Peer-reviewed article
A qualitative study to explore mother's experiences of a family MUAC project in two provinces in South Africa.
Horwood C, Luthuli S, Haskins L, Mapumulo S, Kubeka Z et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study explored how mothers in South Africa experienced a Family MUAC project, which trained them to measure their children's mid-upper arm circumference to identify malnutrition. Fifty-nine mothers across seven sites in Gauteng and KwaZulu-Natal participated in focus group discussions. Mothers valued the support from community health workers, found peer learning helpful, and reported feeling more confident in caring for their children and asking questions at clinic visits. The study found that using community health workers to teach mothers MUAC measurement was acceptable, feasible, and empowering.
Key points
- Mothers appreciated CHWs for being patient, caring, and taking time to develop their skills
- Mothers initially found measuring MUAC challenging but gained confidence with CHW support
- Group learning was positive and mothers helped each other learn about MUAC measurements
- Participating in Family MUAC empowered mothers in child care and improved their relationships with CHWs
- Mothers became more confident to ask questions during clinic visits after participating in Family MUAC
Limitations
This is a qualitative study based on focus group discussions with mothers who were actively participating in the program, so it captures experiences of engaged participants and may not reflect perspectives of non-participants or those who dropped out. The study does not measure actual health outcomes or changes in malnutrition rates among children.
Abstract
Background In South Africa, severe acute malnutrition remains a significant cause of child mortality. Measuring mid-upper arm circumference (MUAC) is a simple, cost-effective approach to identify malnutrition in communities. The Family MUAC intervention supported community health workers (CHWs) to mentor mothers and child caregivers to measure MUAC, record their findings and access nutrition information from the child's Road-to-Health-Book. Family MUAC was implemented in seven sites in two provinces in South Africa: Gauteng and KwaZulu-Natal. This study aimed to explore mother/caregiver's perceptions and experiences of participating in Family MUAC. Methods Focus group discussions (FGDs) were conducted with mothers purposively selected by CHWs based on their active participation in Family MUAC. Trained qualitative researchers conducted one FGD at each participating site. Coding reliability thematic analysis with topic summaries was employed to analyse the data using Nvivo v12. Results Seven FGDs were conducted with a total of 59 participants. Key themes identified were mother's perceptions of the CHW's role, experiences of implementing Family MUAC activities, and perceptions of the broader effect on maternal empowerment and child health. Mothers appreciated the support from CHWs who were perceived as patient and caring, taking time to develop mother's skills and answer questions. CHWs provided ongoing care, encouraged participation and understood the mother's home situation. Mothers experienced group learning positively, and helped each other learn about MUAC measurements. Most mothers experienced measuring MUAC as challenging initially, needing support from CHWs to gain confidence to measure and record findings. Participating in Family MUAC empowered mothers in caring for their child, and improved their relationships with CHWs. Mothers compared support from CHWs to care received at the clinic, saying clinic visits were costly and time-consuming and nurses frequently did not explain their findings. Mothers reported feeling more confident to ask questions during clinic visits after participating in family MUAC. Conclusions Using CHWs to support mothers measuring MUAC in households was acceptable and feasible. CHWs provided ongoing good quality care, relevant advice and support, and empowered mothers. Family MUAC had wide ranging benefits for building relationships and peer support in communities and strengthened mothers perceived role in the care of her child.