey:
Total number of children under 5 with acute malnutrition, in the same project area.

For program/project data recording: If Coverage survey is not available then proxy coverage can be calculated using:
Total number of children under 5 with acute malnutrition for the same period in the same project area.

SQUEAC/SLEAC surveys, Census surveys or other population based surveys that are adequately powered to measure coverage OR
Use program data recording for proxy coverage by using number of children under 5 with acute mlanutrition admitted for treatment over a specified period and estimated caseload of acute malnutrition for the same period.

SQUEAC is a semi-quantitative method that provides an in-depth analysis of barriers and boosters to coverage. It is designed for use as a regular service monitoring tool through the intelligent use of routine monitoring data complemented by other relevant data that are collected on a “little and often” basis. SLEAC is a rapid low-resource survey method that classifies coverage at the service delivery unit (SDU) level. The SDU may be a health centre catchment area, commune, or district.

A SLEAC survey identifies the category of coverage (e.g. “low”, “moderate” or “high”) achieved by the service delivery unit being assessed. The advantage of this approach is that relatively small sample sizes (e.g. n ≤ 40) are required in order to make an accurate and reliable classification.

For Humanitarian setting Spheres Handbook on Food security and nutririon can be used to assess this indicator: https://handbook.spherestandards.org/en/sphere/#ch007_004
Other coverage survey related resources can be accessed at https://www.indikit.net/indicator/1-nutrition/36-coverage-of-acute-malnutrition-treatment-services

Indicator Prioritisation

Level of Indicator

Indicator Context Type

Theme

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Cross-Cutting Themes

Common Approach

Total Reach Indicator

Frequency of Data Collection

Unit of Measure

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Direction of Desired Change

Number of Decimal Points

Indicator is Rounding

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Recommended Disaggregations

Acute malnutrition in children under 5 years of age is defined as having a weight-for-height or weight-for-length z-score more than 2 SD below the median of the WHO child growth standards (WHZ or WLZ < -2) or having nutritional oedema. Again, a MUAC less than 125mm can be used as an alternative measure to define acute malnutrition alongside weight-for-height and nutritional
oedema. (https://files.magicapp.org/guideline/a3fe934f-6516-460d-902f-e1c7bbcec034/published_guideline_7330-1_1.pdf)

CMAM approach is comprised of four components: (1) community outreach and mobilization; (2) outpatient management of SAM without medical complications; (3) inpatient management of SAM with medical complications; and (4) services or programs to manage moderate acute malnutrition (MAM), such a supplementary feeding program.