Dataset
CMAM admission and discharge register — 2024
1,100 admissions across six sites, carrying both MUAC and weight-for-height at admission, so the disagreement between the two admission criteria is measurable rather than assertable, and the treatment outcome every CMAM report is judged on.
- Rows
- 1,100
- Variables
- 14
- Period
- 2024-01-08 to 2024-12-31
- Licence
- CC BY 4.0
- Completeness
- 93%
Standards and methodologies
Files
Files are versioned by filename. A corrected release ships as .v2.csv rather than replacing the file in place, so an analysis pinned to v1 keeps reproducing.
Data dictionary
| Variable | Type | Description | Allowed values |
|---|---|---|---|
child_id | string | Pseudonymous child identifier, one per admission episode. A child readmitted after relapse appears twice. | — |
site_id | categorical | Treatment site. Six sites, one of which draws from a catchment about two hours further out. | SITE-01, SITE-02, SITE-03, SITE-04, SITE-05, SITE-06 |
admission_date | date | Date the child was admitted to treatment. | — |
age_monthsmonths | integer | Age in completed months at admission. | — |
sex | categorical | Sex of the child as recorded at admission. | f, m |
programme | categorical | Treatment programme. Outpatient therapeutic, targeted supplementary feeding, or inpatient stabilisation. | otp, tsfp, sc |
admission_criterion | categorical | The criterion the site recorded as the reason for admission. A child may meet more than one; this records the one entered. | muac, whz, oedema |
muac_admission_mmmm | integer | Mid-upper arm circumference at admission. | — |
weight_admission_kgkg | float | Weight at admission. | — |
height_cmcm | float | Length or height at admission. Missing for a share of admissions, which is what makes weight-for-height incomputable for them. | — |
oedema_admission | boolean | Bilateral pitting oedema at admission. Oedema is severe acute malnutrition whatever the anthropometry says. | true, false |
discharge_date | date | Date of discharge. Blank for children still in treatment at the reporting cut-off. | — |
weight_discharge_kgkg | float | Weight at discharge. Blank where the child had not been discharged. | — |
outcome | categorical | Treatment outcome. Blank for children still in treatment at the cut-off, which is not an outcome and must not be counted as one. | cured, defaulted, died, non-response, transferred |
Provenance
Data quality
- Every record is generated. No real child is described and these figures must never be cited as real programme performance.
- The denominator is the finding. 1,100 children were admitted; 984 reached a treatment outcome, 45 were transferred and 71 were still in treatment at the cut-off. Sphere performance is computed over children who reached an outcome, excluding transfers — 82.3% cured, 13.7% defaulted, 1.0% died, 2.9% non-response. Divide the same cured count by all 1,100 admissions and the cure rate reads 73.6%.
- Site 3 defaults at 20.5% against 11.2% at the best site. The programme as a whole is inside the Sphere maximum of 15% and one site is not, which is exactly the case a district-level figure hides.
- Both admission measurements are recorded for every child with a height, which is what makes the criteria comparable. Of the children severely malnourished by either measure, 468 are severe by weight-for-height only, 24 by MUAC only and 142 by both — a concordance of 22.4%. On any acute malnutrition the two agree on 51.9%.
- The disagreement is not noise, it is age. Children severe by MUAC alone average 14.3 months; those severe by weight-for-height alone average 31.4 months. MUAC grows with age independently of nutritional status, which is why a programme admitting on one criterion is not treating the caseload the other would have found.
- Oedema overrides anthropometry. A child with bilateral pitting oedema is severely acutely malnourished whatever their MUAC or weight-for-height, so the severe caseload is not simply the count below the cut-offs.
Known issues
- Seventy-two admissions (6.5%) have no height recorded, so weight-for-height cannot be computed for them. MUAC can, so any analysis comparing the two criteria has different denominators unless it says otherwise.
- Seventy-one children were still in treatment at the reporting cut-off and have no outcome. Counting them as any outcome is wrong; excluding them without stating the denominator is also wrong.
- Forty-five children were transferred between programmes. Sphere excludes transfers from the performance denominator, and including them changes every rate in the table.
- Nine discharge weights are lower than the admission weight. This is possible in a child who died or defaulted early, and it is also what a transposed entry looks like; the register cannot distinguish them.
- The admission criterion records the one the site entered, not every criterion the child met. A child meeting both MUAC and weight-for-height appears under one of them, so counting admissions by criterion understates overlap.
Worked examples
Python
CMAM performance against the Sphere standards
The same performance table in pandas, with the three candidate denominators computed side by side so the effect of each is visible.
Described here; the notebook is still being written.
Where MUAC and weight-for-height disagree
Computes weight-for-height z-scores from the WHO 2006 reference table, cross-tabulates severe cases by criterion, and decomposes the disagreement by age.
Described here; the notebook is still being written.
R
CMAM performance against the Sphere standards
Builds the outcome denominator correctly, computes cured, defaulted, died and non-response by site and programme, and flags every cell outside the Sphere minimum standards.
Described here; the notebook is still being written.