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MUAC measurements

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 2 replies. You can also reply via email – be sure to leave the subject unchanged.

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Martha.N

Pubic health nutritionist

Normal user

24 Oct 2014, 11:28

Dear all,
I am working on a proposal where we will train and provide MUAC tapes to all mothers/caretakers with children in a camp setting. However I have not been able to get an information regarding performance indicators. Is there any information regarding this. For example if we give MUAC tapes to 900 mothers (calculation based on the GAM levels and assuming one child < 5 yrs per mother ), what percentage of referrals is expected for us to confirm success?. Please also share other indicators we can use to asses performance of that activity.

thanks.
M.N

Mark Myatt

Consultant Epideomiologist

Frequent user

24 Oct 2014, 13:58

This is a very interesting approach. It has been tried by ALIMA. I have a little of their data (regarding performance of mothers at taking the measurement) and I understand that they consider this to be very promising approach.

You question seems to be about performance with an indicator:

    number of SAM kids referred by MUAC measured by mother
    ------------------------------------------------------
       total number of prevalent and incident SAM cases

The numerator may be tricky to get as "source of referral" is seldom collected exhaustively on OTP records. The numerator can only be estimated very approximately. This makes for an inaccurate and imprecise indicator. What you want is difficult to measure.

I think you would be OK if you did a small survey of mothers of cases and more than a low proportion stated that they had come to the program because of measuring their own child's MUAC (or because a neighbour had).

You could be more formal and collect data as above and on changes in the MUAC at admission and on raw admissions. You could then used mortality data from the historical cohorts and life tables to work out a likely number of averted years of life lost (YLL) for SAM this is a very close estimate of DALYs. Divide YLL by the cost of the 900 straps and their distribution and you have a cost per DALY. If this is below US$100 then the intervention is usually though to be worthwhile.

I am interested in how you got to 900 straps. Do you have only 900 mothers with children ages 6-59 months in your camp? I would expect you will also give MUAC straps to CHWs, THPs, TBAs, drug vendors, &c. too.

I hope this helps.

Mark Myatt

Consultant Epideomiologist

Frequent user

25 May 2015, 06:10

An article looking at the technical performance of mothers using MUAC to screen their own children for MAM and SAM has been published and is available here.

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