# D2A: a community-led smartphone tool for malnutrition screening in Kenya

## TL;DR

D2A is a smartphone app developed in Kenya to help monitor child malnutrition through self-reporting by families, showing it can be as effective and cheaper than traditional paper-based methods.

## Contribution

The study introduces D2A, a community-led smartphone app for malnutrition screening, demonstrating its feasibility and cost-effectiveness in remote areas.

## Key findings

- App-based self-reporting showed similar accuracy to traditional methods in identifying malnourished children.
- CHV-assisted households had a 15% higher completion rate compared to unassisted households.
- App-based collection was found to be more cost-effective over seven months.

## Abstract

Timely assessments of child acute malnutrition are essential for effective treatment and prevention of undernutrition. We developed a simple smartphone app, D2A (“Data to Analysis”), to enable regular self-collection of Family MUAC (Mid-upper Arm Circumference) and key household drivers of wasting by mothers and caregivers. Based on a seven-month pilot study with 180 households, we explore the acceptance, accuracy, and cost of app-based self-collection of Family MUAC with and without the assistance of Community Health Volunteers (CHVs) relative to paper-based nutrition screenings. Results indicate: (i) similar classification accuracy of wasted children; (ii) no difference in participant dropout rates and a 15% higher completion rate for CHV-assisted reporting by households (compared to no assistance); (iii) lower cost for app-based collection amortized over seven months. Preliminary evidence suggests that self-reporting by households via smartphone apps constitutes a feasible alternative to less frequent, more costly paper-based nutrition screening, the latter more susceptible to interruption in remote, hard-to-access areas.