| dc.description.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. | en_US |
