The International Rescue Committee (IRC) responds to the world’s worst humanitarian crises, helping to restore health, safety, education, economic wellbeing, and power to people devastated by conflict and disaster. Founded in 1933 at the call of Albert Einstein, the IRC is one of the world’s largest international humanitarian non-governmental organizations (INGO), at work in more than 40 countries and 29 U.S. cities helping people to survive, reclaim control of their future and strengthen their communities. A force for humanity, IRC employees deliver lasting impact by restoring safety, dignity and hope to millions. If you’re a solutions-driven, passionate change-maker, come join us in positively impacting the lives of millions of people world-wide for a better future.

INTRODUCTION

The International Rescue Committee (IRC) in Partnership with the Alliance for International Medical Action (ALIMA), Cooperazione Internazionale (COOPI), Life Helpers Initiative (LHI) and Grassroot Initiative for Strengthening Community Resilience (GISCOR) has been implementing the Integrated Emergency, Recovery and Resilience Response for Crisis-Affected Persons in Zamfara, Katsina and Sokoto States. The project is funded by USAID/BHA.[1] The overall purpose of the project under Nutrition sector is to contribute to the reduction of child morbidity and mortality and build resilience by improving access to safe, quality lifesaving nutrition services for crisis-affected communities in Sokoto, Katsina, and Zamfara (SoKaZa) states. The project aims to enhance community mobilization and sensitization, ensuring families are aware of and can access essential nutrition services, thus improving health-seeking behaviors and timely treatment of acute malnutrition. This will help communities meet their household dietary needs while seeking sustainable solutions to malnutrition.
The Community Management of Acute Malnutrition (CMAM) approach used by IRC and the partners is a methodology[2] for treating acute malnutrition in young children using a case-finding and triage approach. Using the CMAM method, malnourished children receive treatment suited to their nutritional and medical needs. Most malnourished children can be rehabilitated at home with only a small number needing to travel for in-patient care. The CMAM model was developed by Valid International[3] and has been endorsed by World Health Organization (WHO) and United Nation’s Children Fund (UNICEF)[4]. CMAM was originally designed for the emergency context, as an alternative to the traditional model of rehabilitating all severely malnourished children through in-patient care at Therapeutic Feeding Centers. However, it is increasingly being implemented in the context of long-term development programming through integrated approaches, with several Ministries of Health including components of CMAM in their routine services. Through the IMAM (Integrated Management of Acute Malnutrition) program, children who are severely malnourished are managed through the outpatient therapeutic care (OTP), while children with complication are treated through the in-patient program (Stabilization Centers-SC). Coverage surveys (in this case, Semi Quantitative Evaluation of Access and Coverage- SQUEAC survey) are therefore an approach to identifying the uptake of the program among the communities being served by the existing CMAM activities. This will inform the CMAM programming in Sokoto, Katsina and Zamfara (SoKaZa) States which hosts one of the largest IDPS in the northwest and experiencing frequent and ravaging banditry activities. This puts additional pressure on already insufficient and over-stretched nutrition services in the SoKaZa states. As per the IPC analysis published by UNICEF in November 2024, In the northwest, 24 LGAs were classified in Phase 4 (Critical) and 29 LGAs in Phase 3 (Serious). The remaining 18 LGAs were all classified in Phase 2 (Alert).
The primary contributing factors to acute malnutrition in these regions include poor food consumption in both quantity and quality, inadequate feeding practices, poor health services, prevalence of diseases, and low health-seeking behaviors. Moreover, the current economic situation, coupled with food insecurity, limited access to water, sanitation, and hygiene (WASH) services, and persistent issues like banditry, protracted conflict, population displacement, flooding, and general insecurity, exacerbates malnutrition by restricting access to vulnerable populations.
The specific objective on nutrition activities is to reduce the prevalence of acute malnutrition, improve coverage of and access to malnutrition treatment services. As part of the sustainability plan, IRC would like to assess the nutrition situation, barriers to access to malnutrition treatment and ad hoc coverage of nutrition programs. IRC plans to conduct a SQUEAC survey. Below are the details of this methodology.
This SQUEAC survey will be carried out by the IRC and partners including UNICEF and state primary health agency, the nutrition clusters through the steering of an International consultant.

QUALIFICATION OF KEY PERSONNEL

• Technical Team Lead/SQUEAC Expert: Must have advanced university degree in public health, public health nutrition, biostatistics, or other equivalent degree with more than 8 (eight) years of extensive experience in nutrition programs, survey, analysis and knowledge management, • Must have at least 5 years’ experience of CMAM or IMAM program. Must be trained in SQUEAC assessment methodology can present and certificate or document to demonstrate skills, must have completed at least 3 similar assignments in a resource constrained environment.
• Assessment Manager: • Must have advanced university degree in public health, public health nutrition, biostatistics, or other equivalent degree with more than 5 (five) years of extensive experience in nutrition programs, surveys, analysis, and knowledge management, • Must be trained in SQUEAC assessment methodology, and must have managed at lest to SQUAC assessments.
• Enumerators: • Must have at least a diploma in science based disciplines, qualifications in general medicine, nursing or Intermediate degree or High School passed with at least 1 (one) year of experience in community level program will be highly preferred, • Can communicate in local language, and • Experience in data collection using qualitative and quantitative studies is preferred

The overall purpose of the assessment is to estimate the coverage of the CMAM program; to strengthen the routine program monitoring with the aim to increase the program coverage in future; and finally, to allow the IRC, the SoKaZa states and other implementing partners to practice lessons learned from the survey.