TABLE 2.
Summary of Operational Materials Included in Review (n=11)
| Reference | Organizational Source and Setting | Thematic Category | Type of Document | Objective of Document |
|---|---|---|---|---|
| ACF 201742 | Action Against Hunger (DRC, Kenya) | Caregiver detection, CHW diagnosis | Description of program/materials | To describe a simplified, standardized MUAC bracelet under development for testing in the DRC and Kenya. |
| Bailey 201826 | Multiagency (Chad, Kenya, Yemen, Pakistan, Jordan) | Integration | Pilot study (results not yet published) | To summarize the protocol being used by the ComPAS study. The ComPAS study, currently underway as of the writing of this article, aims to integrate the treatment of MAM and uncomplicated SAM by using one product (RUTF) in doses that correspond to growth at each stage of treatment, and using MUAC and edema as the only metrics for admission, monitoring, and discharge. |
| CMN 201534 | Coverage Monitoring Network (no specific setting) | Integration | Advocacy | To advocate for the integration of MUAC into other health and nutrition activities, including vaccination campaigns, well-baby clinics, and water and sanitation programs. |
| Emary 201718 | World Vision (Mauritania) | Caregiver detection | Description of program/materials | To describe qualitative and quantitative tools developed for training and monitoring “Mother-Led MUAC” programs in Mauritania. |
| Friedman and Wolfheim 201435 | Multiagency (no specific setting) | CHW diagnosis and treatment | Description of program/materials | To identify and describe models for how CHWs currently incorporate SAM screening, referrals, and treatment into their work. While there is evidence supporting CHW capacity to conduct all SAM-related activities, there are outstanding questions regarding the conditions that foster success, as well as the optimal mix of iCCM and nutrition-related responsibilities. |
| ALIMA 201715 | ALIMA (Niger, Burkina Faso, Mali, Chad) | Caregiver detection | Description of program/materials | To describe the expansion of “Family MUAC” concepts in Burkina Faso, Chad, Mali, and other locations. |
| MSF 201743 | Médecins Sans Frontières (no specific setting) | Caregiver detection, CHW diagnosis and treatment | Pilot study | To report on lab testing of an alternative MUAC strap for use with adult and child populations. Initial testing of the strap using a standardization process (not on humans, but on differently sized cylinders) showed it to be more accurate and have a higher sensitivity than the standard UNICEF strap. The next step is to test the straps on children in a field setting. |
| Sadler et al. 201125 | Save the Children/Feinstein International Center (Bangladesh) | CHW diagnosis and treatment | Research study | To report outcomes of SAM cases receiving CHW care in Bangladesh (some results also published, see Puett et al. 201220 and Puett et al. 201321). Coverage, weight gain, and recovery were high (89%, 6.7 g/kg/day, and 92%, respectively). The use of multiple pathways to care within the CHW model—use of MUAC, monthly growth monitoring sessions, home visits to sick children, and use of a “watch list” to monitor sick children—facilitated high coverage of screening and diagnosis. See also Puett et al. 201220 and Puett et al. 2013.21 |
| Sayadi 201617 | CMAM Forum (multiple settings) | Caregiver detection | Description of program/materials | To connect agencies interested in adopting “Mother-Led MUAC” programs (Action Against Hunger, Médecins Sans Frontières, GOAL, Concern, World Vision, International Red Cross, International Medical Corps, and Cooperazione Internazionale). |
| Sessions 201716 | Action Against Hunger (India, Mauritania) | Caregiver detection | Pilot study | To describe 2 pilot studies of the “MUAC Mothers” approach. In India in 2015, 61 caregivers were trained to measure MUAC and given information about how to proceed if they classified their child as having MAM or SAM. Seven months after training, approximately 20 were using the tapes actively; the remaining 41 had misplaced, forgotten how to use the tapes, or not participated in measuring. In Mauritania in 2016, CHWs provided training for more than 6,000 mothers on MUAC use, screening for edema, and what to do if a child got a red, yellow, or green reading. |
| Tesfai 201514 | International Rescue Committee (multiple settings) | CHW diagnosis and treatment | Description of program/materials | To describe tools to enable low-literacy CHWs to diagnose and treat uncomplicated SAM. Piloted tools include use of MUAC-only for admission and monitoring, the use of visual materials (color-coded RUTF dosage charts, scales that indicate RUTF dose, and use of icons to facilitate registration and monitoring), and alignment with iCCM vocabulary and tasks. Field tests have been conducted in Chad, India, Mali, and South Sudan. |
Abbreviations: CHW, community health worker; CMAM, community-based management of acute malnutrition; ComPAS, Combined Protocol for Acute Malnutrition Study; DRC, Democratic Republic of the Congo; iCCM, integrated community case management; MAM, moderate acute malnutrition; MUAC, mid-upper arm circumference; NA, not available; RUTF, ready-to-use therapeutic food; SAM, severe acute malnutrition; UNICEF, United Nations Children's Fund.