Implementing the Family MUAC approach for infants under six months in the context of COVID-19 in Ethiopia

ABSTRACT

What we know There is growing evidence of the effectiveness of mid-upper arm circumference (MUAC) in identifying infants under six months at increased risk of mortality but no globally agreed thresholds yet exist for this age group which limits community-based screening. What this article adds In response to the COVID-19 pandemic, GOAL adapted its community-based Management of At-risk Mothers and Infants under 6 months (MAMI) programme in Gambella, Ethiopia by introducing the Family MUAC approach to enable home-based screening of infants under six months and a new type of reversible MUAC tape, specially adapted for the screening of infants under six months of age. Following implementation, the average number of monthly referrals increased (from 11.6 infants pre-training to 19.1 post-training). Pre-training, monthly outreach contributed to most referrals (average 77.0%) and there were no self-referrals. Post-training, the average monthly outreach referrals reduced to 45.3% and self-referrals increased to 41.4%. Measurement accuracy analysis showed that most caregivers trained by Community Outreach Agents (COAs) correctly identified the MUAC of their infants. Based on these results, GOAL will explore the feasibility of moving to using Family MUAC alone for the screening of infants under six months of age.