Default Rate

Outcome

% of children exiting treatment who were classified as defaulters (default rate)

The default rate is one of the core performance indicators of acute malnutrition treatment programmes. It represents the proportion of children discharged during the reporting period who were classified as defaulters according to the applicable programme protocol. In standard CMAM reporting, this commonly means absence for two consecutive scheduled treatment visits/weighings.

To calculate the indicator, divide the number of children classified as defaulters during the reporting period by the total number of children discharged during the same period. Multiply the result by 100 to convert it to a percentage. The resulting percentage is the default rate.

For Sphere-comparable reporting, total discharges comprise children discharged as recovered, died, defaulted or not recovered. Do not include children moved or transferred between treatment sites or components while continuing the same treatment episode, or administrative/‘other’ exits, in this denominator. When combining inpatient and outpatient outcomes, avoid double-counting transfers. Use the defaulter definition in the applicable national or programme protocol and document it; in standard CMAM reporting, a defaulter is a child absent for two consecutive scheduled treatment visits/weighings.

This data can be disaggregated by sex, age group and geographic area, and, if relevant and feasible, also by treatment site, disability and other locally relevant vulnerability characteristics.

1) The indicator does not require a separate survey; use the treatment programme’s routine records.

    

2) Sphere 2018 sets a benchmark of <15% defaulted among discharges from acute malnutrition treatment in humanitarian response. Treat this as a Sphere humanitarian performance benchmark rather than a universal target; outside humanitarian response, use applicable national or programme standards.

    

3) The four core performance indicators of an acute malnutrition treatment programme are recovery rate, death rate, default rate and non-recovery rate. Interpret them together because, under the standard discharge framework, the four outcomes are interdependent and add up to 100%.

   

4) Default is an exit classification, not a confirmed explanation for why a child stopped attending. Investigate missed visits as soon as possible.

Also consider using the following indicators:

• Recovery (Cure) Rate (shows the proportion of treatment discharges that recover)

• Death Rate (complements default with mortality among treatment discharges)

• Non-Recovery Rate (captures unsuccessful treatment outcomes other than default and death)

• Coverage of Acute Malnutrition Treatment Services (shows whether children needing treatment are being reached, complementing retention and discharge performance)