How It Started

Two years ago, Dr. Susan Abdel-Rahman, director of healthcare innovation for the Children’s Mercy Research Institute developed an inexpensive, paper-based device that resembles a traditional measuring tape. The MUAC z-score tape includes age specific, color-coded indicators to signal the risk of malnutrition in children. To use the mid-upper arm circumference (MUAC) tool, healthcare providers simply take one of end of the tape, slide it through two slits to create a loop. The provider then can slide the loop to the mid-point of a patient’s arm and use the color-coded indicators to assess the risk of malnutrition. All within a matter of seconds.

To produce the tool, Dr. Abdel-Rahman and a small team printed large sheets of the measuring tape on the same tear-resistant paper used in shipping envelopes – and cut each one by hand. Through these efforts, Dr. Abdel-Rahman and Children’s Mercy Kansas City were able to evaluate 10,000 children in just two years. However, with a little extra support from Hallmark, Children International and Abbott, the partnership has become a truly world changing idea – making a positive impact on children’s health around the world. 

Building Key Partnerships

To help improve the MUAC z-score tape, Children’s Mercy connected with two other Kansas City companies, Hallmark and Children International. Hallmark’s team of greeting card experts optimized the color contrast; ensured the paper, printing and cutting met quality standards; determined efficiencies for larger production runs; and provided contacts for local, high-quality printers that could meet the unique requirements for the MUAC z-score tape.

With the improved tools courtesy of Hallmark, Children International then began testing the MUAC z-score tape in Guatemala and India and has since expanded its use to vulnerable communities in nine of the 10 countries where it works. Last year, the organization was able to identify more than 5,000 children in need of nutrition support leading to more treatment programs. 

Connecting to a Network of Half a Million

To further help identify and intervene early in the nutritional challenges of even more children, Children’s Mercy Kansas City connected with the Abbott Nutrition Health Institute (ANHI). ANHI creates educational programming and other evidence-based tools to enhance health outcomes. And, it is connected to a network of half a million healthcare professionals worldwide. This network allows ANHI to serve as an education and awareness-building partner for the MUAC z-score tape. 

“Abbott is committed to helping raise awareness of pediatric malnutrition through education about the importance of early identification and intervention,” said Karyn Wulf, MD, MPH, Abbott medical director. “Through this partnership with Children’s Mercy Kansas City and Dr. Abdel-Rahman, we can connect clinicians around the world to this simple, but effective malnutrition identification tool to help accomplish that goal.”

Building upon this partnership, Abbott recognized that there was an opportunity to do more than just distribute the tool, but also train clinicians on how to use the tool. Through one of these educational training programs, the ANHI Growth Summit, Dr. Abdel-Rahman was able to demonstrate how to use this simple and effective malnutrition screening tool to 150 pediatricians, dietitians and clinicians from more than 20 countries around the world.

With the help of ANHI and its connections, the team has been able to further expand the reach of the MUAC z-score tape. ANHI offers MUAC z-score tape training materials, and an accredited self-study course, free of cost, as well as access to the MUAC z-score tape. More than 4,500 clinicians have accessed ANHI’s MUAC z-score tape educational resources so far.

With its global reach and impact on childhood nutrition and health, The MUAC z-score tape was recently recognized among Fast Company’s World Changing Ideas in Wellness and Developing Nation Technologies for 2021.

Building Strong Partnerships for Health Equity

The unique partnership among Abbott, Children’s Mercy Kansas City, Hallmark and Children International is a great example of four organizations bringing together their areas of expertise and resources to move toward stronger global health equity, and provide global scale and reach for early identification of childhood malnutrition:

• Dr. Abdel-Rahman at Children’s Mercy Kansas City conceived of and developed the MUAC z-score tape
• Hallmark conducted research and testing of the paper-based tool and developed manufacturing recommendations.
• Children International piloted the tape outside of the US, in Guatemala and India, and demonstrated the tool’s effectiveness to support hard-to-reach communities outside of hospital settings; and they are now scaling the tape to be used by communities and caregivers across nine countries.
• Abbott Nutrition Health Institute tapped its network of half a million healthcare providers to increase awareness and provide educational training on the tool.

Fighting malnutrition will require global, multisectoral partnerships to create more world-changing ideas like the MUAC z-score tape. Abbott’s goal is to help make sure more families, healthcare professionals and communities around the world have access to tools and resources that improve health and well-being.