1. Semi-Quantiative Evaluation of Access and Coverage of CMAM Birnin Kebbi

2. STAGE 1: Analysis of routine programme data STAGE 3: Small area surveys STAGE 2: Collection of anecdotal information from target communities and those involved in CMAM  Admissions o Weekly/monthly by OTP site and for whole LGA  Exits o Cured o Defaulters o Non response o Deaths  List of all settlements in the catchment area for each OTP  Home locations of beneficiaries and defaulters  Home location and number of community volunteers Hypothesis of high or low coverage in a particular area. Confirm or deny hypotheses of high/low coverage SQUEAC: 3 Stages

3. Diarrhoea and Malaria Rainy Season Less food available Much less food available

4. Preparing LandWeeding Planting rice & beansPlanting guinea corn, millet, maize Harvest rice Processing of harvest Seasonal Labour Demands

5. Mapping Legend: Admissions (Lines) Blue – 1 to 5 Orange – 6 to 15 Green – 16 to 30 Red – 31+ Defaulters (pins) Blue – 1 Green – 2 to 5 Red – 6 to 10 Yellow – 11+

6. Hypothesis on Coverage Ambursa (rural – 50% coverage target) - > 50% coverage - Knowledge of CMAM - Understanding of malnutrition - Positive regarding CMAM Kardi (rural – 50% coverage target) - < 50% coverage in Western Area - Poor understanding of malnutrition - Low awareness of CMAM - No/inactive volunteer - Poor internal communication - Traditional medicine/herbs 1st line Marafa (urban – 70% coverage target) - > 70% coverage - Good admission from every place in the ward - Men are aware of the programme and of malnutrition and are bringing children to the OTP clinic - Good standard of service - Low defaulters - Good outreach Makera (rural – 50% coverage target) - > 50% coverage - High admissions - Admissions coming from most settlements - Positive regarding CMAM Gulumbe (rural – 50% coverage target) - > 50% coverage - Widespread admissions within and outside ward - Volunteers outside ward and in most settlements of size

7. Point Coverage LocationHypothesis on Coverage Cases Found Cases in the Programme Cases not in the Programme Threshold Coverage Classification Kardi< 50%; low coverage 404> 2 cases in the programme < 50% Takalafiya> 70%; good coverage 523> 3 cases in the programme < 70% Gulumbe> 50%; good coverage 1028> 6 cases in the programme < 50% Ambursa> 50%; good coverage 24717> 12 cases in the programme < 50% Total431132

8. Period Coverage LocationHypothesis on Coverage Cases Found Cases in the Programme Cases not in the Programme Threshold Coverage Classification Kardi< 50%; low coverage 734> 3 cases in the programme < 50% Takalafiya> 70%; good coverage 523> 3 cases in the programme < 70% Gulumbe> 50%; good coverage 1578> 7 cases in the programme < 50% Ambursa> 50%; good coverage 372017> 18 cases in the programme > 50% Total6432

9. Barriers to Service Uptake