Abstract
Background
 Approximately 17 million children under five years suffer from Severe Acute Malnutrition (SAM). Although the most frequent barriers to service access in Community Management of Acute Malnutrition (CMAM) programmes have already been identified, there has been no analysis of the relationship between gender-related barriers and access to treatment.
 Approach
 The main objective is to review the key gender barriers to service access and uptake of treatment in CMAM programmes based on evidence gathered from coverage assessments carried out in Sub-Saharan Africa and Asia. A retrospective review of twenty-five coverage assessments was undertaken in 2013.
 Main findings
 Gender-related barriers were detected in 24 of the 25 coverage assessments. The main barriers detected were related to traditional gender roles: Women busy with duties (27.8%) followed by men control household expenditures and decision-making in the family (16.7%) and women sick (15.3%).
 Principal conclusions
 
 Gender-related barriers are present in the majority of the nutrition programs, so if the aim is universal coverage, gender should be considered during the coverage assessment
 Initiatives contributing to gender equality would contribute to overcoming coverage barriers in CMAM programmes
 The traditional use of the CMAM model considered gender with regards to the impact that the intervention could have on gender relations. However gender is now shown to also be a key factor contributing to poor nutrition.
 Further research and assessments should include Gender Based Violence as a single barrier, or as a component of other barriers
Highlights
Approximately 52 million children suffer from acute malnutrition (AM) at any one time [1]
Of the 25 Semi Quantitative Evaluation of Access and Coverage (SQUEAC) assessments included in the analysis, 22 were from Sub-Saharan Africa and 3 from Asia, amounting to 19 countries: Angola, Burkina Faso, Cameroon, Chad, Ethiopia, Ivory Coast, Kenya, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somali, South Sudan, Sudan, Pakistan, Philippines and Yemen
One assessment from Nigeria was excluded because it did not have all of the required data as it was an SQUEAC investigation within a Simplified Lot Quality Assurance Sampling Evaluation of Access and Coverage
Summary
Approximately 52 million children suffer from acute malnutrition (AM) at any one time [1]. There is strong evidence that the management of SAM is a cost-effective way to reduce child mortality [2] For this nutrition-specific intervention to make a substantial difference, treatment coverage needs to be improved. In 2013, approximately 17 million children under five years of age suffered from severe acute malnutrition (SAM). The many frequent barriers to service access in Community Management of Acute Malnutrition (CMAM) programmes have already been identified, there has been no analysis of the relationship between gender-related barriers and access to treatment. The main objective is to review the key gender barriers to service access and uptake of treatment in CMAM programmes based on evidence gathered from coverage assessments carried out in Sub-Saharan Africa and Asia. The main barriers detected were related to traditional gender roles: Women busy with duties (27.8%) followed by men control household expenditures and decision-making in the family (16.7%) and women sick (15.3%)
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