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AFG Coverage Assessment (SLEAC) Report in Jawzjan province (25 Nov 2015)

Subject/Objective: 
The project, of which the current assessment is a part, intends to contribute to improving the performance of IMAM services in Afghanistan, through the provision of in-depth information on coverage, identification of barriers and boosters to access, and definition of recommendations for a durable scale up of nutrition service delivery. The main objectives of this assessment were to collaborate with the Swedish Committee for Afghanistan (SCA) in order to: 1. Classify coverage of each zone 2. Estimate coverage in the province 3. Identify key factors influencing coverage 4. Outline evidence based recommendations 5. Train partner staff in coverage methodologies
Methodology: 
SLEAC uses a two-stage sampling process. Stage one samples villages across the area to be classified (in this case zones). The sampling process ensures a random and spatially representative sample. Stage two samples SAM children at village level. This step ensures an exhaustive sampling of all SAM cases in each village selected. Some specific technical considerations were made to adapt the sampling to the Afghanistan context.
Key findings: 
The coverage estimation for Jawzjan province (including data from both zones) is 40.3% (CI 95% 26.93%-53.59%). This estimation, as well as the classifications, should be considered as reflective only of the accessible areas within the sampling frame, generally around the major cities of Sheberghan and Aqcha and the major radial highways from these cities and towards Balkh. 1 Measuring performance and coverage of IMAM programs in Afghanistan: rolling out of the SLEAC methodology 2 Lot Quality Assured Sampling 2 The most commonly cited barrier to access was that caregivers have little information or knowledge of malnutrition and do not recognise when their child is malnuourished. Many caregivers of both covered and uncovered cases, who are aware of malnutrition and of the treatment services available, had already had the same child or another child admitted admitted to the program. Aside from caregivers of previously admitted cases, those of covered cases were generally advised of available treatment services only once they reached the health facility. Qualitative information from uncovered cases also demonstrated the limited level of involvement of community health workers (CHWs) in nutrition activities, including sensitization, screening and referral. Across covered and uncovered cases, there was also a significant gender bias towards more female SAM cases.
Sample size: 
68
Assessment Report: 
Assessment Questionnaire: 
Available on Request
Assessment Data: 
Available on Request
Webspace(s): 
Assessment Date(s): 
25 Nov 2015
Status: 
Report completed
Unit(s) of Measurement: 
Individuals
Collection Method(s): 
Structured Interview
Field Interview
Population Type(s): 
All affected population
Cluster(s)/Sector(s): 
Leading/Coordinating Organization(s): 
Action against Hunger
Participating Organization(s): 
Save The Children
Location(s): 
Shiberghan
Khwajadukoh
Aqcha
Fayzabad
Khanaqa