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Using a SQUEAC for BSFP coverage assessment?

This question was posted the Coverage assessment forum area and has 3 replies. You can also reply via email – be sure to leave the subject unchanged.

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Leah Richardson

Normal user

31 Aug 2012, 11:53

I'm looking into common practices/guidance around assessing programmatic coverage for Blanket Supplementary Feeding Programs (BSFPs). I read conflicting views of the use of SQUEAC to this regard. What are the recommendations? Thanks.


Normal user

3 Sep 2012, 03:28

One approach is to use a standard anthropometric survey such as SMART perhaps?

Ernest Guevarra

Valid International

Technical expert

3 Sep 2012, 07:59

SQUEAC is primarily an investigative framework / approach to coverage in general. It can be applied to any process that seeks to evaluate access to and coverage of any programme. The investigator/s just need/s to remember to adapt the investigative tools currently used in SQUEAC to the type of programme being evaluated. The SQUEAC toolbox has methods and approaches that have been specifically designed and tested for selective feeding programmes such as CMAM. However, the investigative principles behind the methods are applicable to almost any assessment of programme access and coverage (i.e. tools that assess issues of compliance and defaulting, issues of quality of service, issues of distance, etc.). Also, if the investigator wishes to proceed with the survey component of SQUEAC to arrive at an overall or headline figure of coverage, then survey sampling needs to be designed in such a way that is appropriate to the programme that is being assessed. SQUEAC survey sample design has been specifically designed to address the following issues:

1) coverage is spatially heterogenous hence requires a sampling method that is spatially representative

2) selective feeding programmes particularly OTP tend to have very small total populations from which to sample from (SAM children 6-59 months old) hence sampling method should be able to work with small sample sizes

Hence, if you are to assess BSFPs, SQUEAC can be adapted accordingly.

For the investigation, the toolbox should be adapted in such a way that assesses the different barriers and boosters to coverage and access of a BSFP. It also needs to take into account that there is a wider or bigger population eligible for BSFP hence a wider / bigger set of respondents to collect information from.

For the survey component, the issue of coverage spatial heterogeneity still remain in BSFP even if it is not highly selective / not selective at all. Hence, sampling method should still be spatially representative. As for small sample sizes, because BSFP is akin to a "universal" programme (i.e. all or almost all the population is eligible), then the issue of small sample sizes is not relevant hence sample size requirements will increase which may mean longer survey.

In this regard, the comment that SMART may be used to assess coverage of BSFP holds because it will follow typical sample size estimations without small sample size considerations. However, SMART uses population proportional sampling which is a sampling method that does not take into account spatial heterogeneity.

Mark Myatt

Consultant Epideomiologist

Frequent user

3 Sep 2012, 10:55

SQUEAC is a toolbox of coverage assessment tools and there is no reason why these tools cannot be used to assess the coverage of SFP programs (or just about any program). The main issue will be how you do case-finding in stage II (hypothesis testing) and stage III (coverage estimation). This will depend on the type of program being assessed. If by "blanket" you mean a universal program (i.e. all HHs with children eligible) then a sample of HHs taken using a map-segment-sample technique could be used. If you mean all HHs with children with MAM then a house-to-house / door-to-door sample will be best. If you use active case-finding for MAM cases and you end up with a sample of "nearly SAM" cases (these methods tend to lack sensitivity for MAM) ... this is OK (and quick and cheap) as long as you report what you did.

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