Promoting Mother-led-MUAC in the COVID-19 Era

“I am now the home nurse for my child.” Ndakaitei speaks confidently as she - measures her 5 year old daughter Miltread’s arm to screen her for malnutrition using a colour-coded Mid Upper Arm Circumference (MUAC) tape. She learnt to do this just a few months ago during a Mothers Support Group meeting conducted by the local Village Health Worker (VHW).

From 2015, Ndakaitei (44) who lives in Nyaminyami district in Zimbabwe has been attending Mothers Support Group Meetings where mothers share and learn about best feeding and hygiene practices they should adopt to ensure they raise healthy children. During these meetings the VHW has been training mothers on Mother-led-MUAC which is simply a process which helps mothers to detect early signs of malnutrition in their children using a MUAC tape. Ndakaitei and all mothers with children under the age of 5 who reside in the five districts of Nyaminyami, Binga, Hurungwe, Chimanimani and Bulawayo were given MUAC tapes by Save the Children through the Ministry of Health and Child Care.

Equipping each mother with a MUAC tape and training her how to take the measurements on her child helps to protect children, while limiting the transmission of COVID-19 through sharing of MUAC tapes. Before COVID-19 pandemic, the VHWs would use the same MUAC tape to measure every child’s MUAC at the community Active Screening point. This practise has now been stopped and active screening is now conducted differently. Mothers now measures their child’s MUAC using the MUAC tapes they were given whilst the VHW observes the process and records the readings.

“When I measure my child, if the MUAC tape shows the colour green, it means she is healthy, if it’s yellow, it means my child is at risk of malnutrition and I will have to take her to the clinic. If the tape shows red colour, it means my child has Severe Acute Malnutrition and needs to be treated immediately. I measure my child’s MUAC once every week,” said Ndakaitei while explaining how she measures her daughter’s MUAC.

“From the time I started measuring my daughter, the tape shows green colour and this means she is healthy. All mothers including myself were given MUAC tapes to measure our children so that we don’t share the same tapes as there is COVID-19,” added Ndakaitei.

Putting mothers at the centre of malnutrition screening processes which had for long been solely the role of the VHWs is important as cases of moderate and severe acute malnutrition are detected earlier, thus prompting quick responses by nurses. This helps in early detection and management of cases of Severe Acute Malnutrition.

Ndakaitei says the support groups meetings have also been helpful in equipping her on how she can protect herself, her daughter and the rest of her family from the COVID-19 pandemic.

“The support group meetings are helpful because I continue to learn about how to take care of my child. Our Village Health Worker also taught us about COVID-19 and how we should protect ourselves and our families. Our VHW taught us to make facemasks for our families and to practice good hygiene. We now meet in small groups, wash our hands before meetings, wear face masks throughout the meeting and we do not shake hands or sit close to each other.”

“At home I make sure my children wash their hands often. We installed a tippy tap at our home so that we can wash our hands and visitors who come into our home can also wash their hands.”

Save the Children is implementing the Nutrition in Emergencies project in partnership with the Ministry of Health and Child Care, across five drought affected districts in Zimbabwe. The project supports 90,150 children under five, pregnant and lactating women through the provision of life-saving nutrition treatment to all children affected by acute malnutrition. The mothers are supported through community level Infant and Young Child Feeding in Emergencies (IYCF-e), promotion of exclusive breastfeeding, mother-led active screening, COVID-19 awareness and prevention, promotion of exclusive breast feeding among other nutrition interventions in the context of the drought and COVID-19 emergency.