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  • Original Article
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Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing newborn weight in rural India



To determine the accuracy and acceptability of a handheld scale prototype designed for nonliterate users to classify newborns into three weight categories (2500 g; 2000 to 2499 g; and <2000 g).

Study Design:

Weights of 1100 newborns in Uttar Pradesh, India, were measured on the test scale and validated against a gold standard. Mothers, family members and community health stakeholders were interviewed to assess the acceptability of the test scale.


The test scale was highly sensitive and specific at classifying newborn weight (normal weight: 95.3 and 96.3%, respectively; low birth weight: 90.4 and 99.2%, respectively; very low birth weight: 91.7 and 98.4%, respectively). It was the overall agreement of the community that the test scale was more practical and easier to interpret than the gold standard.


The BIRTHweigh III scale accurately identifies low birth weight and very low birth weight newborns to target weight-specific interventions. The scale is extremely practical and useful for resource-poor settings, especially those with low levels of literacy.

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Support for the study was provided by the Saving Newborn Lives program of Save the Children—US, through a grant from the Bill & Melinda Gates Foundation. Support for the main trial in which this study was nested came from the United States Agency for International Development (USAID) India (New Delhi) Mission, through grants HRN-A-00-96-90006-00, Family Health and Child Survival Cooperative Agreement and GHS-A-00-03-00019-00, Global Research Activity Cooperative Agreement to Johns Hopkins University; and Save the Children—US through a grant from the Bill & Melinda Gates Foundation. We thank Luke Mullany of Johns Hopkins University for advice on statistical analyses. The Birthweigh scale was originally designed and developed under the HealthTech program, supported by USAID and managed by PATH. PATH redesigned the BIRTHweigh scale in consultation with study investigators, Gary Darmstadt and Vishwajeet Kumar, along with Luke Mullany, and produced and provided the prototypes for this study. We also thank Jessica Fleming at PATH for assistance with training of project workers on use of the scale. Developers of the Birthweigh III scale at PATH included Yancy Seamans, Bill Van Lew and Glenn Austin.

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Correspondence to G L Darmstadt.

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Darmstadt, G., Kumar, V., Shearer, J. et al. Validation of accuracy and community acceptance of the BIRTHweigh III scale for categorizing newborn weight in rural India. J Perinatol 27, 602–608 (2007).

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