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Table 1 Boosters and barriers to access and coverage found during Stage 1 and 2, with scoring for each method

From: Estimating program coverage in the treatment of severe acute malnutrition: a comparative analysis of the validity and operational feasibility of two methods

  Weighted scoresa Simple score
Caregivers Program staff External support team
Boosters
 Good use of the health post where screening and referral of SAM cases takes place 3 3 1 3
 A preference for treatment with ready-to-use therapeutic foods from the health centers 3 3 1 3
 Frequent sensitization of caregivers at health centers, which improves retention 2 2.5 1 3
 Sharing of information on the program by caregivers who are (or were) in the program 3 2.5 2 3
 Information on malnutrition and community-based management of acute malnutrition diffused by local radio 3 1.5 1 3
 Sensitization during home visits by community nutrition volunteers supported by NGO 3 2 1 3
 Knowledge on malnutrition among the community 3 3 2 3
 Knowledge on the existence of CMAM services among the community 3 3 3 3
 Knowledge and appreciation of free health care that encourages presentation at health centers 3 3 2 3
 Good management of stock and continuous service delivery 2 3 1 3
 Screening at village level by MSF surveillance team 3 2 2 3
 Screening at village level by NGO-supported community nutrition volunteers 3 2 1 3
 System in place for following up absent and defaulting cases 3 2 1 3
 Service has a positive reputation due to the good behavior of staff and a calm and efficient management of the CMAM sites 3 3 2 3
 Caregivers have the support of their husbands, family, and/or the community that encourages them to go to the health center 3 2 2 3
Boosters total 43 37.5 23 45
Barriers
 Poor condition of the roads between the village and the health center 3 1.5 3 3
 Distance between the village and the health center is too long 3 2 3 3
 A lack of means for making the journey to the health center (availability of finances or transport) 3 1.5 3 3
 Screening by MSF teams is done at a central point in the villages and not door-to-door 2 2.5 3 3
 Refusal of husband or family, or lack of support to search for treatment 1 1.5 1 3
 Insufficient staff numbers to ensure an efficient management of CMAM services at health center 1 2 1 3
 Perception that the caregiver does not have the time and therefore does not prioritize visiting the health center 1 3 3 3
 Alternative health-seeking behavior (traditional health practitioner or pharmacy) 1 3 3 3
 Lack of knowledge on CMAM services among the community 1 1 3 3
 Lack of knowledge on malnutrition among the community 2 1 2 3
 Lack of knowledge that children can be readmitted 2 2 2 3
Barriers total 20 21 27 33
  1. a1 point for low importance for access and coverage, and 3 points for high importance on access and coverage