How to Measure Arm Circumference with Shakir’s Strip
Last Updated July 31, 2025, 9:23 a.m.
Health practitioners use a simple tool called the Shakir’s strip to assess the nutritional status of children. It’s a quick and effective way to detect malnutrition early so that the right steps can be taken to support a child’s health. This guide will walk you through the correct procedure for using a Shakir’s strip to ensure accurate results.
Procedure
1. Explanation of Purpose and Procedure
Always begin by informing the mother or caregiver about what you’re about to do. Say something like: “The purpose of this measurement is to check your child’s growth and nutritional health using a special measuring tape.”
2. Hand Washing
Wash your hands thoroughly with soap and clean water for at least 20 seconds. Dry them using a clean towel or let them air dry. Good hygiene helps prevent the spread of disease.
3. Prepare the Materials
- Place clean Shakir’s strips in a kidney dish and put it on a tray for easy access.
- Ensure each strip is in good condition with clear green, yellow, and red color zones.
4. Expose the Child’s Upper Arm
Ask the mother to lift the sleeve on the child’s left upper arm. If the left arm can’t be used, the right arm is an acceptable alternative. Make sure the strip touches the bare skin.
5. Find the Midpoint of the Upper Arm
Use your fingers to locate the top of the shoulder (acromion) and the tip of the elbow (olecranon). Measure the midpoint between these two points.
6. Apply the Shakir’s Strip
- Wrap the strip around the mid-upper arm, keeping it flat and snug.
- It should not be too tight or too loose. Avoid twisting the strip.
7. Read and Interpret the Measurement
- Green: Well-nourished.
- Yellow: Moderate malnutrition.
- Red: Severe acute malnutrition.
Record the measurement in centimeters and the corresponding color zone.
8. Explain the Result to the Mother
- Green: “Your child is growing well and is healthy!”
- Yellow: “Your child needs a little more food to grow strong. We’ll monitor this closely.”
- Red: “Your child needs urgent help with food and health care. We’ll take action right away.”
9. Dispose or Clean the Strip
If the strip is single-use, discard it properly according to your facility’s guidelines. If it’s reusable, clean and disinfect it thoroughly before the next use.
10. Provide Follow-Up Advice
- Green: Encourage continued healthy feeding and return for regular checkups.
- Yellow: Recommend more frequent and nutritious meals. Ask them to return in 2 weeks or 1 month for another check.
- Red: Refer the child immediately to the nearest health facility for urgent care and provide clear instructions on where to go.
By following these steps carefully, community health workers can play a key role in identifying and responding to malnutrition, giving every child a better chance at a healthy life.
Total: 20 Marks
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