Coverage of Acute Malnutrition Treatment Services

Coverage is the key indicator for the management of acute malnutrition. It measures the proportion of severely malnourished children who need treatment against those actually receiving treatment.

Coverage is assessed by SLEAC (Simplified Lot Quality Assurance Sampling Evaluation of Access and Coverage) or SQUEAC method (Semi-Quantitative Evaluation of Access and Coverage). Both methods are described in the guidance below, and in more detail at the CMAM Coverage Monitoring website. 

Disaggregate the data by gender, age, geographic area and specific vulnerable groups, such as minorities.

1) According to the SPHERE Standards, coverage is perceived as acceptable when it is more than 50% in rural areas; more than 70% in urban areas and more than 90% in a camp situation.

2) Coverage can also be calculated for MAM children receiving treatment in the Supplementary Feeding Program (SFP).

3) Programmatic data should be analysed to identify areas of potential high and low coverage. Qualitative data is then collected to look for boosters and barriers to coverage, and gain further understanding of reasons why acutely malnourished children are accessing (or not) treatment.

4) The amount of time required for the methods depends on numerous factors, including accessibility, distance to travel, screening tools used, number of staff and previous experience. Generally, SLEAC assessments take less time to implement (5-7 days) than SQUEAC assessments (usually take a minimum of 3 weeks days excluding reporting); however, SQUEAC assessments yield more detailed information.

5) If your team does not have any experience with SLEAC or SQUEAC, inquire Coverage Monitoring Network for a consultant who can train your team and supervise the survey quality.

6) Coverage of Malnutrition Treatment Services is one of ECHO's Key Outcome Indicators (see below). ECHO phrases the indicator differently, as "Coverage of the nutrition program", meaning the proportion of the total number of under 5 SAM cases which are adequately admitted in the nutrition programme.