Utilization of Family Mid upper Arm Circumference Tape for Early Detection of Child Malnutrition in Nomadic Communities - Turkana South, Kenya.

Abstract

Malnutrition remains a major public health concern in Turkana South Sub-County, Kenya, where children from nomadic pastoralist communities often present at health facilities with advanced stages of undernutrition. The Family-led Mid-Upper Arm Circumference (F-MUAC) screening approach is promoted as a community-based strategy for early detection and referral of malnutrition cases. However, evidence on its uptake and utilization in this context has been limited. This study assessed the utilization, coverage and key determinants of F-MUAC use among caregivers in Turkana South. A cross-sectional mixed-methods design was employed, involving quantitative data from 244 caregivers of children aged 6–59 months selected through simple random sampling and qualitative data from six focus group discussions. Quantitative tools included structured questionnaires and F-MUAC demonstrations, qualitative data explored perceptions and contextual barriers. A 100% response rate was achieved with most respondents being women (97.95%), married (92.21%) and engaged in livestock rearing (26%) or petty trade (25%). About 70.5% of caregivers reported screening their children in the two weeks prior to the survey while 29.5% had not used the tape consistently. Knowledge of malnutrition was significantly associated with F-MUAC utilization (OR = 6.05, p < 0.001). However, technical measurement errors were common, strongly linked to incorrect tape placement (OR = 203.85) and misalignment of the reading window (OR = 136.55) (p < 0.001). Mistrust in the tool due to discrepancies with facility-based readings was noted by 5.3% of respondents. Undernutrition prevalence remained high particularly among children aged 6–24 months (19.5%) compared to those aged 25–59 months (15.2%). The study shows that family led F-MUAC screening improves early detection and promotes community ownership of child health. While the approach reduces the burden on overstretched health systems and lowers screening costs, its utilization depends on the household’s ability to act on referrals. Economic empowerment is therefore crucial not only to create time for screening but also to support access to care. Linking F-MUAC with income-generating activities and broader livelihood programs can enhance its uptake and impact. Integrating F-MUAC into routine outreach, harmonizing home and facility tools and ensuring policy-level support can foster a more resilient and inclusive nutrition response in fragile, underserved areas.