Effect of Family Muac Approach on Detection of Acute Malnutrition Among Under-Five Children on Art: Facility Based Quasi Experimental Study From Public Health Hospitals in Addis Ababa, Ethiopia 2024

Background Malnutrition is defined as deficiencies, excesses, or imbalances in an individual’s energy and/or nutritional consumption. Nutritional status assessment can be done by using anthropometric, clinical and biochemical methods and, dietary practices. Mid Upper Arm Circumference (MUAC) is a simple tool for the assessment of acute malnutrition in different ethnic back grounds. Family MUAC also known as MUAC for mothers or Mother-MUAC is a program that teaches mothers and other caregivers how to use the easy-to-use Mid-Upper Arm Circumference (MUAC) tape to recognize the early signs of malnutrition in their children. The approach was developed with the objective of improving coverage of treatment services, detecting cases earlier and improving awareness on malnutrition. The identified knowledge gap pertains to the absence of a practiced approach utilizing Family Mid-Upper Arm Circumference (MUAC) measurements in Ethiopia. Therefore, the study aimed to investigate how the implementation of family MUAC measurements impacts the detection of acute malnutrition of under-five children who are on ART program in Addis Ababa, Ethiopia. Methods and Materials : A facility based nonequivalent pretest-posttest quasi experimental study was conducted among under-five children who are on ART program from public health hospitals in Addis Ababa. For intervention group MUAC training was given by trained trainers with support of nutrition expert using a training guideline adopted from GOAL Global, for 12 weeks and every two week an ongoing reinforce training was provided and one MUAC was provided for each caregiver in the intervention group and for the Control group the tradition or standard of care was continued in the hospital, where they were attending. Data was collected using structured questionnaire. Paired t-test for continuous variables and McNemar’s test for categorical variables was applied to check significant difference of family MUAC within groups at pre-and post-intervention. At 95% confidence level, value with P < 0.05 was considered as statistically significant. Results The baseline mean score of MUAC knowledge in intervention group and Control group has no significant difference. was 1.025 increased to 1.815 at endline, with a p-value of < 0.001, indicating a highly statistically significant but in control group showed no significant change in MUAC knowledge, with a baseline mean of 1.05 and an endline mean of 1.097 (p = 0.183). The mean score of acute malnutrition knowledge for the intervention group increased from 1.21 (60.5%) at baseline to 1.46 (73.0%) at endline, with a p-value of 0.001 shows statistically significant comparing to control group, showed no significant change, with baseline and endline means of 1.42 and 1.43, respectively, and a p-value of 0.87.The study also shows that 14.5% malnutrition was detected and 85.5% not detected in Control group while 37.4% malnutrition was detected and 62.6% not detected in Intervention group. Conclusion Providing Family MUAC approach for Caregivers of under 5 children improves knowledge of acute malnutrition and increase detection of malnutrition. Hence Health policies should consider integrating Family MUAC monitoring into routine care for under 5 children, especially those on ART. This could be an effective strategy for enhancing early diagnosis and intervention in resource-limited setting.