Effective coverage of the integrated management of acute malnutrition (IMAM) program in six districts of Ethiopia
1
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
2
Nutrition, World Food Program, Addis Ababa, Ethiopia
3
Nutrition, Ministry of Health, Addis Ababa, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Evidence shows that increased care-seeking does not always translate into the receipt of quality care, underscoring the need to strengthen both access to and quality of treatment services. Thus, the objective of this study is to estimate the effective coverage of the integrated management of acute malnutrition (IMAM) program. Data and
METHODS:
We estimated effective coverage of the Integrated Management of Acute Malnutrition (IMAM) program in a six-district cross-sectional study by linking household surveys with health facility assessments. Multistage cluster sampling was used to select 727 households, and 72 health posts were randomly sampled for facility assessments. Effective coverage was calculated as the product of health facility service readiness and contact coverage using a generalized linear model on an appended dataset, with confidence intervals derived via the delta method. Using multivariable logistic regression with cluster-robust standard errors, we assessed the association between district-level health facility readiness and wasting service coverage, adjusting for household and health system characteristics.
RESULTS:
The contact coverage for wasting management service was 17% for severe acute malnutrition (SAM), 24.2% for moderate acute malnutrition (MAM), and 21.7% for global acute malnutrition (GAM) or combined SAM and MAM. Facility readiness was 57.9% for SAM, 53.9% for MAM, and 56.1% overall. Readiness-adjusted coverage was 9.8% for SAM, 13.1% for MAM, and 12.2% for GAM. In the multivariable analysis, coverage of wasting management services was significantly higher in households visited by Health Extension Workers (OR=1.90, p=0.048) and significantly lower among children of caregivers aged 25-34 years (OR=0.31, p=0.006).
CONCLUSIONS:
The study revealed suboptimal readiness-adjusted coverage for wasting management services in the study area. Strengthening the health system, particularly through investments in the health workforce, service capacity, quality, and equitable access, emerges as a strategic priority for achieving the goals of the Global Action Plan on Child Wasting.
Evidence shows that increased care-seeking does not always translate into the receipt of quality care, underscoring the need to strengthen both access to and quality of treatment services. Thus, the objective of this study is to estimate the effective coverage of the integrated management of acute malnutrition (IMAM) program. Data and
METHODS:
We estimated effective coverage of the Integrated Management of Acute Malnutrition (IMAM) program in a six-district cross-sectional study by linking household surveys with health facility assessments. Multistage cluster sampling was used to select 727 households, and 72 health posts were randomly sampled for facility assessments. Effective coverage was calculated as the product of health facility service readiness and contact coverage using a generalized linear model on an appended dataset, with confidence intervals derived via the delta method. Using multivariable logistic regression with cluster-robust standard errors, we assessed the association between district-level health facility readiness and wasting service coverage, adjusting for household and health system characteristics.
RESULTS:
The contact coverage for wasting management service was 17% for severe acute malnutrition (SAM), 24.2% for moderate acute malnutrition (MAM), and 21.7% for global acute malnutrition (GAM) or combined SAM and MAM. Facility readiness was 57.9% for SAM, 53.9% for MAM, and 56.1% overall. Readiness-adjusted coverage was 9.8% for SAM, 13.1% for MAM, and 12.2% for GAM. In the multivariable analysis, coverage of wasting management services was significantly higher in households visited by Health Extension Workers (OR=1.90, p=0.048) and significantly lower among children of caregivers aged 25-34 years (OR=0.31, p=0.006).
CONCLUSIONS:
The study revealed suboptimal readiness-adjusted coverage for wasting management services in the study area. Strengthening the health system, particularly through investments in the health workforce, service capacity, quality, and equitable access, emerges as a strategic priority for achieving the goals of the Global Action Plan on Child Wasting.
| eISSN: | 2654-1459 |
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