Dakar, Niamey, 6 September 2016. Teaching mothers and other family members to screen children for malnutrition can lead to earlier detection and fewer hospitalizations, according to a new study published today in the journal Archives of Public Health.
The study, Mothers screening for malnutrition by mid-upper arm circumference is non-inferior to community health workers: results from a large-scale pragmatic trial in rural Niger, compared two screening strategies in separate health zones of Mirriah District in rural Niger from 2013-2014.
In one health zone, nearly 13,000 mothers and other family members screened their own children after receiving brief training on how to use color-coded Mid-Upper Arm Circumference (MUAC) bracelets and to check for edema. In the other health zone, community health workers performed the malnutrition screenings, in line with current recommendations.
Where mothers screened for malnutrition children were admitted for treatment at an earlier stage of the life-threatening condition. This meant that they were also less likely to require inpatient care than children in the community health workers’ zone, both at admission and at any other point during their treatment. Overall costs were substantially lower in the zone where mothers were taught the screening techniques.
“Mothers see their children every day and are in the best position to detect the earliest signs of malnutrition,” said Dr. Sayadi Sani, coordinator of the Nigerien organization BEFEN. “This study shows how making them the focal point of screening strategies with a simple tool like MUAC can be a real game changer in global efforts to address malnutrition.”
Some of the study authors likened MUAC bracelets to thermometers: a tool parents can use at home to detect a problem early and indicate when to seek medical care for their child.
“The idea is so simple and the potential impact on reducing malnutrition-related morbidity and mortality is so great,” said Dr. Susan Shepherd, medical expert for ALIMA. “Helping parents know when their child needs help can create a quantum leap in bringing care to malnourished kids.”
Color-coded MUAC tapes to determine the nutritional status of a child have been in existence for decades, but have mainly been used by humanitarian aid workers, health professionals or community health workers. ALIMA and its Nigerien partner BEFEN were the first groups to explore teaching mothers how to use this simple and inexpensive tool in 2011.
Community health workers will continue to play an integral part of the health response in communities around the world. But because of their many responsibilities, they can usually only screen children, at best, once a month. Teaching others how to use MUAC at home is a better use of their skills, and recognizes the central role that parents can play in the screening process.
“I am sure this publication will have a major influence on policy makers,” said Dr. André Briend, from the University of Tampere and the University of Copenhagen. “It will help improve early detection and overall management of severely malnourished children.”
Today, it is estimated that more than 50 million children suffer from acute malnutrition, including at least 16 million suffering from the severest form. Even with the dramatic increase in availability of treatment over the past decade, only 10-15 percent of children with severe acute malnutrition are treated. Putting mothers at the center of screening strategies could be a key step in increasing access to treatment in areas where malnutrition poses a high risk of death or illness.
“There is no one-size fits all approach to family MUAC training, but ALIMA has begun teaching tens of thousands more mothers in programs in Niger, Chad, Mali and Burkina Faso,” said Dr. Ali Ouattara, ALIMA’s Deputy Director of Operations. “Hopefully in the coming years, all parents in areas where malnutrition takes a heavy toll will know how to use MUAC bracelets.”
ALIMA is a humanitarian medical aid organization created in 2009. Teams work hand-in-hand with a network of local and national medical organizations to provide life-saving care to some of the world’s most neglected communities in acute emergencies and recurring crises. ALIMA’s medical research priorities are determined together by this network and benefits further from partnerships with international organizations and academic research institutions. Since its inception, ALIMA and its partners have treated nearly 2 million patients, led 41 emergency medical aid programs, and led 10 operational research projects focusing on malnutrition, malaria, emergency surgery, and Ebola.
*** Direct link to the paper: http://archpublichealth.biomedcentral.com/articles/10.1186/s13690-016-0149-5
***Guidelines for how to scale-up training mothers and other family members to screen for malnutrition are available at: http://alimaong.org/empowering-mothers-to-prevent-malnutrition/