Family-led mid-upper arm circumference (FL-MUAC) approach and the screening of acute malnutrition in children aged 6 to 59 months in Africa: a scoping review

Introduction: family-led mid-upper arm circumference (FL-MUAC) is a community-based acute malnutrition screening approach that is centered on training the mother or caregiver to use colour-coded MUAC tapes to screen children for malnutrition. A scoping review was conducted to summarise available evidence and evaluate the use of the FL-MUAC approach in the screening for acute malnutrition in Africa. A systematic literature search was performed using electronic databases to identify relevant research documents investigating the FL-MUAC approach. The search sources included PubMed, Google Scholar, and institution websites such as the Emergency Nutrition Network (ENN) and The State of Acute Malnutrition. Documents were screened and assessed for eligibility and data was extracted from the eligible documents. Twelve documents were eligible for review based on the inclusion and exclusion criteria. Eight peer-reviewed articles and four operational documents were included in the scoping review. The results show that the FL-MUAC approach has been used by mothers and caregivers to monitor their children's nutrition status in sixteen countries including Zimbabwe, Niger, Kenya, Chad, and Mali. In the sixteen countries where the approach has been implemented, there has been evidence of improved acute malnutrition screening coverage and increased frequency of screening, low hospitalization rate, and high cure rate of malnutrition cases attributed to the FL-MUAC approach. In conclusion, the FL-MUAC approach is still being piloted in most African countries. In addition, available evidence shows that FL-MUAC has the potential to be effective in early diagnosis and improved coverage for acute malnutrition. However, there is a need to integrate the FL-MUAC into healthcare systems and promote the standardization of monitoring and evaluation indicators.