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Basquin, Cecile; Imelda, Awino; Gallagher, Maureen, E-mail: mgallagher@actionagainsthunger.org
International Symposium on Understanding Moderate Malnutrition in Children for Effective Interventions. Compilation of abstracts2014
International Symposium on Understanding Moderate Malnutrition in Children for Effective Interventions. Compilation of abstracts2014
AbstractAbstract
[en] Full text: Despite an increased number of nutrition treatment coverage assessments conducted, they often focus on Severe Acute Malnutrition (SAM) treatment. In a recent experience in Kenya, Action Against Hunger| ACF International (ACF) conducted a coverage assessment to evaluate access to SAM and Moderate Acute Malnutrition (MAM) treatment. ACF supports the Ministry of Health (MoH) in delivering SAM and MAM treatment at health facility level through an Integrated Management of Acute Malnutrition (IMAM) programme in West Pokot county since 2011. In order to evaluate the coverage of Outpatient Therapeutic Programme (OTP) and Supplementary Feeding Programme (SFP) components, the Simplified Lot Quality Assurance Sampling Evaluation of Access and Coverage (SLEAC) methodology was used. The goals of the coverage assessment were i) to estimate coverage for OTP and SFP; ii) to identify barriers to access to SAM and MAM treatment; iii) to evaluate whether any differences exist between barriers to access to SAM versus to MAM treatment as SFP coverage and uptake of MAM services were never assessed before; and iv) to build local capacities in assessing coverage and to provide recommendations for the MoH-led IMAM programme. With the support of the Coverage Monitoring Network (CMN), ACF led the SLEAC assessment as part of an on-the-job training exercise for MoH and partners in July 2013, covering all of West Pokot county. SLEAC is a rapid and low-resource survey method that uses a three-tier classification approach to evaluate and classify coverage, i.e., low coverage: < 20%; moderate: 20% -50%; and high coverage: ≤ 50%. In a first sampling stage, villages in each of the four sub-counties were randomly selected using systematic sampling. In a second sampling stage, in order to also assess MAM coverage, a house-to-house approach was applied to identify all or near all acutely malnourished children using Mid Upper Arm Circumference (MUAC) tape and identification of bilateral pitting oedema. Results showed that none of the four sub-counties achieved high coverage classification. The coverage for OTP was moderate in North and South Pokot, whilst low in West and Central Pokot. The overall county coverage classification was moderate. SFP coverage classification was found to be low across all four sub-counties and county wide as well. The assessment also identified that barriers to access to SAM and MAM treatment were often similar, e.g., the main barrier to access for both services was lack of programme awareness in Central and West Pokot. Some key recommendations towards increasing coverage included to improve stakeholder awareness via advocacy, engaging with the use of mass media, increasing outreach activities, and to minimize rejection by revising screening methods and systems in place. These were applicable to both OTP and SFP components of IMAM. Coverage evaluations for MAM treatment are less commonly conducted than those for SAM treatment as it is more challenging to identify cases of MAM physically. Nonetheless, in order to document program effectiveness, it will be important to further explore methods that can evaluate coverage of MAM programming. (author)
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International Atomic Energy Agency, Department of Nuclear Sciences and Applications, Division of Human Health, Nutritional and Health-Related Environmental Studies Section, Vienna (Austria); 139 p; 2014; p. 91; International Symposium on Understanding Moderate Malnutrition in Children for Effective Interventions; Vienna (Austria); 26-29 May 2014; IAEA-CN--217/80P; Also available on-line: http://www-pub.iaea.org/MTCD/Meetings/PDFplus/2014/cn217/cn217_AbstractCompilation.pdf; Poster presentation
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