RELIABILITY AND ACCURACY OF ANTHROPOMETRIC MEASUREMENTS PERFORMED BY STUDENT NURSES AMONG INFANTS AGED BETWEEN ZERO TO ONE YEAR IN KILIFI COUNTY HOSPITAL, KENYA
Bogonko, Venah Nyakerario
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Anthropometric measurements are inexpensive and non-invasive way of assessing nutritional status of children. Reliable and accurate anthropometric data is fundamental in monitoring and improving health status of children. Despite the resources, procedures and training on growth monitoring, little research has been undertaken to assess the reliability and accuracy of these measurements among trainee nurses. Unreliability of these measurements may lead to misclassification and inappropriate interventions. The objectives of the study were to assess the inter-observer reliability and accuracy of weight, height, Mid Upper Arm Circumference (MUAC) and their indexes among infants performed by student nurses in Kilifi County Referral Hospital. A cross-sectional study design was applied to establish the reliability and accuracy of anthropometric measurements taken by student nurses. Six students who had already undergone training in anthropometry and had three months practical experience in Maternal Child Health Clinic (MCH) were identified and divided into 2 groups. They were asked to repeatedly measure weight, height/length and MUAC of 320 infants. On every 5thchild (n=60) an additional measurement was taken by a gold standard nutritionist to evaluate their accuracy. Intra-Class Correlation (ICC) coefficient was calculated to evaluate reliability, mean difference and Pitman’s statistic to assess level of accuracy. The Intra-Class Correlation (ICC) coefficient among student for all anthropometric measurements was above 0.9 which indicated near perfect reliability. The student nurses accurately measured weight, length, Weight-for-Length (WFLz) and Weight-for-Age z score (WFAz). The mean difference in student nurses measurement compared to expert for Mid Upper Arm Circumference (MUAC) was -0.096(95% CI -0.141 to -0.050 cms), Height-for-Age z score (HFAz) was 0.006 (95%CI-0.014 to 0.025 z scores) and MUACz was 0.078(95%CI -0.122 to -0.033 z scores). There was evidence that the variance of paired measurements of MUAC, HFAz and MUACz differed from those of the expert (pitman statistic <0.05). Student nurses who had undergone theoretical training but had minimal supervised practical experience in anthropometry reported high reliability and accuracy scores for all anthropometric measurements assessed in this study. However, more studies in different settings would need to be done to enhance generalizability of findings. Key words: reliability, accuracy, anthropometric measurements, infants and malnutrition.