Coverage Monitoring Network (CMN) Project – Phase II
Practical Requirements for CMAM Coverage Assessments
SLEAC
The SLEAC method is a low-resource method for classifying and estimating the coverage of selective
feeding programs; it is intended for use in programs delivering CMAM services over many service
delivery units. SLEAC can be conducted at (1) the national or regional level for programs delivering
CMAM services through health districts; and, (2) the district level for programs delivering CMAM
services through primary healthcare centers. In either case, such a survey will produce
classifications of program coverage at the level of the investigation unit.[1]
This document is designed to present practical lessons learns by experts in the field, and to provide
guidance on effective operational preparation and requirements. Due to the difference in size and
scope between district level and national or regional assessments, preparatory and methodological
steps must be tailored to the type of assessment. These distinctions are made clear in the body of
this document.
1. INFORMATION
I. Terms of Reference (ToR)
A ToR document should be developed outlining the background of the program including
justification for a coverage assessment as well as the objectives, condition and schedule, and
expected outputs.
II. Investigation Protocol
A detailed investigation protocol should be developed detailing the procedural method in the design
and implementation of the assessment. Sections might include, but are not limited to, the following:
context and justification; general and specific objectives; methodology; assessment period; target
population; sampling procedure; data analysis; limitations; ethical considerations; budget.
The investigation protocol is often required for validation of the assessment by MoH and the
National Ethnical Committee (if necessary).
III. Program Data
The SLEAC methodology relies on the availability of accurate and up to date program data. The
following program data should be made available, in electronic format, at least two weeks before the
assessment commences.
a) National, regional or district-level nutrition data

All nutrition surveys conducted in the intervention zone (SMART, MICS, etc.)
[1].
FANTA. Semi-Quantitative Evaluation of Access and Coverage (SQUEAC)/ Simplified Lot
Quality Assurance Sampling Evaluation of Access and Coverage (SLEAC) Technical Reference.
Washington DC: FANTA; 2012.
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b) Routine Program Data

Number of OTP and SFP sites in the investigation area

Monthly statistical data (i.e. admission, cure, death and defaulter rates, length of stay, MUAC
at admission etc.)
c) Demographic data for the target area

List of villages with population figures and the average percentage of children aged 6-59
months (<5 years) in the area

In the absence of reliable village lists, census divisions like enumeration areas (EAs) can be
used for sampling purposes
III. Area Maps
A map of the investigation zone is an essential requirement to conduct a coverage assessment. For
regional or national assessments, a detailed map of each administrative region is required. Ideally,
the map will have the following specifications:

1:50,000 scale

Indication of administrative divisions, village locations, roads and rivers

If possible, the mail should be printed on A0 or A1
If EAs are used for sampling, photocopies of individual EA maps are required to indicate the precise
section, village or multiple villages that comprise the selected EA.
2. SURVEY TEAM
As the CMN project aims to build capacity, it is important to specify who and how many participants
will attend the training to carry out the assessment.
The team should comprise:



Steering Committee: 2 to 3 delegates from the MoH who are available to help organize and
supervise the assessment for its entire duration. Active implication of partner organizations
involved in conducting other nutrition surveys like SMART will help facilitate the process.
Technical Committee: 5 to 10 people from various national partner organizations
associated with nutrition. The technical committee will be trained on the SLEAC
methodology by the consultants(s) and will be implicated in the elaboration and submission
of the investigation protocol.
Investigation Team: 30 to 40 participants with experience in conducting surveys. It is a
good idea to recruit surveyors that have worked on other national nutritional surveys like
SMART or MCIS.
Please note that the number of participants will vary according to the size and scale and ideal
duration of the assessment. For large national investigations, increasing the number of participants
will reduce the duration.
3. FINANCE & BUDGET
Costs for a SLEAC assessment are broken down into two parts:
a) Costs for the field work (host agency)
b) Costs for the consultant(s): for large-scale, national SLEAC assessments, a team of two consultants
may be required for division of responsibility, supervision and tasks.
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4. ARRANGEMENTS FOR THE CONSULTANT(S)

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An invitation letter for visa applications or any other arrangements to obtain a visa upon
arrival
Arrangements for internal flights to and from the capital, if needed
Airport collection and drop-off
Accommodation (secure and suitable for expatriates)
Security briefing on arrival in the field
Local SIM card for communication with the team
5. TIMEFRAME
It is very difficult to estimate the duration of a SLEAC assessment; the timeframe depends entirely
on the number of regions assessed, the size of each region and the travel distance between regions.
For pilot national SLEAC assessments conducted for the first time, unforeseen challenges are to be
expected during the preparatory stages.
Please note that all preparatory measures taken to elaborate and validate the investigation protocol
before the arrival of the consultant(s) will significantly reduce the preparatory stage and help
facilitate the assessment.
Generally, preparation and training can take about two weeks. From there, the general rule of thumb
is 1 week per region. One to two days should be allocated to travel time between regions. Again, this
is an extremely rough estimate and will vary according to the size of the region. The table below
illustrates a typical schedule.
Weeks
1 to 2
weeks
1 week
Activity
Preparatory Phase
 Meeting with MoH
 Technical committee meeting, technical training and
elaboration of the investigation protocol
 Budget validation
 Sampling
 Operational planning
 Ethical committee validation (if necessary)
Classroom Training and Field Exercises
Classroom Training
 Opening session including introductions and schedules
 Theoretical training of the SLEAC methodology (2 days)
Field Exercises
 MUAC standardization (1 day)
 Practical training in urban context (1 day)
 Practical training in rural context (2 days, to account for
travel)
 Survey preparation
Venue
Facilitator
Base
Consultant(s)
and lead
agency
Base
Consultant(s)
and lead
agency
Field
Consultant(s)
and lead
agency
1 week
per
region
Field Data Collection and Analysis
Active case finding and wide area surveys
Field
Consultant(s)
and lead
agency
1-2
days
Data analysis and survey debriefing in the capital
Base
Consultant(s)
and lead
agency
6. LOGISTICS
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The following suggests, in detail, the practical provisions required for training, fieldwork and
completion of a SLEAC assessment.
I. Vehicles & Transport


The investigation team will require drivers and vehicles to be available full-time for a
number of days (5 days for training plus 7 days per region for data collection) during
fieldwork, depending on the geographical spread and conditions.
Each vehicle must carry a first aid kit.
II. Training Venue & Work Facility
The investigation team will require a place for meetings and trainings. The training room needs to
be large enough to accommodate the entire investigation team for group work, equipt with tables
and chairs, and with electricity and a projector.
III. Logistic Materials
a) For training








Projector
Flip chart
Markers and pens
Stapler and staples
Masking tape
Post-its
Notepads for the participants
Pencils, sharpeners and erasers
b) For field work per person




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
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Clip board
Back-pack
Plastic folder for loose papers
Notebook
Pen, pencil, sharpener and eraser
MUAC band
RUTF packets
OTP/SFP referral slips
IV. Other Provisions


Ample water should be made available for field work
Lunch and coffee break for training days
7. NOTIFICATION OF INTERESTED PARTIES
As a courtesy, and in the interest of ensuring those targeted by the survey are available at the time of
the visit, it is important to notify village chiefs, camp leaders or other key community figure of the
survey’s intention.
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