Hi, I am trying to work out estimated beneficiary numbers using prevalence and incidence for SAM and MAM.
For SAM as I understand it you take the total population of your area e.g. 450,000, then take estimate of under five population 20%. We have the prevalence 3.1% that gives 2790 (450000*20%*3.1 = 2790). But we know that the actual number of children to treat every year is two to three times higher than prevalence. Is it 2 times higher or 3 times higher?
Assuming it is 3 then I have been told different methods of calculating it, is it
Using example above 2790+ (2790*3) = 11160 OR again using example above 2790*3 = 8370 ?
Then how do you do this for MAM?
THANKS!
Confused of London!
Hi Annonymous 169
A similar question was posted in 2009. Log to the link below.
http://www.en-net.org.uk/question/157.aspx
Hope it helps
Thanks
Rogers
Rogers Wanyama
Answered:
13 years agoDear Annonymous 169
To add on Rogers. you can also find similar question with reply from the following link.
http://www.en-net.org.uk/question/212.aspx
Cheers
Kiross
Anonymous
Answered:
13 years agoOthers have pointed out:
[url]http://www.en-net.org.uk/question/157.aspx[/url]
and:
[url]http://www.en-net.org.uk/question/212.aspx[/url]
One approach is to use the formula:
EXPECTED = POP * U5% * EP% * CFI
where:
POP = Total population
U5% = Percentage of total population age 6-59 months
EP% = Estimated prevalence
CFI = Correction factor to estimate incidence from prevalence
The value of CFI is uncertain (see the links above). A CFI of 2.0 (in this formula) is broadly in-line with published estimates. This level of CFI is used for SAM. I do not think we have a good idea of the value of CFI for MAM (so I would use 2.0).
The problem with:
EXPECTED = POP * U5% * EP% * CFI
is that it takes a "fairy tale" view of programming in the sense that it assumes a coverage proportion of 100%. I have looked at coverage of TFC, OTP (in both CTC and CMAM guises) and SFP and have never seen coverage above 89%. Here are some rules of thumb for different program types:
TFC : Typical range 0.5 - 5% (maximum seen is c. 30%)
OTP : Typical range 20% - 80% (minimum 8%, maximum 89%)
SFP : Typical range 5% - 20% (limited data available)
We have to face it ... most programs achieve coverage below SPHERE minimum standards.
The point is that we need to account for coverage in the formula:
EXPECTED = POP * U5% * EP% * CFI * COVERAGE
Using your data and assuming the program will hit the SPHERE minimum of 50% we have:
EXPECTED = POP * U5% * EP% * CFI * COVERAGE
EXPECTED = 450000 * 20% * (3.1 / 100) * 2.0 * (50 / 100)
EXPECTED = 2790
Another approach is to use the formula:
EXPECTED = POP * U5% * EP% + (POP * U5% * EP% * CFI)
That is prevalent cases + incidence cases.
A value of 1.6 is used for CFI (this is a published estimate). This level of CFI is used for SAM. I do not think we have a good idea of the value of CFI for MAM (so I would use 1.6).
This formula also fails to account for coverage. A better formula is:
EXPECTED = POP * U5% * EP% * IC + (POP * U5% * EP% * CFI * AC)
where:
IC : Initial phase coverage (often low)
AC : Achieved coverage (i.e. after the first few months)
It is sensible to use:
IC = AC / 2
as the average between starting at zero and achieving 50% some time later.
Using your data and:
AC = 50%
and:
IC = 50% / 2 = 25%
we get:
EXPECTED = 450000 * 0.2 * 0.031 * 0.25 + 450000 * 0.2 * 0.031 * 1.6 * 0.5
EXPECTED = 2930
The two methods give similar answers.
You have to be aware that there are big sources of error in both of these approaches:
POP : Subject to secular change but also displacement and migration
U5% : Subject to secular change &c. and public health shocks
CFI : An informed guess base on limited data
EP% : For SAM this will be very imprecise (e.g. 1.15%, 95% CI = 0.38%; 2.57%).
And COVERAGE is not known. We have to be realistic about what we will achieve. I'm sure that the agencies that "achieve" 8% coverage started out thinking they would get 80% coverage.
BEWARE : You need to use EP% for your program admission criteria. If you use MUAC then EP% is for the MUAC case-definition not the W/H case-definition.
So ... a short answer ... there is no really correct way. There are different ways of getting an informed guess which, given the same assumptions, give roughly the same answers.
I hope this helps.
Mark Myatt
Technical Expert
Answered:
13 years ago