Use of MUAC by novel community platforms to detect, diagnose and treat severe acute malnutrition

Research snapshot¹

There is growing consensus that making mid-upper arm circumference (MUAC) use more widely accessible among caregivers and community health workers (CHWs) will help decentralise the management of severe acute malnutrition (SAM) and increasing programme coverage, including the management of uncomplicated SAM by CHWs. A systematic review was conducted of published and operational evidence since 2000 describing the use of MUAC for detection and diagnosis of SAM in children aged 6-59 months by caregivers and CHWs, and of management of uncomplicated SAM by CHWs outside of formal healthcare settings. A total of 1,072 records were screened. Of these, 43 were selected for full-text screening and 22 were found to meet the study eligibility criteria. Data were extracted on study design, intervention, control and key findings, and operational lessons were synthesised.

Findings show that caregivers can use MUAC to detect SAM in their children with minimal risk and with many potential benefits in terms of early case detection and coverage. There is also evidence that CHWs can correctly use MUAC for SAM detection and diagnosis and to help provide a high quality of care in the treatment of uncomplicated SAM when training, supervision and motivation are adequate.

Important limitations of the review were the small number of published research studies and their narrow geographic scope, and most described intensive, small-scale interventions. Findings are therefore not generalisable to public-sector healthcare systems.

The authors conclude that scaling up the use of MUAC by caregivers and CHWs to detect SAM in household and community settings is a promising step towards improving the coverage of SAM detection, diagnosis and treatment. Further research is needed on scalability, applicability across a wider range of contexts and coverage impact and cost, as well as on the primary use of MUAC for SAM detection.