Review of recent innovations in portable child growth measurement devices for use in low- and middle-income countries

Figures & data

Figure 1. Images showing the (a) the portable baby/child length and height measuring board [15] and (b) portable baby/child/adult length and height measuring board [16] currently in use by UNICEF.

Table 1. Key operational/functional requirements for height/length measurement devices as defined in the UNICEF TPP [12].

Operational requirement	Minimum performance	Ideal performance
Accuracy	Field measurement of humans (infants, children and adults) recorded by trained surveyors within ±3 mm	Field measurement of humans (infants, children and adults) recorded by trained surveyors within ± 1 mm
Range	30–215cm
Precision	± 2 mm	±1mm
Temperature	–10 to +45
Humidity	80% relative humidity
Mass	Max. 6 kg	Max. 2 kg
Output display	Clear digital readout in dimly light settings with one decimal digit (mm).	Back-lit LCD screen or similar for low light anti-glare screen with high contrast for bright light reading
Data collection	Reading to remain on the display until the device is activated again.	-Outputs are automatically recorded, and data automatically transferred to the preferred device, even with low battery power. (see data storage capacity under operational/ functional requirements). -Connectivity range within 10 m -Preferably meeting IEC 60601-1:2015 or equivalent Standards for medical Electrical
Price	150–200 USD	300USD
Durability	The device must be able to withstand the intended use during its operational life without compromising functionality or accuracy. The durability can preferably be demonstrated by being compliance to EN 62262 IK 09 or equivalent for impact resistance and compliance to IEC standard 60529, IP53 for water particle size permeability

Table 2. Key physical and public health attributes to consider in the evaluation of available devices.

Physical attributes	Public health attributes
•Transportation – Devices should be portable via multiple means of transportation including cars, motorbikes, boats, public transportation and on foot, often in rough terrain.	•Accuracy – Should allow for the in-the-field measurement of humans accurate to ±3mm.
•Environmental – Temperatures can range from extreme heat combined with high humidity and sunlight exposure to freezing, with extreme freezing being uncommon.	•Training – Field operators usually have a minimum of secondary education but operators with a higher education level are common. The field operator may occasionally have less than secondary level depending on the country and the additional tasks of the operator.
	•Child friendliness - The device must be child-friendly and designed to avoid distress or harm to the child by incorporating soft edges/surfaces and child-friendly colours and illustrations which are gender neutral and appealing to all cultures.
	•Price – The device should cost less than the US $300.

Table 3. The key international standards outlined (ISO) in the UNICEF TPP.

ISO 13485 Quality Standard for Medical Devices [18] – Design, production, installation and servicing of medical devices and related services.

ISO 14001 Environmental Management [19] – This standard helps to protect the environment by preventing adverse environmental impacts, reducing the environmental impact of the organisation and enhancing environmental performance.

IEC60601-1 Basic Performance and Safety Requirements [20] – outlines requirements for medical devices to operate safely in medical and non-medical surroundings, whether used by trained or untrained staff.

BS EN 62262 IK 09 Impact Resistance [21] – outlines the impact strength of electrical equipment and specifies the capacity to which a component can protect against impact damage. Impact resistance is measured by means of IP codes from IK00 to IK10 with IK09 is representative of 10J of kinetic energy in the form of an impact.

IEC 60529, IP53 [22] – refers to dust protection and resistance to sprays of water.

Table 4. List of child growth measurement devices and specifications used for children below 24 months.

Product name	Dimensions (cm)	Mass (kg)	Temperature range (°c)	Measurement range (cm)/minimum gradations (mm)/ Error (mm)	Price (US$)
				Test-retest reliability
	Measuring mats
Seca 210 [23]	L: 134.0	0.5	+10 to +40	10 to 99	83.00
	W: 30.0			5
	H: 14.0			±5
				–
Marsden HM-110 baby measuring mat [24]	L: 30.0	–	–	10 to 110	£25.00 (33.00^a)
	W: 8.0			5
	H: 10.0			–
				–
Charder HM110M [25]	L: 140.0	0.4	–5 to 35	10 to 110	55.00
	W: 30.0			5
				–
				–
Hopkins measure mat II [26]	L: 135.0	0.5	–10 to +40	10 to 99	49.95
	W: 31.0			1
	H: 14.0			–
				–
	Rod-style infantometers
Seca 207 [27]	L: 104.0	0.81	–	7 to 99	144.00
	W:12.0			1
	H: 28.8			–
				–
Charder HM80M [28]	L: 62.0	0.7	–5 to 35	35 to 80	72.00
	W:27.0		(–20 to +60)^b	1
	H: 7.0			±10
				–
Charder HM80P [29]	L: 89.0	0.688	+5 to +35	10 to 80	64.00
	W: 33.5		(–20 to +60)^b	1
				±10
				–
Charder HM101M [30]	L: 104.0	0.8	+5 to +35	10 to 100	–
	W: 27.5			1
	H: 5.5			±10
				–
Marsden HM-80P [31]	L: 88.0	–	–	10 to 80	£45.00
	W: 10.0			1	(59.00^a)
	H: 33.0			–
				–
Cardinal Detecto digital length measuring device [32]	L: 62.0	0.7	+10 to +40	35 to 80	273.00
	W: 29.0			1
	H: 7.0			–
				–
Charder HM80D [33]	L: 62.0	0.7	+5 to +35	35 to 80	185.00
	W: 29.0			1
	H: 7.0			±10
				–
	Cradle-style infantometers
Seca 416 [34]	L: 10.5	3.2	–	33 to 100	555.00
	W: 16.5			1
	H: 40.2			–
				–
Seca 417 [35]	L: 11.2	1.6	–10 to +40	10 to 100	222.00
	W: 31.0			1
	H: 12.0			–
				–
				±5
Hopkins 3 in 1 measuring board [36]	L: 200.0	5.7		0 to 200	576.75
				1
				–
				–
	Photographic measurement
Fletcher et al. [37]	–	–	–	–	–
				–
				±15–± 36 depending on lighting
				–
Tang et al. [38]	–	–	–	–	–
				–
				±11
				–

^aIndicates price from manual conversion based on the exchange rate in July 2020.

^bIndicates allowable storage temperature range if given.

Figure 2. Image showing (a) the operation of an infant measuring mat [26], (b) the Marsden HM80P portable infantometer [29] and (c) the Seca 416 infantometer [34].

Figure 3. Images showing (a) baby doll being held on a specially designed blanket during the testing of the Baby Napp software in Fletcher et al. [37] and (b) baby doll showing the placement of feature marker stickers in Tang et al. [38].

Table 5. List of child growth measurement devices and specifications used for children above 24 months.

	Dimensions (cm)	Mass (kg)	Temperature range (°c)	Measurement range (cm)/minimum gradations (mm) Error (mm)	Price (US$)
Product name				Test-Retest Reliability
	Stadiometers
Charder HM200P PortStad [39]	L: 35.0	1.9	+5 to +35	14 to 205	95.00
	W: 40.0			1
	H: 243.0			±10
				–
Seca 213 [40]	L: 59.0	2.5	+10 to +40	20 to 205	166.00
	W: 33.7			1
	H: 216.0			±5
				–
Marsden HM-250P [41]	L: 51.5	–	–	13.5 to 210	£60.00
	W: 35.0			1	(79.00^a)
	H: 213.0			–
				–
ADE Germany MZ10042 [42]	L: 34.8	–	–	15 to 201	£100.00
	W: 21.4			1	(132.00^a)
	H: 41.0			–
				–
Hopkins	L: 61.6^c	–	–	25 to 200	89.95
Portable stadiometer[43]	W: 35.6^c			1
	H: 11.5^c			–
				–
	Laser height measurement
Schrade and Scheffler [44]	L: 18.0	–	Measuring device is the GLM 250 VF (see below)
	W: 6.4		0.96
	H: 16.0
GLM 250 VF professional [45]	L:12.0	0.24	–10 to +50	50 to 15000	£359.92
	W:6.6		–20 to +70^b	0.1	(471.00^a)
	H: 3.7			±1
				–
Mayol-Kreiser et al. [46]	L:27.5	0.527	Measuring device is the GLM 40 (see below)
	W:11.0		0.95
GLM 40 professional [47]	L:10.5	0.09	–10 to +45	15 to 4000	£88.20
	W:4.1		–20 to +70^b	1	(115.00^a)
	H:2.4			±1.5
				–
Baumann et al. [48]	L:35.6	1	Measuring device is the Disto D2 (see below)		179.00
	W:2.54		0.95
Leica Disto D2 [49]	L:11.6	1	–10 to +50	5 to 10000	179.00
	W:4.4		–20 to +70^b	0.1
	H:2.6			±1.5
				–
Sørensen et al. [50]	L: 50.0	0.8	Measuring device is the Zamo (see below)		€70
	W: 3.0		0.99		(83.00^a)
	H: 4.0
Bosch Zamo [51]	L: 10.5	0.08	–10 to +40	15 to 2000	£50.00
	W: 3.8		–20 to +70^b	1	(65.50^a)
	H: 2.2			±3.0
				–
Capaltec HeightLight [52]	L: 16.0	0.2	–10 to +30	≥3000	£240.00
	W: 8.5			1	(317.0^a)
	H: 2.7			±1.5
				–
Kiko laser height measurer [53]	L: 8.5	0.083	–15 to +50	–	89.00
	W: 8.5			–
	H: 4.0			±1.5
				–
	Photographic
Barros et al. [54]	–	–	–	–	–
				–
				–
				–
Penders et al. [55]	–	–	–	–	–
				–
				±9
				–
Liu et al. [56]	–	–	–	–	–
				–
				±11
				0.99

^aIndicates price from manual conversion based on the exchange rate in July 2020.

^bIndicates allowable storage temperature range if given.

^cIndicates disassembled/folded dimensions.

Figure 4. Images showing (a) operation of the prototype in Mayol-Kreiser et al. [46] and (b) the operation of the prototype used in Sørensen et al. [50].

Figure 5. Images showing the positioning of the subject and digital marker placement in Liu et al. [56].

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