It is known that the first quarter of the year is one of the busiest times for the nutrition workers especially the Barangay Nutrition Scholars for the conduct of Operation Timbang (OPT) Plus.

OPT Plus is the annual weighing and height measurement of all preschool children 0-59 months old. This is conducted to identify and locate the malnourished children for referral to relevant nutrition and nutrition-related services.

Among the indicators quantified during OPT Plus is the number of underweight and severely underweight children. Weight gain is an indicator of growth while weight loss or no change in weight are indicators of poor growth.

Taking weight includes the proper measurement tools to ensure accuracy. The hanging weighing scale is commonly used during the OPT Plus. The scale can weigh up to 25 kg and is graduated by 0.1kg (100g) increments.

Prior to weighing of children, a few reminders must be observed:

• Hooks are complete and in good condition. Needle or pointer is moving freely.
• Adjustment screw is working and weighing pants are clear and without tear.
• Rope is strong, long enough, and tied well.
• Nutrition workers should make sure that the weighing scale is within tolerable limits of accuracy and detect equipment deterioration beyond the tolerable levels of accuracy.

It is important to calibrate the weighing scales prior to its use to ensure the reliability and accuracy of the tool because all measuring devices degrade over time. This is typically caused by normal wear and tear.

In weighing the young children, the procedures in proper weight taking should be noted:

• Hang the weighing scale from a tree branch, ceiling beam or pole.
• Attach empty weighing pants to the hook of the weighing scale, adjust the scale to zero, and then remove from the scale.
• Check if the face or dial of the weighing scale is at eye level, not lower or higher and check if the child is barefoot, in minimum clothing and with empty pockets. Ask mother or someone to hold the child.
• Put the measurer’s hands through leg holes. Gently pull legs through the leg holes making sure that the strap is in front of the child.
• Put arms around the child and attach the strap of the weighing pants to the hook of the scale and allow the child to hang freely.
• Check the child’s position. Make sure the child is not touching anything.
• Hold the weighing scale and read the weight at eye level to the nearest 0.1kg. Read the measurement when the weighing scale’s needle is moving. Record data.
• Put arms around the child and gently lift the child by the body. Remove the strap from the weighing scale. Give the child to mother or caregiver and remove the weighing pants.

Weighing scales to be used must be calibrated before the beginning of the weighing activity and every after weighing of 10 children to maintain its  accurateness.

In light of the current COVID-19 pandemic, the National Nutrition Council released Memorandum No. 010 “Interim Guidelines in the Conduct of OPT Plus, Nutrition Screening, Growth Monitoring and Promotion (GMP) activities in the context of COVID-19 Pandemic and other related disasters.”

The memorandum emphasizes the following preparatory steps in weighing children:

• Nutrition workers should thoroughly disinfect the weight and other frequently-touched surfaces using diluted household bleach solutions or alcohol solutions with at least 70% alcohol after every use and between measurements.
• Ensure physical safe distance between the mothers/caregivers and their children with the members of the OPT Team until their measurements can be taken. Members of the OPT Team wear face masks, face shield and gloves when taking measurements. Mothers/caregivers should also wear face masks and face shields. Strictly follow the latest guidelines of COVID-19 Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Diseases.

Minding the correct steps of measuring a child’s weight is important to generate accurate measurement. A big salute to all nutrition workers for their dedication in the frontlines of nutrition service delivery amid the COVID-19 situation. (NO I Vazamija Therese A. Villasi, RND)

References:

Food and Agriculture Organization of the United Nations and National Nutrition Council of the Department of Health. (2017). Electronic operation timbang plus tool user’s guide. Retrieved from http://www.fao.org/3/i6847en/I6847EN.pdf

Inter-agency Technical Working Group on Child Growth Standards. (12 January 2012). Implementing guidelines on operation timbang plus (OPT +). Retrieved from https://www.nnc.gov.ph/phocadownloadpap/userupload/elavapie/OPT%20Plus%20Guidelines.pdf

National Nutrition Council and University of the Philippines Los Baños. 2013. Trainer’s Manual on Basic Course for Barangay Nutrition Scholars. Manila:Philippines.