(see previous papers on Direct Recording Scale : 1, 2)

UNISCALE S. K. Roy 03.01.2000
UNISCALE David Morley 07.01.2000
Re: UNISCALE Krishna Belbase 13.01.2000
Re: UNISCALE S. K. Roy 14.01.2000

Date: Mon, 3 Jan 2000 18:37:59 +0600 (TASHST)

From: "Dr. S. K. Roy" <skroyaticddrb.org>



Dear Friends,

I would be most obliged if any of you can help me sending results/ references of validity and stability in field condition of the use of UNISCALE. I would like to get the methodology if compared with Salter Scales.

Thank you very much,

Yours sincerely



Dr SK.Roy, Scientist

Clinical Sciences Division, ICDDR,B

GPO BOX 128, Dhaka, Bangladesh

Fax 880-2-882 3116, Tel 880-2-8811751-60, 880-2-601701, Tel Res 880-2-911-7095

Date: Fri, 07 Jan 2000 14:07:15 +0000

From: David Morley <Davidatmorleydc.demon.co.uk>



DEAR DR ROY,While I think the Uniscale is technically wonderful, it is expensive and it does NOT help the mother to understand the meaning of a growth curve.

With the Direct Recording Scale over time, the mother comes to understand the meaning of the growth curve along with the Grandmother and her elder daughters. More important there is a little evidence with the Maasai that the mother takes action when faltering occurs. This is summarised below and I will ask TALC to send you [and the scientific papers describing this.



A new approach to Growth Monitoring involving the Direct Recording Scale.

Just as Paulo Freire used words important to people to teach literacy, so we can use child growth to teach numeracy. Research among the Maasai of Kenya suggests that at the same time we can improve the nutrition of the children being measured.

Growth monitoring is difficult because it involves the creation and decision making from a line graph,considered by Piaget to be one of the more difficult concepts to teach in education. It needs to be taught in a highly practical manner. One successful method involves measuring known quantities of water into a bucket hanging below the Direct Recording Scale.

For this a plastic bottle cut to hold 400cc at one end and 200cc at the other end is required. As the water is poured into the bucket below the spring the mothers see the spring stretch and themselves with a ball pen create successive points on the growth curve. A more detailed description of this method of teaching is available from TALC*.

The following are results from a large controlled study of the Direct Recording Scale among the Maasai in Kenya:

1. Mothers appreciate being involved. They understand what weighing and plotting a growth curve means. When shown several charts they can select the most appropriate growth curve.

2. After 2 years the grandmothers experience with the scale, who are the decision makers, and their grand-daughters, the future mothers, also understood the growth curve. Even 50% of the fathers and older sons understood it well.

3. Once a mother understands, that the vertical lines on the chart indicate months, she can more easily understand the timing of other sections of the chart (e.g. Immunisations). She may be put more in the 'driving seat' of her child's PHC.

4. An unexpected finding from the recent Maasai study by Meegan ( Published in "Tropical Doctor", 29,23-27 Jan'99) was a difference in growth faltering. Faltering was defined as no gain in weight for two months, or a loss of 200 grams in children under 2. Among 339 children weighed by their mothers on the Direct Recording Scale only 8% faltered compared with 30% among 127 children weighed by CHWs on dial scales.

[Subsequent questions to mothers, weighing their children on Direct Recording Scales in 20 homesteads, showed that the mothers themselves had noticed growth failure early and had given extra feeds of goat, or cow's milk to the infant. Whether we can find equivalent improvement in other communities that do not have ready access to milk is still not known]

*Copies of the scientific papers giving more details of these studies and the scales , available from :

TALC, POB 49. St Albans, AL1 5TX. UK.

Ph' 44 (0) 727 853869. Fax. 44 (0) 727 863845.

E-mail: talcukatbtinternet.com


David Morley


David Morley,Emeritus Professor of Tropical Child Health, University of London.


Tel: & Fax. 44 (0) 1582 712199.

Preferred Address; 51 Eastmoor Park, Harpenden, AL5 1BN. UK.

Date: Thu, 13 Jan 2000 13:52:03 -0800

From: kbelbaseatunicef.org (Krishna Belbase)

Subject: Re: UNISCALE


Dear Dr Roy,

As part of product development and field-testing process, UNISCALE was subjected to a number of tests -- some rigorous, some simple -- addressing validity, durability, acceptaibilty and related isues.

1. In 1996, a rapid field study was conducetd by a group of nutritionists in Indonesia who made favourable recommendations for large-scale use of UNISCALE based on convenience, multipurpose usage, acceptability and cost advantage criteria but stressed the need for adequate training.

2. In 1996-97, a more detailed study was conducted involving field sites in 3 countries with main focus on durability as defined by a) the proportion of scales which were non-functional on unpacking following shipment to the field sites and b) The rate of failure or breakdown during the testing period. This study also assessed the degree of acceptability using qualitative techniques using opinion surveys and focus group discussions.

The study made specific recommendations which included the need to improve durability and training on appropriate use of the scale. The development of the latest "S model" of UNISCALE which came out after the above study involved the use of lot quality assurance measures and testing in aggressive environmental conditions in order to improve durability.

3. Another rapid study was conducted recently by a group of scientists from Cornell University to decide on the use of UNISCALE in the WHO multicentre growth reference study. Based on satisfactory findings, UNISCALE is currently being used in field sites in 6 countries selected by the study.

I would be happy to share the reports of the above studies if you need further details and also help answer any other questions you may have.

To our knowledge, no systematic study has been conducted comparing UNISCALE with Salter scale.



Krishna Belbase, Nutrition Section

UNICEF, New York

Phone: 212-824-6302

Date: Fri, 14 Jan 2000 16:01:31 +0600

From: "Dr. S. K. Roy" <skroyaticddrb.org>

Subject: Re: UNISCALE


Dear Dr. Belbase,

Thank you very much. Your suggestions are very helpful I have rceived documents from Mr. Stuart Gillespie which may contain the same studies. If not please send me yours my email asoon as possible.




Dr SK.Roy, Scientist

Clinical Sciences Division, ICDDR,B

GPO BOX 128, Dhaka, Bangladesh

Fax 880-2-882 3116, Tel 880-2-8811751-60, 880-2-601701, Tel Res 880-2-911-7095