MUAC tape helps caregivers safeguard their children against wasting during the pandemic
As COVID-19 restrictions suspended health services in Kupang, caregivers learned how to screen their children for wasting at home.
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When 22-month-old Jevan was discharged from the puskesmas (health centre) in March, his mother Magdalena Naimuni was filled with joy, but also worry. After being treated for more than a month for severe wasting, Jevan’s nutritional status had returned to normal.
To avoid relapse, Jevan needed to be regularly screened for any recurrence of wasting in a posyandu (community health post). But as he was discharged, COVID-19 restrictions began to suspend health services in Kupang municipality.
“I clearly remember the health staff telling me that I should take Jevan to the posyandu every month so that his nutritional status could be closely monitored,” said Magdalena. “But the posyandu services were postponed and visits to the puskesmas were also limited, so I had no way of knowing if Jevan had a problem.”
Jevan was one of over two million children suffering from severe wasting in Indonesia, the most dangerous form of undernutrition. If left untreated, it can lead to dire short-term consequences, including a nearly 12-fold increased risk of dying due to a weak immune system. In the longer term, physical growth and mental development can also be adversely affected.
In Indonesia, 6.2 million children under five – about 10.2 per cent – are wasted, or acutely malnourished, the third highest number in the Asia-Pacific region. In East Nusa Tenggara Province where Jevan and his family live, more than 12 per cent of children suffer from wasting, while 42 per cent suffer from stunting, or chronic malnutrition.
Although potentially deadly, wasting can be treated through integrated outreach services at the community level. But as the pandemic forced local authorities to implement measures to slow the spread of the virus, parents like Magdalena feared that these services could be impacted indefinitely.
“I can smile because Jevan is cured, but how long will this pandemic last?” she said. “What if Jevan suddenly gets sick, how could I take him to puseksmas? This haunted me every time I saw Jevan playing and cheerful. I didn’t want to take any risk of knowing too late that my child was malnourished.”
When 22-month-old Jevan was discharged from the puskesmas (health centre) in March, his mother Magdalena Naimuni was filled with joy, but also worry. After being treated for more than a month for severe wasting, Jevan’s nutritional status had returned to normal.
To avoid relapse, Jevan needed to be regularly screened for any recurrence of wasting in a posyandu (community health post). But as he was discharged, COVID-19 restrictions began to suspend health services in Kupang municipality.
“I clearly remember the health staff telling me that I should take Jevan to the posyandu every month so that his nutritional status could be closely monitored,” said Magdalena. “But the posyandu services were postponed and visits to the puskesmas were also limited, so I had no way of knowing if Jevan had a problem.”
Jevan was one of over two million children suffering from severe wasting in Indonesia, the most dangerous form of undernutrition. If left untreated, it can lead to dire short-term consequences, including a nearly 12-fold increased risk of dying due to a weak immune system. In the longer term, physical growth and mental development can also be adversely affected.
In Indonesia, 6.2 million children under five – about 10.2 per cent – are wasted, or acutely malnourished, the third highest number in the Asia-Pacific region. In East Nusa Tenggara Province where Jevan and his family live, more than 12 per cent of children suffer from wasting, while 42 per cent suffer from stunting, or chronic malnutrition.
Although potentially deadly, wasting can be treated through integrated outreach services at the community level. But as the pandemic forced local authorities to implement measures to slow the spread of the virus, parents like Magdalena feared that these services could be impacted indefinitely.
“I can smile because Jevan is cured, but how long will this pandemic last?” she said. “What if Jevan suddenly gets sick, how could I take him to puseksmas? This haunted me every time I saw Jevan playing and cheerful. I didn’t want to take any risk of knowing too late that my child was malnourished.”
Empowering caregivers at home
In May, when local COVID-19 restrictions were still in place, Magdalena was visited at home by Mama Mansur, a community health worker supported by the District Health Office and UNICEF. During the visit, Mama Mansur showed Magdalena how she could check Jevan’s nutritional status herself by administering the mid-upper arm circumference (MUAC) test.
The MUAC test uses a tape to measure the circumference of a child’s arm with red, yellow and green indicators that can determine if they are malnourished. If the child measures red, then they are severely wasted and need immediate treatment. A yellow measurement indicates moderate acute wasting while a green one shows that the child is healthy. Mama Mansur taught Magdalena how to use the test and instructed her to take her son’s measurement once a month.
While the test is simple, it took time for Magdalena to learn how to do it correctly. The next month, she measured Jevan’s arm and saw that the result was yellow – indicating moderate malnutrition. Worried that Jevan may have relapsed and become malnourished again, she measured his arm twice more and saw that the results were also yellow before calling for help.
When Mama Mansur returned to her home, she guided Magdalena to measure Jevan’s arm properly. This time, the result was green, meaning that Jevan was healthy. Magdalena was relieved, realizing that she had pulled the tape too tightly before. Before leaving, Mama Mansur also counselled her on infant and young child feeding to provide healthy, safe and diverse complementary foods according to Jevan's age to help maintain his healthy nutritional status.
During the pandemic, UNICEF is working with health authorities in Kupang to provide MUAC tapes and support to parents and caregivers so they can monitor their children’s nutritional status and seek help if needed.
“Even before COVID-19, severe wasting was a persistent threat to millions of Indonesian children,” said Blandina Rosalina Bait, UNICEF Indonesia Nutrition Officer. “With the pandemic putting malnourished children at an ever-high risk, it is critical to strengthen the capacity of families with tools like the MUAC tape for early detection of child wasting to prevent a deterioration in children’s nutrition status.”
After learning how to monitor and feed her son, Magdalena is hopeful as she sees Jevan slowly progressing. These days, he is more active around the house and is filling out his once gaunt frame. Magdalena is determined to continue following all the advice she has been given, knowing that she can help keep him healthy at home.
UNICEF is grateful to the Government of Japan for their support to keep the most vulnerable children healthy and protected during the COVID-19 pandemic.
