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Action Against Hunger’s Nutrition Information Services provide direct and remote support with the planning and implementation of nutrition assessments.

A national IMAM coverage survey that used a mixed-methods approach provided valuable insights into true service coverage and barriers to accessing IMAM services. The approach leveraged routine programme monitoring data and primary data collection in selected locations. The findings and the strong stakeholder engagement contributed to health system strengthening and enabled quality improvement of services.

This coverage survey consisted of a series of SLEAC surveys, which were conducted across three selected districts, namely Rautahat district in Madhesh Province, Dolakha district in Bagmati Province and Mugu district in Karnali Province, to identify key barriers and boosters of access and coverage from the community perspective. It was complemented by qualitative data gathered through interviews with health workers and field observations by the survey team.

The treatment of severe and moderate acute malnutrition is supported by national Integrated Management of Acute Malnutrition (IMAM) guidelines. In 2019, a guidance note was issued to enable the use of RUTF for children with severe and moderate acute malnutrition during emergencies. In 2023, approximately 160,000 children were estimated to suffer from wasting, including an estimated 19,775 children who needed life-saving treatment for severe wasting. Due to a lack of investment for essential nutrition supplies and quality improvement, only 10,556 children with severe wasting were treated, which represented the lowest admission rate recorded over the course of the last 7 years. As information about treatment coverage is scarce, a coverage assessment was deemed necessary to assess the IMAM programme access and to identify the barriers and boosters of access to treatment in Zimbabwe.

This case study is part of a compendium of country-level case studies produced by the Delivery System for Scale project that explore promising, context-specific approaches to scale the management of wasting treatment for children under five. In Madagascar, the management of severe and moderate acute malnutrition (SAM and MAM, respectively) are handled by different Government entities, which complicates the provision of comprehensive, quality care across the continuum between the two conditions. Despite these challenges, Anosy region serves as a unique and powerful example of local collaboration for integrated SAM and MAM management, highlighting the positive changes that can result from mainstreaming such collaboration within individuals, across teams and within routine operational procedures. This case study, therefore, describes the innovations that were implemented in Anosy, their advantages and limitations, and relevant considerations for other regions and national stakeholders moving forward.

The Global Performance Report 2018 outlines and reflects on Action Against Hunger’s global achievements and reach in 2018.

Many methods are available to assess barriers and boosters to coverage. Depending on the information needed and resources available, actors can chose the most appropriate approach. Regardless of the method for collecting the data, a critical analysis of the programme and its performance should be carried out regularly.

The Coverage Monitoring Network has developed the SQUEAC Assessment Companion and SQUEAC Supervision Guidelines for use by SQUEAC assessment leaders and supervisors who are familiar with the methodology to support the planning and delivery of SQUEAC assessments to the required quality and standard. The content of this toolkit closely follows the SQUEAC and SLEAC Technical Reference (full reference available below) with additional material which has been developed by the Coverage Monitoring Network and others.

The Coverage Monitoring Network has developed the SQUEAC Assessment Companion and SQUEAC Supervision Guidelines for use by SQUEAC assessment leaders and supervisors who are familiar with the methodology to support the planning and delivery of SQUEAC assessments to the required quality and standard. The content of this toolkit closely follows the SQUEAC and SLEAC Technical Reference (full reference available below) with additional material which has been developed by the Coverage Monitoring Network and others.

This article explains in detail how to build a prior for stage 3 of the SQUEAC survey.