I believe that you can only do it if you ensure that at least 70-80% of the children are screened, more importantly, you will need to verify that there are no duplicates. For this, you will need to check new cases and old cases in the register. This will help avoid duplicates.

Please look at the national census- demographic breakdown if available- this will provide you with percentage of children in different age groups. If not available the estimated under five population in emergencies is estimated to be 15% and in development situation 10-12 %.based on the total population in the area- you should get an estimated no of children. Hope this helps! 
good luck! Rita 

Dear Lani, 

I not very sure about country you are in; but to estimate dinominator for screening you can explore following resorces 

1. SMOH, Locality/County Health Department population data that they have taken into account for calculation of EPI or VAS or polio program targets or vaccine estimation  

2. You can also reach out to Nutrition information working group under nutrition sector/cluster they can assist you on estimating the dinominor for the screening of the area 

3. Look for the latest SMART Anthropometric survey  conducted in the area that will give you a better estimate of % of children aged 6-59 months 

Hope this will work for you 

The estimate of children aged 6-59 months can be in the RGPH (from the French Recensement Général de la Population et de l’Habitat / General Census of Population and Housing Habitat) census reports where you can contact statisticians from statistical institutes

Many thanks for the replies so far.

To add a little more information for clarity, I have sufficient data for the denominator (number of children in the target age group) and I believe I can get reliable data on the numerator.

What I'm wondering about is what has been used by others to measure the coverage of screening, and if there are thoughts on what I'm proposing. If what I'm proposing seems reasonable, what thresholds would be recommend to consider the coverage as good, adequate, and poor.

For example: good coverage  - >75% screened every month; poor coverage - <40% screened every month

If you know of any studies that present results on screening coverage, that could be useful as well.

Dear ,

I understand your need for a simple and appropriate metric to assess screening coverage for children aged 6-59 months in Addis Ababa. Using the ratio of children screened in the last month to the total number of children in the target age group as your numerator and denominator seems like a reasonable approach.

However, it's important to consider the following points when interpreting and setting thresholds for this metric:

Data quality:

• Accuracy of MoH records: Ensure the MoH records accurately reflect the number of children screened and the target population size. Consider potential data gaps or inconsistencies.
• Age range: Clearly define the age range for the target population (6-59 months) to avoid ambiguity.

Interpretation of coverage:

• Temporal variations: Screening coverage can fluctuate seasonally or due to other factors. Consider tracking the metric over time to identify trends and potential issues.
• Context and benchmarks: Compare your coverage measure to national or regional standards or targets. Set thresholds based on specific goals and considering local context (e.g., resource limitations, disease burden).

Thresholds for adequacy:

• Minimum acceptable coverage: While SPHERE Standards don't provide specific thresholds, WHO recommends at least 80% coverage for essential child health interventions, including screening programs. However, this might not be feasible in all contexts.
• Target coverage: Aim for a higher target coverage (e.g., 90-95%) to ensure adequate protection for the target population.
• Unacceptable coverage: Consider defining an unacceptably low coverage level (e.g., below 50%) that triggers immediate action to improve access and address underlying issues.

Additional considerations:

• Equity: Analyze coverage by different subgroups (e.g., geographical location, wealth quintile) to identify and address disparities.
• Reasons for non-screening: Understand why some children are not being screened (e.g., lack of awareness, access barriers, service quality) to inform targeted interventions.

While I haven't found specific examples of using this exact metric with predefined thresholds, similar approaches have been used in various contexts. For instance, UNICEF's Child Immunization Coverage Estimation (CICER) tool utilizes coverage ratios calculated from surveys and administrative data.

Ultimately, the most appropriate thresholds and interpretation of your chosen metric will depend on your specific goals, context, and available data. Consider consulting with relevant stakeholders (MoH, UNICEF, NGOs) to discuss local benchmarks and best practices for monitoring and improving screening coverage in Addis Ababa.

I hope this information helps!

kemal J Tunne 

Emergency Nutrition Coordinator ,Ethiopia