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How to assess coverage and challenges to coverage in home fortification program

This question was posted the Coverage assessment forum area and has 2 replies. You can also reply via email – be sure to leave the subject unchanged.

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Roman

Normal user

4 Aug 2014, 04:28

The prevalence of malnutrition like anemia is very high among the under five children in underdeveloped countries. For improving anemia, nutritional status some NGOs were taken home fortification program by introducing Micronutrient Powders (MNP). Now we want to assess coverage and challenges to coverage in home fortification program by focusing on the usage of the MNP by caregivers, nutrition counseling and awareness campaigns, policy enabling. For this purpose, what kind of indicators we can use? Which sampling design is more appropriate for this? What types of analysis procedures we can apply?

Diana Carter

Nutrition officer, WFP Kenya

Normal user

4 Aug 2014, 08:09

Your question may be better handled in the Home Fortification Network Forum: http://network.hftag.org/

Mark Myatt

Consultant Epideomiologist

Frequent user

4 Aug 2014, 10:56

A key factor in deciding how to assess coverage is whether the programs is universal (e.g. all children age two years or below) or selective (e.g. people meeting a case-definition). A universal program (e.g. EPI) can usually be assessed using a simple survey. A selective program usually needs a biased sampling procedure (i.e. biased to finding eligible cases) particularly if the condition is quite rare (e.g. SAM). For these surveys I would always use a spatial sample.

Looking at barriers with surveys is quite simple using a "negative deviance" ("if not, why not?") model as used in CSAS and SLEAC surveys (also in stage III SQUEAC surveys). The limit to this approach is that we are usually limited to a single type of informant and the data lack depth in the sense that it is often unclear how different barriers are related to each other. That said, we started using this approach with the CTC (CMAM) research program and managed to reform programs such that coverage reached 70% or higher.

If you require in-depth knowledge of barriers and how they interact then I think you should use SQUEAC.

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