How to Identify and Refer Children with Acute Malnutrition For: Aid workers, Health Workers

1. How to Identify and Refer Children with Acute MalnutritionFor: Aid workers, Health Workers Malnutrition increases the risk of illness and death for young children. It is important to screen all children under five every two weeks to ensure that you identify the children that require special attention. Those already malnourished require assessment and specialized management. For children under five, there are two easy ways to screen for malnutrition: by looking for oedema and measuring around the upper arm which are explained below. By comparing the results of screening of all children, we can tell if the population as a whole, and particularly the children require additional support to ensure they remain healthy and well nourished. Step by Step How to Measure Mid Upper-Arm Circumference (MUAC) For children measuring more than 65 cm and over 6 months old Step 1: Ask the mother to remove clothing that may cover the child’s left arm. Step 2: Calculate the midpoint of the child’s left upper arm by first locating the tip of the child’s shoulder (Arrows 1 and 2) with your finger tips. Bend the child’s elbow to make a right angle (Arrow 3). Place the tape at zero, which is indicated by two arrows, on the tip of the shoulder (Arrow 4) and pull the tape straight down past the tip of the elbow (Arrow 5). Read the number at the tip of the elbow to the nearest centimeter. Divide this number by two to estimate the midpoint. The midpoint can be mark with a pen on the arm (Arrow 6). Step 3: Straighten the child’s arm and wrap the tape around the arm at midpoint. Make sure the numbers are right side up and that the tape is flat around the skin (Arrow 7). Step 4: Make sure the tape has the proper tension (Arrow 7) and is not too tight or too loose (Arrows 8-9). Repeat any steps as necessary. Step 5: When the tape is in the correct position on the arm with the correct tension, read and call out the measurement to the nearest 0.1cm. Step 6: Follow the instruction for the color that are shown below.

2. How to Identify and Refer Children with Acute MalnutritionFor: Aid workers, Health Workers If the color is red (MUAC below 11 cm), then the child is severely malnourished and need to immediately be taken to the nearest qualified health worker, health facility or hospital for assessment, treatment and follow up. If the color is yellow (MUAC below 12.5 cm), then the child is moderately malnourished and needs assessment and supplementary foods (additional enriched food). If UNIMIX/CSB is not available, follow the guidelines on good complementary food listed fact sheet “The best foods for children under 5” years Green color (MUAC above 12.5 cm) means that the child is healthy and not malnourished. This child should continue to eat the good foods listed in fact sheet “The best foods for children under 5” • Check for Oedema • Using you thumb, gently apply pressure to both feet for 3 seconds • If you can still see the print of your thumb on both feet, then the child has oedema • Oedema is a sign of the child being severely malnourished. The child needs to be taken to the closest health facility immediately to receive specialized treatment including therapeutic food and medical treatment.