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Post a reply: ‘Emergency threshold for SAM’ - YES or NO

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Dear colleagues
Recently, UNICEF presented the new thresholds / terminology for Stunting and Wasting (GAM only). For wasting the thresholds as such did not change, only the classification terminology. However, the issue of having also a specific threshold for SAM was raised. And this was not the first time. In 2018, during a GNC meeting in NYC the same topic was on the table. Various people have expressed concerns if we establish these thresholds, and others are worried if we do not have them. Note that in the past some organizations have used 2% or 5% SAM as a threshold.
Here a few of the arguments raised by some (‘right’ or ‘wrong’).

AGAINST SAM thresholds:
- There is an inability of most surveys including SMART to demonstrate accuracy down to 2% (overlapping confidence intervals) and
- There should be another way to assess nutritional vulnerability.
- Having a SAM threshold would give actors more reason to NOT intervene if the SAM was not e.g. >2% (or whatever threshold was decided).
- Not having this threshold gives us more flexibility to look at the other factors, e.g. aggravating factors, and start programmes before any emergency threshold has been reached.

FOR SAM thresholds:
- Many people like to use thresholds as a justification to start a project (a threshold might objectively justify funding, etc.). After all, thresholds are often used for that….

We would like to encourage a debate amongst practitioners and hear more on their experiences and their rationale on this topic. This debate can possibly facilitate the decision for the collective whether or not to push for further establishment for such a threshold.
We very much like to hear your options and rationale on this.
Regards, Mija (and some other colleague practitioners)

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