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