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Post a reply: Use of single coverage estimator with expanded OTP protocol

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In the Cox's Bazar refugee settlements, nutrition sector partners are using an expanded protocol for OTP. Children are admitted to OTP based on regular international standards (MUAC <115mm and WFH <-3 Z score) (oedematous cases are referred straight to inpatient care), however since July 2019, they are discharged only when they become well nourished (MUAC ≥125mm and WFH ≥-2 Z score). 

I am supporting the sector with a coverage survey using the SLEAC methodology. If they were using a regular discharge criteria (as they were before July), I would classify coverage using the single coverage estimator by estimating Recovering cases out of the programme and incorporating this figure into the denominator. 

However is it appropriate to do this when an expanded protocol is in use?

My concern is that, because of the expanded protocol, there may be a large number of OTP Recovering cases IN the programme which would result in a disproportionately large number of Recovering OUT cases, leading to an inaccurate estimate and classification. 

Many thanks in advance for any advice or opinions on this. 

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