Percent of women with a low mid-upper arm circumference (<22.5)
The percent of women with a mid-upper arm circumference (MUAC) below 22.5 cm (ACC/SCN, 1992).
This indicator is calculated as:
(Number of women ages 15 to 49 with mid upper arm circumference <22.5cm / Total number of women between the ages of 15-49) x 100
For a related MUAC indicator used to screen women with HIV, see “Percent of HIV positive women who have mid-upper arm circumference <21 at first postnatal visit within 6 weeks of delivery,” in section on Women’s Nutrition and HIV and A Guide to Screening for Food and Nutrition Services Among Adolescents and Adults Living With HIV (Fanta, 2010).
A measure of MUAC in women of reproductive age (15-49). Data can be disaggregated by age grouping, reproductive status, and, where available, relevant socioeconomic and demographic factors such as education, income, and urban/rural residence.
DHS or other population-based surveys; health facility records.
The measurement of MUAC is commonly used as an indicator of malnutrition and wasting in children. MUAC can be used as an indicator of maternal nutritional status in non-pregnant women because of its high correlation with maternal weight and weight for height, as well as, during pregnancy to screen for risk of low birth weight and perinatal mortality (Krasoved and Anderson, 1991). Increases of MUAC during pregnancy are generally less than .05 cm and it can be considered a proxy indicator for women’s pre-pregnancy or early pregnancy weight (Krasovec and Anderson, 1991; WHO 1995). The same cut-off value can be used to define undernutrition in both pregnant and non-pregnant women because of the slight change of values change during pregnancy. Since MUAC is correlated with pre-pregnancy weight, it may be useful for identifying pregnant women at risk of IUGR, especially where scales are not available (WHO, 1995).
MUAC is easily obtained in clinical settings or during population-based surveys. The measuring tapes are portable and inexpensive, and persons with limited education or experience can learn to take this measurement accurately. The measurement of MUAC not only yields useful data, but also raises awareness about nutritional status among those participating in the study. MUAC is used primarily for screening, because it changes slowly in large populations. However, it is potentially useful for evaluating the impact of interventions in a given (limited) population. In settings with limited infrastructure and resources, MUAC may be the most feasible anthropometric indicator to use.
MUAC is primarily used for screening rather than evaluation purposes. Although the correlation between MUAC and pre-pregnancy weight is statistically significant, the association is considered too weak to allow MUAC to be substituted for pre-pregnancy weight in individuals (WHO 1995). While the value of MUAC >33 has been used to identify overweight, the cutoff has not been validated for women and pregnancy outcomes.
nutrition, newborn (NB), safe motherhood (SM)
ACC/SCN, 1992, Second Report on the World Nutrition Situation, Geneva: ACC/SCN.
FANTA (Food and Nutrition Technical Assistance) Project. 2010. A Guide to Screening for Food and Nutrition Services Among Adolescents and Adults Living With HIV . Washington, D.C.: Academy for Educational Development. http://www.fantaproject.org/publications/Screening4FNS.shtml
Krasovec, K. and M. Anderson, eds. (1991). Maternal nutrition and pregnancy outcomes: anthropometric assessment. Pan American Health Organization: Scientific Publication No 529.
WHO, Maternal anthropometry and pregnancy outcomes: A WHO Collaborative Study, World Health Organization Supplement 1995: 73:32-37.