MUAC Screening for Malnutrition; Disparities Across LGAs and Performance in Bayelsa State

Introduction Malnutrition remains a critical threat to child survival in Nigeria, especially in ecologically vulnerable states like Bayelsa. Although the Mid-Upper Arm Circumference (MUAC) tool is widely used for early detection of severe acute malnutrition (SAM), disparities in screening coverage and case detection across local government areas (LGAs) remain under-explored. This study assessed regional MUAC screening performance during the June 2025 Maternal, Newborn, and Child Health (MNCH) Week in Bayelsa State, with a focus on identifying disparities in screening distribution and SAM prevalence. Methodology A cross-sectional quantitative design was adopted, using secondary program data from the Bayelsa State OPS Room Final Report. The dataset included MUAC screening indicators across eight LGAs. Variables analyzed included the number of children screened, Red MUAC cases identified, screening coverage percentage, and Red MUAC prevalence. Descriptive statistics and Pearson correlation analysis were conducted using Python and SPSS to examine trends and relationships.

Out of 538,813 children screened, significant disparities were observed across LGAs. Ogbia LGA accounted for over 52% of screenings, while Ekeremor and Nembe contributed less than 8% combined. Red MUAC prevalence varied from 0.03% to 1.78%, with Nembe recording the highest burden. A moderate positive correlation (r ≈ 0.41) was found between screening coverage and Red MUAC detection, indicating that higher screening volume did not always equate to higher detection efficiency.

The study revealed operational and equity gaps in MUAC screening implementation across Bayelsa State. Disparities in both screening coverage and SAM detection underscore the need for data-driven planning, targeted deployment, and health system strengthening. These findings highlight the importance of regionalized nutrition surveillance to ensure equitable service delivery, particularly for high-risk and hard-to-reach populations. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study received ethical approval from: Bayelsa State Primary Health Care Board Research Ethics Committee (BSPHCBREC) Bayelsa State Primary Health Care Board, Yenagoa, Nigeria. Decision made: The BSPHCBREC granted full ethical approval (Approval No; Ref: BSPHCB/ERC/2025/112) for this study on 2nd of June 2025, waiving the need for individual participant consent as the research involved secondary analysis of anonymized programmatic data from the Maternal and Child Health Week (MCHW) OPS Room Report. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present work are contained in the manuscript