Maham Zahid, Rukhsana Khan, Siham Sikander, Tehzeeb Zulfiqar.
Are LHWs equipped enough to detect malnutrition in under-5 children? a kap survey of district Rawalpindi.
Pak J Med Res Jan ;55(1):20-4.

Background: Malnutrition remains one of the major problems in developing countries including Pakistan. Despite raised awareness, there is little improvement in nutrition indicators in Pakistan, which calls for identification of the causes of stagnant rates. Objectives: To assess the proficiency of lady health workers (LHWs) to detect malnourishment in under-5 children using Salter scales and growth charts. Study design, settings and duration: Cross sectional study done in district Rawalpindi from May to August 2013. Subjects and Methods: Knowledge and skills of 59 LHWs related to growth charts were determined by cross-sectional method; and availability of tools were assessed by a short survey in district Rawalpindi. Results: None of the LHWs had growth chart while Salter-weighing scale was available with 34 (57.6%). In knowledge assessment 78.8% LHWs scored good marks (above 80%) while 19.2% scored average (60-79% marks). Skills of LHWs related to child weighing were satisfactory but major deficiencies were noted regarding hanging the Salter-scale to stable support and tarring the scale-needle to zero reading. Conclusion: For timely identification of malnutrition in children, availability of Salter-weighing scales and growth charts must be ensured with the LHWs. Policy message: LHWs trainings should be updated with frequent trainings and refresher courses. They should be provided with updated materials like charts for Weight-for-Height and Mid-Upper Arm Circumference (MUAC) measuring tapes. Key words: Lady health workers, under-5 nutrition, malnutrition, growth charts, severe acute malnutrition.

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