Peer-reviewed article
Acceptability, feasibility, appropriateness, uptake and cost perceptions of family mid-upper arm circumference supported by two-way SMS in western Kenya.
Choo EM, Lara-Arevalo J, Achieng C, Odhiambo M, Okello MA et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study examines how caregivers and healthcare workers in western Kenya experienced Family MUAC, an approach where caregivers learn to measure children's mid-upper arm circumference to detect wasting early, supported by two-way text messaging with health workers. The intervention was widely accepted and seen as cost-saving and empowering, with high uptake among caregivers. Main barriers included inconsistent measurements and phone-sharing difficulties, while direct communication with health workers built trust and reduced unnecessary clinic visits.
Key points
- Caregivers found Family MUAC acceptable, appropriate, feasible, and empowering for early detection of child wasting
- Perceived cost savings occurred because SMS communication reduced unnecessary travel to health centers when children were not malnourished
- High uptake of the intervention was reported among enrolled caregivers
- Barriers to uptake included inconsistent MUAC measurements, limited social support, and issues with phone sharing
- Direct two-way SMS communication with healthcare workers built trust and strengthened patient-provider relationships
Limitations
This qualitative study captures perceptions and experiences but does not measure actual health outcomes or provide quantitative data on measurement accuracy, uptake rates, or cost savings. The sample was purposively selected based on engagement level, which may not represent the full range of user experiences.
Abstract
Early identification and treatment of acute malnutrition can decrease mortality and morbidity related to wasting or low weight-for-height. Teaching caregivers to measure mid-upper arm circumference (MUAC), an approach known as Family MUAC, may support early diagnosis of wasting. Family MUAC paired with mobile support from healthcare workers resulted in a 37% reduction in child wasting in the Mama Aweza trial in Kenya. This study examines the intervention's acceptability, feasibility, appropriateness, uptake, perceptions of cost savings, and factors influencing engagement with Family MUAC. This qualitative study involved eight focus group discussions with caregivers enrolled in the Mama Aweza trial and fourteen in-depth interviews with caregivers who participated in the intervention arm, Family MUAC supported by two-way short message service (SMS). Caregivers were purposively selected based on engagement level with the intervention. Eighteen program staff and healthcare workers from three facilities in western Kenya participated in in-depth interviews. The Theoretical Domains Framework informed design of data collection tools. Caregiver and healthcare worker perceptions of Family MUAC with two-way SMS centered on seven themes. The intervention was viewed as acceptable, cost-saving, appropriate, feasible, and empowering. Caregiver uptake was high, and integrating child growth monitoring with other health services may help enhance sustainability. Barriers to uptake included inconsistent MUAC measurements, limited social support, and issues with phone sharing. Refresher trainings could increase accuracy of MUAC measurements and improve engagement. Direct communication with healthcare workers via SMS built trust and strengthened patient-provider relationships. Caregivers also reported perceived cost savings, as SMS communication reduced unnecessary travel to health centers when children were not malnourished. This study supports Family MUAC with two-way SMS as a promising approach to empower caregivers and highlights their critical role in child health and nutrition interventions. Future interventions can focus on improving measurement accuracy and mitigating negative social influences on caregiver-led interventions.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Family MUAC: teaching caregivers to measure mid-upper arm circumference to identify wasting early, supported by two-way SMS communication with healthcare workers
- Population
- Caregivers of young children in western Kenya enrolled in the Mama Aweza trial; 14 caregivers in intervention arm (in-depth interviews), 8 focus groups with caregivers; 18 program staff and healthcare workers from three facilities
Key finding
Intervention was viewed as acceptable, cost-saving, appropriate, feasible, and empowering by caregivers and healthcare workers