Effect of Family MUAC Utilization in Identifying Severity of Acute Malnutrition at Admission to Nutrition Programs Among Children Aged 6–59 Months Ethiopia

Abstract

Mid-upper arm circumference (MUAC) screening is a simple community-level method for detecting acute malnutrition. The Family MUAC approach, which trains caregivers to measure their children's MUAC and refer them for treatment, has shown promise, but evidence regarding its impact on malnutrition severity at admission is limited. To address this gap, we conducted a longitudinal study from March to May 2024 in two districts in Eastern Ethiopia, enrolling 360 children aged 6-59 months. We compared children referred by their mothers or caregivers using the Family MUAC (n = 180) with those referred by Health Extension Workers (HEWs) (n = 180). We found that the median MUAC at admission was 119 mm (IQR 116-120) in the mother-referral group versus 116 mm (IQR 115-119) in the HEWs-referral group, and the proportion of severe acute malnutrition (MUAC < 115 mm) was lower among caregiver-referred children (4.2% vs. 18.4%). Multivariable regression analysis showed that mother/caregiver-referred children had an 80.5% lower risk of severe MUAC at admission [ARR 0.195(0.06, 0.59)] and a 75% reduced likelihood of SAM admission compared to the HEWs-Referral group (ARR 0.25; 95% CI, 0.148-0.448). The Family MUAC approach significantly reduced the severity of malnutrition at admission. Consequently, this strategy should be expanded and prioritized in national screening programs.