Dear Estelle,

Even, if the rural areas are only accessible by motorbike. I would prefer the wood locally (or manufactured) measuring boards as you need a strong/resistant tool.
As we generally do in SMART Nutritional survey.
Plastic board are fragile and should be imprecise if damaged by transport or during field utilization.
You could consider the option of resistant locally made bag-pack (in denim for example) for board transportation or even directly strap the wood board to the back of field worker.
Hope its helps

Hi Stella,
To help answer your question it is useful to understand the purpose of the measuring - is it a survey or surveillance or growth monitoring etc? frequency - one-off, monthly, quarterly? can you train people in the community to use the measuring board so it does not have to be transported in/out of the community?
kind regards,
El

Thank you both for your input.

El- the objectives is growth monitoring during outreach visits by health center staff. The area we are working in is very large, consisting of a few hundred villages. We have plans to conduct a pilot in one catchment area to train village health volunteers to perform growth monitoring, and each volunteer will have a board for use in the village. If the model is successful we want to expand this to all areas, however this will take time.

I think the best option will be to provide a measuring board with carry straps to each village, this will reduce the distance the outreach team will need to transport the board. This would happen at a later day anyway, so we are just bringing it forward. These can then be used by the village health volunteers once we roll out the volunteer project to all areas at a later date.

Many thanks, this really is a great way of nutting out problems. Your advice is very appreciated.

We have a solution for the existing bulky, unsafe wooden htboard. This innovation was the product from field experences and lessons learned in the implementation on the WHO CGS program. ALLENSTICK measuring made easy is made up of aluminum which utilizes laser engraving tech for bold, accurate and clearer numerical symbols. It weigh less thans 2.5kg. Safe to use no bulky and heavy head piece. Provided with pictogram for easy instruction. The instrument is provided with backpack bag for weighing scale and other supplies necessary for health worker on the move. It very convenient, more affordable, safe, can save our trees , and most off all durable and accurate as compared to wooden board that is affected by moisture and shrinkage.

Thank you Allen, do you have a link to a website that sells them? I have googled it, but can only see your blog post and presentation on the product.

Question for Dr Allen: What is the basis for saying that the ALLENSTICK is more accurate than the wooden height board? Is there a study done to support that claim?

Thank you.

Dear Estelle,
Thanks for sharing more details on the program. From your response I think you have come to the conclusion that the best option is that each volunteer have their own height board.

An important fact to take into consideration is that its promotion, support and protection of IYCF, maternal nutrition and WASH that will address the underlying causes of malnutrition in the families and communities. The act of growth monitoring wont.

In a limited resource setting (human and/or non-human) its more effective to focus on maternal nutrition, WASH and IYCF than on the process of measuring children. Often GMP with all good intentions just ends up measuring children because it takes time to do a good height measurement and it needs more than one person.

By your description the volunteer will travel house to house to measure eligible children, this is quite cumbersome. It may work in a pilot because of the additional resources but it will be very challenging to scale up and sustain and importantly handover to the local government. Therefore, very important to consider the strategy, goal/purpose, the activity and the desired outcome.

Wish you and the volunteers all the best.
El

Dear El,

Thanks for the considered response and the encouragement to look at the effectiveness and sustainability of the project.

The growth monitoring is part of a broader approach to addressing the issue of malnutrition. We are working within the Government system, which requires that child growth be monitored regularly, therefore one of our objectives is to ensure that this is done correctly. This will be done in conjunction with the promotion of good IYCF behaviors and counseling for parents with malnutrition. Our focus will be on supplementing existing govt. nutrition training for health staff with workshops that emphasize practicals, where staff can build and practice their skills using case studies. This will then be supported with supervision.

The VHV program is also part of Govt. policy, but yes, to be done correctly it will require a big commitment both in terms of funding and human resources. Past projects show that whilst enthusiasm is often strong, results are often not good. There are some fundamentals issues with the system which would need to be addressed for it to work, and as you say, these may mean the activities would be unsustainable. We are currently working with govt to decide if this is indeed the best use of efforts and resources.

Really appreciate your feedback and questions and very open to any other comments you may have!

Best wishes,

E

Dear Estelle,
Not knowing the country its makes it difficult to fully understand the situation.

In resource "poor" situations one option of doing GM regularly is to limit height measurement to be done only at health facilities. And outreach can focus on promotion (maternal nutrition, IYCF, WASH, immunisation, IMCI) and screening for SAM using MUAC and referral to nearest health facility. Its important to address all the underlying causes of malnutrition, based on UNICEF's conceptual framework of malnutrition.

Best wishes,
El

 Dear  All,

 Is there any  other option rather  than stadiometer? Our volunteers  are facing difficulty  in  carrying the wooden one.

My opinion too, how do we scale up community based height measurement? What

type can be used?