
Inclusion and exclusion errors in the targeted supplementary feeding programme of Ethiopia
Author(s) -
Gebremedhin Samson,
Bekele Tilahun,
Retta Negusse
Publication year - 2018
Publication title -
maternal and child nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 63
eISSN - 1740-8709
pISSN - 1740-8695
DOI - 10.1111/mcn.12627
Subject(s) - medicine , malnutrition , inclusion (mineral) , inclusion and exclusion criteria , environmental health , pediatrics , anthropometry , alternative medicine , gender studies , pathology , sociology
Ethiopia's targeted supplementary feeding (TSF) programme aims to rehabilitate moderately malnourished children and pregnant and lactating women in selected chronically food‐insecure districts. Screening for malnutrition is made by health extension workers through the quarterly community health days (CHD) events based on mid‐upper arm circumference (MUAC) thresholds. This validation study examined the extent of targeting errors of inclusion (providing aid to the nonneedy) and exclusion (failure to reach the needy) in the TSF programme, among preschool children in 6 TSF districts. The study was conducted within 7 days after the completion of the CHD event. Multistage cluster sampling was employed to recruit 1,104 children. Data were collected using interviewer‐administered questionnaire and by reviewing CHD registers. A paired t test was used to compare the MUAC measurements taken during the CHD and during the survey. The study found a global acute malnutrition prevalence of 13.0%. During the CHD, only 54.8% of the children were screened for malnutrition. The overall inclusion and exclusion errors of the TSF were 16.5% and 40.3%, respectively. The reasons for the exclusion errors were low coverage of the screening programme (67.2%) and MUAC measurement errors (32.8%). The mean including standard deviation ( M ± SD ) of the MUAC measured by health extension workers (11.8 ± 0.9 cm) was significantly lower than the measurements made by fieldworkers in the survey (12.1 ± 1.0 cm; p < .001). The study concluded that high targeting errors are committed in the TSF programme of Ethiopia. Targeting can be enhanced through accurate measurement of MUAC and maximization of the coverage of the screening programme.