Competence of maternal and child health clinic workers in detecting malnutrition in Somalia.

BACKGROUND The MCH clinic workers in Somalia receive formal and in-service training to perform their professional duties. Their competence in the field was never examined. This study assessed their competencies in detecting malnourished children 5 years and below in Beledweyne. OBJECTIVE To assess the competence of MCH clinic workers in detecting malnourished children. DESIGN Cross-sectional study. METHODS The study was conducted in 1989. We obtained data on children five years and below from the MCH clinic in Beledweyne, Somalia. We analyzed two months data. We used CASP program to calculate the Weight-for-Age index (WFA). The nutritional status determined by the MCH clinic workers and the WFA index were used to estimate the positive and negative predicted values of the MCH clinic workers' competence in detecting malnourished children. RESULTS We studied 487 children 5 years old and below. The health workers determined that 13.5% were malnourished. The positive and negative predicted values of the MCH clinic workers' nutritional measure were 76% and 92% respectively. CONCLUSION The MCH clinic workers showed deficiency in their competence to detect malnourished children. They misclassified 10% of the children, which was worse among the malnourished, due to incorrect plotting of the child's current weight on the growth chart.