Family MUAC Project

A team from the Centre for Rural Health is excited to be working in partnership with UNICEF and the South African National Department of Health (NDoH) in a pilot project in Gauteng and KwaZulu-Natal which aims to work with Community Health Workers (CHWs) to teach and empower mothers in households to screen their own children for malnutrition using a simple MUAC tape.

The project was initiated by UNICEF and the NDoH because malnutrition remains a major public health concern in South Africa (SA). Acute malnutrition places children at high risk of serious illness or death from common childhood illnesses like diarrhea and pneumonia, and Severe Acute Malnutrition (SAM) is a factor in around one-third of child deaths in SA. ut. pPoor outcomes can be prevented if malnutrition is identified early and appropriate interventions put in place.

In South Africa, screening for malnutrition has been undertaken in health facilities where trained health professionals weigh children and measure their height/length. This requires expensive, heavy equipment and health workers with the skills to plot weights/heights on growth charts to identify malnourished children.  Thus growth monitoring and screening for malnutrition is only available for  children whose mothers or carers bring them to the clinic regularly. In many cases the most vulnerable households are least likely to bring their children regularly, leading to late diagnosis of malnutrition and high risk of morbidity and mortality.

Measuring the Mid Upper Arm Circumference (MUAC) is a simple low-cost method that can be used for growth monitoring as an alternative to measuring weight and height. MUAC uses a simple, colour-coded, graduated tape to measure the circumference of the child’s arm, and interpretation of the results is facilitated through the red and yellow zones marked on the tape. It is a simple, easy to use, accurate, acceptable and affordable method to identify children with wasting and can be effectively used by CHWs and family members.  Adopting this approach moves growth monitoring away from professional health workers in health facilities and places it in the hands of CHWs or family members in the community, acknowledging that families are in the best position to detect the earliest signs of wasting, and leveraging the fact that families want to participate fully in promoting the health of their children. MUAC has the potential increase the coverage and frequency of growth monitoring, empower mothers and community workers to take responsibility for growth monitoring, and improve early diagnosis of moderate and severe malnutrition.

In this project the CRH team will work with teams of CHWs in selected clinic catchment areas in two provinces, Gauteng and KwaZulu-Natal. These areas were identified by the DoH in each province based on there being a high prevalence of malnutrition. We will work to mobilise local communities to support Family MUAC, as well as train and mentor participating CHWs to empower mothers and child carers in their households to implement Family MUAC.  Further, we will undertake an evaluation to assess the effectiveness of this program in identifying malnutrition in households.