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Recovering cases in coverage calculation

This question was posted the Coverage assessment forum area and has 8 replies. You can also reply via email – be sure to leave the subject unchanged.

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Anonymous 730

Nutrition and Food Security Officer

Normal user

19 Apr 2017, 09:12

I have just been looking at the formulae for coverage assessment, which defines the coverage as:

No. of SAM cases in treatment + No. of recovering cases in treatment
---------------------------------------------------------------------------------------------------------------
Total No of SAM cases in the community + No. of recovering cases in treatment

I read something which I will quote:
Period coverage: this estimator uses data for both current and recovering cases. Recovering cases are children that should be receiving treatment because they have not yet met discharge criteria"

My question is: How do these differ from SAM cases in treatment?
Am I correct in saying that the difference is that the recovering cases in treatment do not have SAM but have not reached the criteria for discharge, while the SAM cases in treatment still have SAM?

Paul

Frequent user

19 Apr 2017, 11:41

Hi Anonymous,
You are correct.

E.g. A child is admitted with a MUAC less than 11.5cm and discharged with MUAC greater than 12.5cm for 2 consecutive visits. This child will go through 3 periods of treatment we can define as;

1) SAM (MUAC <11.5cm and in the programme)
2) recovering from SAM (MUAC >11.5cm and in the programme) and
3) discharge cured (e.g. MUAC >12.5cm for 2 consecutive visits)

It is worth assessing that the children are being discharged correctly according to the criteria since keeping a child in the programme long after they have been cured will inflate the period coverage.

Anonymous 730

Nutrition and Food Security Officer

Normal user

19 Apr 2017, 11:47

Perfect.Thanks Paul

Lio

CMAM advisor

Technical expert

19 Apr 2017, 12:22

You may also note that we don't advice anymore to use "period" and "point" for coverage estimation; please consider using the new "single coverage estimator" which you can find here: http://www.ennonline.net/fex/49/singlecoverage

Tammam Ahmed

H&N Project Manager/Relief International

Normal user

19 Apr 2017, 13:07

Treatment coverage =
Children with SAM receiving therapeutic care / Total number of SAM children

I think better to use this formula, the numerator includes both No. of SAM cases in treatment + No. of recovering cases in treatment and the denominator includes only the total affected SAM cases without including those in the program, otherwise duplication is the result.
Best

Paul

Frequent user

19 Apr 2017, 13:15

Hi Tammam,
The formula you are quoting is for "point coverage". This is not duplication. Point and period coverage diagnose different aspects of the programme.

Traditionally both point and period coverage were reported. Guidance from agencies then changed to report only one indicator, whichever is most relevant to the programme being investigated. Which is the more appropriate in any particular circumstance is debatable.

As Lio has mentioned, a new "single coverage estimator" has been developed. It is more complicated to calculate but enables a comparison of programmes which would not be possible for example if one programme reported point coverage while another reported period coverage.

Paul

Frequent user

19 Apr 2017, 13:19

I should add that the formula for point coverage does NOT include recovering cases in the programme. That is period coverage. Do not confuse the two.

Tammam Ahmed

H&N Project Manager/Relief International

Normal user

19 Apr 2017, 13:29

Thanks Paul, You are right. But every one has its added values based on good or bad Case-Findings and recruitment as below:-
If there is good case-finding and recruitment (i.e. SAM cases found early in the stage of the disease) and short lengths of stay then the period coverage estimator is likely to be appropriate.
• If there is poor case-finding and recruitment (i.e. SAM cases found late in the stage of the disease) and long lengths of stay due to late presentation and / or late admission then the point coverage estimator is likely to be appropriate

Lio

CMAM advisor

Technical expert

19 Apr 2017, 13:39

I believe you should evolve with the new methods and terminology, meaning don't use anymore "point" and "period" but use "case-finding effectiveness" which corresponds to the formula Tammam describes and to the previous "point coverage" and use the "single estimator" which is a modified/improved formula of the previous "period coverage", this last takes into account children who recovered without being admitted in the programme which are the R-out in the formula.
All the best

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