Development and evaluation of a colour-coded scale for birthweight surveillance in rural Egypt

Birthweight surveillance is an important epidemiologic tool, yet it is largely unattainable in locales where most births occur at home attended by traditional midwives. A tempered-steel hand-held scale developed by Program for Appropriate Technology in Health (PATH, Seattle, USA) was adapted for use by Egyptian traditional midwives; it identified newborns weighing less than 2.5 kg by a colour code (yellow versus blue). The scale and reporting system were field tested in a rural Egyptian village. Traditional midwives reported 98% of 299 livebirths attended and 85% were reweighed by Salter scale within 48 hours. Sensitivity of the scale was 100%, specificity 94%. Field conditions are specified for incorporating this method into a surveillance system.