Prevalence of Acute Malnutrition (MUAC, oedema)

What: The indicator measures the prevalence of children with mid-upper arm circumference (MUAC) between 115mm and <125mm (moderate acute malnutrition) and <115mm (severe acute malnutrition) and/or bilateral oedema. Why: Low MUAC and nutritional oedema are linked to mortality among malnourished children. When: • To conduct community screening for early detection of malnutrition among children in emergency and development nutrition projects. • To measure the impact and outcome of CMAM programs. • To conduct a rapid nutrition assessment in a community during an emergency or post-emergency.

Data can be collected either as a part of SMART survey collecting for also other anthropometric data or in a separate survey collecting MUAC-only data. The second option is much faster and is used when a lack of time or funding does not allow the conducting of a full-scale SMART survey.

MUAC is recorded in mm (or cm with one decimal) and not rounded.

Disaggregate the data by gender and age groups

1) Measurements of acute malnutrition are generally age-independent, while it is useful to have a broad understanding of the age group (whether 6 months and above or whether 23 or 59 months and below). Having a good understanding of the accurate age, will of course be beneficial and allow for disaggregation by age. Indikit currently states: ‘This indicator relies on accurate age assessment. Since people often do not remember the exact dates of their children’s birth, the data collectors should always verify the child’s age. This can be done by reviewing the child’s birth certificate, vaccination card or another document; however, since many caregivers do not have such documents (and since they can include mistakes), it is essential that your data collectors are able to verify the child’s age by using local events calendars. Read FAO’s Guidelines (see below) to learn how to prepare local events calendars and how to train data collectors in their correct use.

2) Some countries may be using old cut off points (such as 120/ 110mm) as opposed to the WHO currently recommended 125/ 115mm. If you work in a country using older standards, report the results according to the older as well as the more recent standards. Always record the exact circumference (in mm), not just whether it is below or above the cut off point.

3) Prevention-oriented projects should use this indicator only if their strategy is likely to have an impact on the nutritional status of the target population. If your project is too short or focuses, for example, primarily on improving agricultural production, use less ambitious indicators measuring, for example, nutritional intake (such as Minimum Dietary Diversity) or specific nutritional practices.

4) In many countries, acute malnutrition is prone to significant seasonal differences (e.g. ranging from 5% in the months following the harvest to 11% before the harvest). Therefore, if you need to compare your baseline and endline data to assess the result of your work, ensure that the data is collected at the same time of a year, otherwise you will receive two sets of data which say very little about the change your project has (not) achieved.

5)Reporting may also be as ‘Prevalence of global acute malnutrition among children 6-59 months’ or variations of this (e.g., prevalence of MAM).