Questions on MUAC reliability

After several trainings, reliability of MUAC at field level is still a concern in some of our projects. Is someone working in other types of tapes / strips or other more reliable tools to measure MUAC?

Comments

Reliability

I note that you use "reliability". Is this because you are worried about repeatability of measures?

See this post for a review of indicators. The evidence is that MUAC is probable better, and certainly no worse, than other practical indicators of wasting with regard to error. This is not a reason to be complacent about error. We still have to train and supervise and train and supervise some more as we would with any measure. There are other posts on this site that also address the issue.

During the CTC research program we found the bulk of errors where in recording numbers or in interpreting the numerical result to classify the degree of wasting. We found that errors all but disappeared when we used colour-banded MUAC straps and used the colour-band to decide admission. This could also be used in prevalence surveys with classical estimators. What error that did remain was in "pulling" (i.e. a worker would pull tighter close to classification thresholds). The error here favours sensitivity. It favours the child (e.g. a child with a MUAC of 116 mm would get into the program).

You could use a device such as shown in this post but I think this will not affect admissions greatly but might be useful for prevalence surveys.

I hope this is some use.