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Proposed by: Cyrus Shahpar
Contact (name, email, phone, skype): Cyrus Shahpar, globalhealth@gmail.com
Best way and times to contact during RHoK 2.0 Dec 4/5 2010: email
Malnutrition is common in natural disasters, especially in prolonged emergencies such as floods. Currently, measures of height, weight and age are used to define whether a person is underweight/overweight (weight and age), stunted or tall (height and age), or wasting/obese (weight and height). Determination of height (or length if less than 2 years old) is a cumbersome process, because children are measured using a heavy wooden board that must be carried to each assessment. More rapid accurate assessment of height or length would be extremely helpful to assessing malnutrition in emergencies. Ideally, the solution would be an open source application for a camera-enabled mobile device (e.g. Android tablet or phone) that could accurately calculate the height or length of a person. It would also be helpful to include inputs for age and weight, so that the software could calculate whether the person was stunted/wasted/underweight.
An NGO wants to do a rapid assessment of malnutrition in a relief camp. A surveyor goes to the relief camp with their HeightCatcher enabled device and performs rapid measurements of malnourished infants in real time. They can immediately calculate the individual and camp burden of malnutrition and text the results to the local office. This information is used to direct relief efforts and share with partners
Currently, the relief camp worker comes to the camp carrying a heavy wooden board that is relatively expensive to make. The board is used to measure the affected population, but those recording measurements often round the height to the nearest 0.5cm, because the 1mm markings are so small that it is easier to round. This impacts data quality because the smallest measurement error can affect the categorization of nutrition status.
An NGO wants to do a rapid assessment of malnutrition in a relief camp. A surveyor goes to the relief camp with their HeightCatcher enabled device and performs rapid measurements of malnourished infants in real time. They can immediately calculate the individual and camp burden of malnutrition and text the results to the local office. This information is used to direct relief efforts and share with partners.
Must use an open source application that can be loaded on a camera-enabled mobile device
Malnutrition calculations and the ability to SMS results
Background on assessment of nutritional status by anthropometry
Anthropometry is the measurement of the human body. It is a quantitative method and is highly sensitive to nutritional status, especially among children. There are different types of measurements (Beaton, et al 1990).
1. Height/ length for age Low height-for-age index identifies past under nutrition or chronic malnutrition. It cannot measure short-term changes in malnutrition. For children below 2 years of age, the term is length-for-age; above 2 years of age, the index is referred to as height-for-age. Deficit in height / length for age is referred to as stunting. Length is measured below 85 cm; height is measured 85 cm and above. Recumbent length is on average 0.5 cm greater than standing height, although the difference is of no importance to the individual child. A correction may be made by deducting 0.5 cm from all lengths above 84.9 cm if the standing height cannot be measured (WHO, 2000).
2. Weight for age Low weight for age index identifies the condition of being underweight, for a specific age. The advantage of this index is that it reflects both past (chronic) and/or present (acute) under nutrition, although it might not be possible to distinguish between the two.
3. Weight for height/ length Low weight for height helps identify children who suffer from current/ acute under nutrition or wasting and is useful when exact ages are difficult to determine. Weight for height/ length is appropriate for examining short term effects such as seasonal changes in food supply or short term nutritional stress brought about by illness. The above three indices are used to identify three nutritional conditions, stunting, underweight and wasting, respectively. Underweight: Underweight, based on weight for age, is a composite measure of stunting and wasting and is recommended as the indicator to assess changes in the magnitude of malnutrition over time. There is a relationship between the prevalence of underweight and several national indices such as gross national product (GNP), female education, governmental social support, sources of energy foods, and distribution of income (UN Report, 1992).
Stunting: Low height/ length for age, stemming from a slowing in the growth of the fetus and the child and resulting in a failure to achieve expected length as compared to a healthy well nourished child of the same age, is a sign of stunting. Stunting is an indicator of past growth failure, constituting a proxy for chronic malnutrition. It is associated with a number of long term factors including chronic insufficient protein and energy intake, frequent infection, sustained inappropriate feeding practices and poverty. In children over 2 years of age, the effects of these long-term factors may not be reversible. Data on prevalence of stunting in a community may be used in problem analysis in designing interventions. Information on stunting for individual children is useful clinically as an aid to diagnosis. Stunting, based on height for age, can be used for evaluation purposes but is not recommended for monitoring, as it does not change in the short term such as 6 - 12 months.
Wasting: Wasting is the result of the weight falling significantly below the weight expected for a child of the same height/ length. Wasting indicates current or acute malnutrition resulting from failure to gain weight or actual weight loss. Causes of that include inadequate food intake, incorrect feeding practices, disease, and infection or, more frequently, a combination of these factors. Wasting in individual children and population groups can change rapidly; it shows marked seasonal patterns associated with changes in food availability or disease prevalence to which it is very sensitive.
If an application can be developed with some accuracy, then it will be tested in the field and compared to current measurement methods.
A worthwhile idea
Currently working on this proposal @ RHoK 2.0 Birmingham
RHOK Birmingham
We've created an app that uses a reference object and allows users to infer the height from that.
Source is available at
https://github.com/RHOKBrum/HeightCatcher
You can download an .apk of the app from
http://dl.dropbox.com/u/2940359/HeightCatcher.apk
Blog entry describing Height Catcher with video