Meta-analysis of Barriers and Boosters from 78 coverage assessments supported by the CMN

Coverage assessments are one of the most important tools to analyse and improve access to CMAM programs. During its first phase, The Coverage Monitoring Network (CMN) carried out over 70 coverage assessments. The purpose of this present study, which has used a total of 78 CMN assessments, is to provide an in-depth analysis of the barriers and boosters identified during the first qualitative phase of coverage assessments in order to identify common trends. Moreover, to support a more global analysis, the barriers and boosters were grouped into five overarching categories;

– Geographic
– Temporal
– Socio-cultural
– Financial
– Quality of care

For this analysis a total of 385 barriers have been collected which were sorted in to 27 different categories. From this analysis, the five main barriers identified are 1/ Poor outreach activities (14%2), 2/ Distance (10%), 3/ Poor delivery of service (8%), 4/ RUTF stock breaks (7%) and 5/ Lack of awareness about malnutrition and lack of awareness of the program (7% both). Under the global categories mentioned above, quality of care (43%) is the most commonly occurring barrier directly impacting upon access to the program.
With regards to boosters, a total of 367 were collected from the reports and sorted under 25 categories. From this analysis, the five main boosters identified are 1/Awareness that SAM can be treated effectively (13%), 2/ Effective system in place for referral and transfer (10%), 3/ Key community figures actively support the program (10%), 4/ Awareness the service to treat SAM is available (9%), 5/ Regular active case finding activities (7%). Under the global categories mentioned above, socio-cultural (43%) and quality of care (38%) are the most common categories of boosters.
This study demonstrates that socio-cultural and quality of care, either as boosters or barriers are the main categories to focus on for improving and/or continuing the access to CMAM programs.