#HTE

Reader Submitted: MUAC-Scrape: Measuring for Malnutrition

A team from Harvard University’s Master in Design Engineering Program (MDE) collaborated with IRC’s Airbel Impact Lab to re-design the MUAC-tape. The original MUAC -tape (Middle Upper Arm Circumference) is a tool distributed to caretakers in countries that require humanitarian assistance. The tape measures the circumference of a child’s arm (6 to 59 months old) and helps determine if the child has acute malnutrition (or wasted :low weight-for-height where a child is thin for his/her height but not necessarily short). The team’s research discovered that of the 49.5 million children with malnutrition (MAM & SAM) in 2018, only 40% were diagnosed, and 55% of those diagnosed would visit clinics. However, 75% of the children will complete the treatment cycle once children visit the clinic. Further research from the Airbel Impact Lab showed that of the 90% of caregivers trained to use the MUAC-tape, only 20% have visited a health clinic, and a significant number have only used the tape once. The team concluded that the main issues are the significant gap between those with malnutrition and those who get diagnosed, and the gap between those who get diagnosed and those who visit the clinic. Hence, the team decided that the new design should encourage regular screening and reliably notify the urgency of the child’s state of malnutrition.

The team from MDE designed the MUAC-Scrape. The new design retains a similar shape and mechanism as the old design. This is because the mechanism of the original MUAC-tape is already well taught, and the simple shape allows the product to retain a competitive production cost. However, key features were added or improved. This includes the ability to mark the tape with the current measurement of the child, and different colored rows so that the caretaker can mark the measurement for each child in the household. When caretakers receive the tape, it is reminded that red areas being revealed while measuring the child is still an indication of being at high-risk of malnutrition. Furthermore, since caretakers can now mark the tape, caretakers should also check changes in the child’s measurements, and a drop in the measurement is a sign for alarm.

The MUAC-Scrape is made with latex-based scratch paper. This is because research showed that the diagnostic elements of the tape became a stigma for caretakers and discouraged use of it. Hence, a non-stigma inducing design is laminated over the diagnostic, so that results are not revealed until caretakers use the tape, and those with healthy children are not discouraged from testing their children again.

For the next steps, the team will begin prototyping batch quantities and testing.

Kozuki N, Van Boetzelaer E, Tesfai C, Zhou A. Severe acute malnutrition treatment delivered by low-literate community health workers in South Sudan: A prospective cohort study. J Glob Health. 2020 Jun;10(1):010421. doi: 10.7189/jogh.10.010421. PMID: 32566163; PMCID: PMC7295452.