21 October 2014

Who has Coverage covered? Learning from the SAM side of the big tent

This might just be me catching up with the rest of the nutrition community.  But the more I find out about SAM (severe acute malnutrition) coverage thinking, the more I think the rest of the nutrition community--so concerned with scaling up--has a thing or two to learn from our SAM colleagues.

I'm just reading the latest Coverage Matters report from the Coverage Monitoring Network and ENN.   There are several articles which interrogate the naive assumption of serene coverage increases over time.

The articles are short and accessible and cover things like:

* the Tanahashi coverage diagram (from availability coverage, accessibility coverage, acceptability coverage, contact coverage, to effectiveness)  

* active outreach to generate early admissions--the context is SAM prevention and treatment, but the principle obviously extends to early trimester and early childhood interventions on the chronic side

* the role of audits (programme and social) to identify barriers to coverage scale up and to generate solutions for overcoming them

* reasons for non-attendance: from lack of awareness of the programme or the problem, to family members barring participation

* the relationship between coverage and effectiveness (don't assume effectiveness stays constant)

* the SQUEAC (semi-quantitative evaluation of access and coverage) tools (e.g. for creating "mind maps" of assumptions about how programmes work and people engage with them) seem to have usefulness beyond the SAM programmes

Just another reason to close the "chronic" - "emergency" divide.

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