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EXECUTIVE SUMMARY
A Semi-Quantitative Evaluation of Access & Coverage (SQUEAC) assessment was conducted in Feb 2014 in Tando Mohammad Khan (TMK) & Badin districts, Sindh province, where ACF currently implements a Community Management of Acute Malnutrition (CMAM) program.
The Severe Acute Malnutrition (SAM) coverage assessment revealed a number of addressable barriers as well as boosters to program access and coverage. The key boosters to the program included (i) Awareness about CMAM program, (ii) Active CBV's Community Based Volunteer's (CBVs) and(iii) Strong community outreach and follow-up. Key barriers to program access and uptake identified were (i) Distance /lack of public transport, (ii)Patchy coverage leading to uncovered SAM cases and (iii) Sharing of RUTF as it is considered as chocolate (mostly due to sachet packing). In Badin District, in addition to the above mentioned barriers, community migration due to labour demand was also a contributing barrier to continuity of availing service.
The coverage assessments results obtained here are for areas where ACF implements CMAM since July 2012 in TMK District. Coverage was estimated to be:
TMK: Coverage1 = 68.3 (95% CI =60.4%-75.1%)
Coverage is above the SPHERE minimum standard for rural areas of 50%.
The barriers identified in the last SQUEAC Jan-Feb 2013 that was conducted at TMK were mostly addressed, the recommendations were followed and eventually improved coverage. The coverage in TMK has improved to 68.3 (95% CI =60.4%-75.1%) in Feb 2014 as compared to 62.6% (95% CI=53.8%-70.6%) in Feb 2013, with CIs that overlap.
ACF is providing CMAM services in 4 UCs of Badin District since Sep 2011 through different ECHO grants. The coverage result from these 4 Union Councils is:
Badin: Coverage= 61.5 (95% CI =52.7%-69.4%)