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LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG
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Page 1: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

LET’S TALK ABOUT...

COVERAGETrenton DAILEY–CHWALIBÓG

Page 2: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

WHYEVALUATE COVERAGE?

Page 3: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

EVALUATE/MET NEED

NEW APPROACH → NEW INDICATOR

Yesterday: Efficacy

Efficacy of the CMAM protocol is defined by how well it works in controlled conditions*.

Example: 95% cure rate, 5% default rate

Today: Effectiveness

The cure rate of a beneficiary cohort under program conditions.

We are unable to greatly improve efficacy; however, we can improve effectiveness.

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EFFECTIVENESS

EFFECTIVENESS

Effectiveness depends on:

1. Severity of disease: thorough case finding and early treatment seeking

2. Compliance: a high level of compliance is necessary. This insures that the beneficiary receives a treatment of proven efficacy.

3. Defaulting: good retention from admission to cure is required.

Page 5: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

EFFECTIVENESS COVERAGE

EFFECTIVENESS COVERAGE

Coverage is directly dependent on:

1. Severity of disease: thorough case finding and early treatment seeking to ensure that the majority of admissions are uncomplicated incident cases

2. Compliance: a high level of compliance is necessary. Coverage is indirectly dependent on compliance

3. Defaulting: coverage requires good retention from admission to cure.

Page 6: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

EVALUATING/MET NEED

Met need = Effectiveness × Coverage

Meeting need requires both high effectiveness and high coverage; and, coverage and effectiveness depend on the very same things, therefore: • Effective programs have high coverage• High coverage programs have high cure rates

Page 7: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

EVALUATING/MET NEED II

Let’s look at how programs with low coverage fail to meet need.

Page 8: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

HOW DO WE DEFINE

COVERAGE?

Page 9: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

EQUATIONS

TYPES OF COVERAGE

OVERALL COVERAGE

Coverage

Treatment coverage

Direct calculation

Indirect calculation

Geographic coverage

Page 10: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

GEOGRAPHIC VS. TREATMENT

GEOGRAPHIC COVERAGE

Measures service availability for the treatment of SAM

TREATMENT COVERAGE

Measures the service access and uptake for the treatment of SAM

...not only are these two definitions of coverage different, but they are used for different means.

COVERAGE/TYPES I

Page 11: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

GEOGRAPHIC VS. TREATMENT

GEOGRAPHIC COVERAGE

Is used as a process indicator to measure the scale-up and decentralization of SAM treatment services

TREATMENT COVERAGE

Is used as an impact indicator to evaluate the extent to which available CMAM services successfully reach a high proportion of SAM cases

COVERAGE/TYPES II

Page 12: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

COVERAGE/GEOGRAPHIC I

GEOGRAPHIC COVERAGE• The proportion of administrative divisions (a health district

or a health zone, for example) providing CMAM services to the total number of service delivery units

• The proportion of health centers in a region (or country) providing CMAM services to the total number of health centers in the region

Page 13: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

COVERAGE/GEOGRAPHIC II

GEOGRAPHIC COVERAGE

Page 14: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

COVERAGE/TREATMENT

TREATMENT COVERAGETreatment coverage can be measured either directly or indirectly.

It is defined as:

the proportion of all people needing or eligible to receive a service that actually receive that service.

Page 15: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

COVERAGE/TREATMENT/INDIRECT CALCULATION

INDIRECT CALCULATION• The expected SAM caseload is subject to much variation • The under 5 population estimate is not always reliable

Page 16: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

COVERAGE/TREATMENT

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The nutrition sector was pushed to develope an alternative method to indirect coverage calculations, that was neither based on prevalence nor on population estimates...

SQUEAC

Page 18: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

CARTOGRAPHIE

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ESTIMATES/REGIONAL VS. NATIONA

Page 20: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.
Page 21: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

COUVERTURE/APERÇU DES MÉTHODES

Page 22: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

QUESTIONS?

Page 23: LET’S TALK ABOUT... COVERAGE Trenton DAILEY–CHWALIBÓG.

MERCI