Anthropometric knowledge and measurement evaluation among female volunteer community health workers in Depok

Abstract

Background: At the community level, assessment for children nutritional status is measured by female volunteer community health workers (FVCHW) through a monthly integrated health post (Posyandu). Based on initial observation, volunteers have sufficient understanding of anthropometric measurement on a knowledge basis, however, to put it into practice, several common pitfalls remain. As they are not formally trained, refreshment on basic knowledge and practical training on anthropometric assessment is needed.

Objectives: As part of Kampung Caraka Project that attempts to empower locals to be deliberately aware of community health and well-being, this particular study aims to evaluate knowledge of FVCHW as well as their accuracy and precision on anthropometric assessment.

Methods: Thirty nine women participated in this intervention study. Total sampling was performed to involve thirteen integrated health posts in Kedaung Depok. Further, voluntary sampling was applied to select three participants who were FVCHW in their respective post. The inclusion criteria were women who at least had been a cadre for a year and excluded those who did not commit till the end of the program.  Education on anthropometric assessment was given prior to the evaluation. Knowledge evaluation was conducted by validated and reliable pre and post test questionnaires consisting of 10 questions. Accuracy and precision were evaluated for length, height,  mid upper arm circumference (MUAC) and head circumference measurements. Two rounds of independent measurements were carried out to evaluate precision, while accuracy was observed by comparing measurement results to the gold standard. Emergency Nutrition Assessment (ENA) SMART was used to evaluate measurement precision and accuracy. Descriptive analysis was performed to present the level of precision and accuracy. Paired t-test was carried out to test knowledge mean score difference.

Results: Final analysis involved thirty two participants. The measurement results showed women with good precision for MUAC, height, head circumferences and length measurement were 23.1%, 23.1%, 53.8% and 33.3%, respectively. In contrast, most women had poor accuracy for height, length and head circumference measurement, and only 7.7% of women had good accuracy on MUAC measurement. There is a significant difference of knowledge score before and after the education given (p-value 0.02, CI 95%).

Conclusions: Women participating in this study had good precision yet poor accuracy, implying the necessity of standardized procedure and regular equipment calibration prior to anthropometric measurement. There is a difference in mean scores before and after the education given, yet still denoted as low capacity. Further and more comprehensive education is highly required.