Performance of surrogate markers of low birth weight at community level in rural India.

Low birth weight (LBW) is the most important determinant of infant mortality rate (IMR). In India, the current IMR is around 72 per 1000 live births and prematurity and LBW account for 49.6% of infant mortality as reported by the government of India in 1990. 3 To reduce the IMR, early identification, prompt referral and management of low birthweight babies is essential. In India, 80% to 90% of the roughly 20 million births in rural areas, occur at home and are conducted by illiterate and often untrained traditional birth attendants (TBAs). Provision of valid weighing scales at domiciliary level poses logistic (carrying a heavy scale), as well as, operational problems (inability of TBAs to read ). Also, because of sociocultural reasons, parents are reluctant to get their children weighed immediately after birth. To overcome these problems. various surrogate measures like mid-arm circumference (MAC), chest circumference (CC), etc, have been assessed for appropriateness of use to detect LBW newborns. In an earlier paper, we had identified cut oV points for CC and MAC in hospital births to detect low birthweight newborns. Here, we describe the feasibility and validity of the two indicators in identifying low birthweight babies under field situations using health workers.