Assessment of caregivers’ ability to measure wasting status of their children (6-59 Months) and the associated factors at Mwanamugimu Nutrition Unit Mulago Hospital, Kampala Uganda

Abstract

Background: Globally, acute malnutrition among children under 5 years is still a major challenge. Recently, it was proven that when caregivers are at the center of malnutrition screening strategies using Mid-Upper Arm Circumference (MUAC), it increases the coverage and enhances timely screening. The objective of the study was to assess caregivers ‘ability to measure and classify the nutrition status of their children aged 6-59 months using MUAC tape, factors that influence their ability, and their perceptions about measurement of mid upper arm circumference. Methods: A total of 73 caregiver-child pairs were enrolled at Mwanamugimu nutrition unit, Mulago national referral hospital. Enrolled caregivers were given a 120-minutes training on measurement and classification of nutrition status using MUAC tape. A pre-tested questionnaire was used to collect data about their ability and factors that could influence their ability to measure MUAC of their children. A total of 7 Focus Group Discussions (FDGs) were conducted to determine their perceptions about measurement of MUAC. Quantitative data was analyzed using STATA 15 whereas Qualitative data was analyzed using Atlas.ti. Results: Overall, 72 (98.6%) of the caregivers were able to measure mid upper arm circumference and classify the nutrition status of their child as either normal or malnourished with a 100% sensitivity, 97.1% specificity, 97.5% Positive Predictive Value (PPV) and 100% Negative Predictive Value (NPV). There was a very high level of agreement between caregivers and health care worker in the nutrition status classifications using MUAC with a k = 0.892. All (7/7) FGDs showed positive attitude towards MUAC measurement, the participants were willing to teach other caregivers in their communities. Training for caregivers and mass community sensitization about measurement and categorization of MUAC and the roles of the empowered caregivers was mentioned to be paramount for them to execute the task comfortably without fear. Conclusion: This study indicated high sensitivity and specificity and high positive predictive value as well as high level of agreement between caregivers’ and nutritionist’s measurement and classification of nutrition status of the children 6-59 months using colored mid upper arm circumference tape. The findings provide evidence that caregivers can measure and categorize the nutrition status of their children using color coded MUAC tape when provided trained.