Predicting Low Birth Weight: A comparison of Anthropometric Measurements taken by Midwives and Community Health Workers in Uganda

Abstract

Abstract; Background In many resource constrained countries Uganda inclusive, women continue to give birth from home/in the community where there are no weighing scales to measure and record birth weight. There is also lack of enough weighing scales and skilled health personnel at health facility level to ensure that birth weight for every child is timely determined. Birth weight is an indicator of the chances for survival, growth, long-term health and psychosocial development of neonates. Different anthropometric parameters are reliable surrogates of birth weight although they are highly contextual. This study assessed the best anthropometric surrogate of birth weight usable at facility and community levels in western Uganda. Methods A cross sectional study was conducted between July and September 2017, whereby anthropometric values of 553 neonates born at Mbarara Regional Referral Hospital were measured by two midwives and later repeated by two community health workers to determine the reproducibility. Data regarding birth weight, height, foot length and circumference of head, mid upper arm, chest, thigh and calf were collected and recorded. Frequencies, percentages and mean and standard deviation were used to describe categorical and continuous demographics of neonates respectively. Pearson correlations, specificity, sensitivity, likelihood ratios, diagnostic odds ratios and area under the curve (AUC) were determined and used to establish the most reliable anthropometric parameter that best estimates birth weight of neonates. Results Chest Circumference was the most reliable parameter (AUC= 0.89, DOR= 33.57). There were statistical significant mean differences in all the anthropometric measurements made by midwives and CHWs except for chest circumference (Mean difference = 0.03 cm, 95% CI: -0.22-0.29, p = 0.7963) and foot length (Mean difference = 0.03 cm, 95% CI: -0.22-0.29, p = 0.7963). Conclusions Chest circumference taken within 24 hours after birth is the best nthropometricsurrogate measure of birthweight. Community Health workers can measure chest circumference with almost the same accuracy like midwives.