Automated Z-Score Based Nutritional Status Classification for Children Under Two Using Smart Sensor System
Downloads
The classification of nutritional status in children under two years old is crucial for monitoring growth and early detection of nutritional problems. However, in many healthcare facilities, this classification is still performed manually, requiring relatively long processing times and being prone to human error in both measurement and data recording. The problem addressed in this study is the inefficiency and potential inaccuracy of manual nutritional status classification in toddlers. This research aims to develop an automatic and digital device capable of measuring body length and weight and classifying nutritional status in children under two years old efficiently, accurately, and in real time. The device utilizes electronic sensors integrated with a microcontroller to streamline the process and reduce measurement error. The main contribution of this study is the design and realization of a portable automation device that integrates an HC-SR04 ultrasonic sensor for measuring body length and a 50 kg full-bridge load cell sensor for measuring body weight, both controlled by an ATmega328P microcontroller. The device processes the data measurement digitally, displays the results on a 20 × 4 LCD, and provides a printed copy via a thermal printer, enhancing the data recording efficiency. The method involves the design of hardware circuits, sensor calibration, software programming using the C language in the Arduino IDE, and performance testing of the device by comparing its results to standard measuring instruments. The device’s performance is evaluated based on measurement error percentage and precision level. The results demonstrate that the device achieved an error percentage of 1.26% for body length measurement and 0.98% for body weight measurement. The overall system error is recorded at 0.5%, with a precision level ranging from ±0.08 to ±0.4.
[1] H. Andriani, E. Friska, M. Arsyi, A. E. Sutrisno, A. Waits, and N. D. Rahmawati, “A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys,” BMC Public Health, vol. 23, no. 1, Dec. 2023, doi: 10.1186/s12889-023-16728-y.
[2] N. I. L. Gusnedi Gusnedi, Ricvan Dana Nindrea, Idral Purnakarya, Hermita Bus Umar, Andrafikar, Syafrawati, Asrawati, Andi Susilowati, Novianti, Masrul, “Risk factors associated with childhood stunting in Indonesia: A systematic review and meta-analysis,” Asia Pac J Clin Nutr, vol. 32, no. 2, pp. 184– 195, 2023, doi: 10.6133/apjcn.202306_32(2).0001.
[3] Y. Ayukarningsih, H. Sa’adah, M. A. Kusmayadi, and M. Z. Ramadhan, “Stunting: Early Detection with Anthropometric Measurements and Management (Stunting: Deteksi Dini Dengan Pengukuran Antropometri Dan Penatalaksanaannya),” Journal of Health and Dental Sciences, vol. 04, no. 01, pp. 91–104, 2024, doi: 10.54052/jhds.Article.
[4] P. Piqueras, A. Ballester, J. V Durá-gil, and S. Martinez-hervas, “Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review,” vol. 12, no. July, 2021, doi: 10.3389/fpsyg.2021.631179.
[5] N. E. Soboksa, S. R. Gari, A. B. Hailu, and B. M. Alemu, “Childhood Malnutrition and the Association with Diarrhea, Water supply, Sanitation, and Hygiene Practices in Kersa and Omo Nada Districts of Jimma Zone, Ethiopia,” vol. 15, p. 1178630221999635, 2021, doi: 10.1177/1178630221999635.
[6] Y. F. Djoumessi, “The impact of malnutrition on infant mortality and life expectancy in Africa,” Nutrition, vol. 103, p. 111760, 2022, doi: 10.1016/j.nut.2022.111760.
[7] N. Gaffan, A. Kpozehouen, C. Degbey, and Y. G. Ahanhanzo, “Effects of the level of household access to water, sanitation and hygiene on the nutritional status of children under five, Benin,” BMC Nutr, vol. 9, no. 1, p. 95, 2023, doi: 10.1186/s40795-023-00751-8.
[8] J. Lin and X. L. Feng, “Exploring the impact of water, sanitation and hygiene (WASH), early adequate feeding and access to health care on urban – rural disparities of child malnutrition in China,” Matern Child Nutr, vol. 19, no. 4, p. e13542, 2023, doi: 10.1111/mcn.13542.
[9] R. Saheed et al., “Impact of Drinking Water Source and Sanitation Facility on Malnutrition Prevalence in Children under Three: A Gender-Disaggregated Analysis Using PDHS 2017–18,” Children, vol. 9, no. 11, p. 1674, 2022, doi: 10.3390/children9111674.
[10] E. S. Chade et al., “The Influence of Nutritional Status on Brain Development: Benefits of Exclusive Breastfeeding,” Pediatr Rep, vol. 16, no. 3, pp. 724–735, 2024, doi: 10.3390/pediatric16030061.
[11] A. Kansu and M. Ays, “The significance of MUAC z-scores in diagnosing pediatric with special emphasis on neurologically discable children,” Front Pediatr, vol. 11, p. 1081139, 2023, doi: 10.3389/fped.2023.1081139.
[12] A. Ahmed, J. Hoddinott, and S. Roy, “Food Transfers, Cash Transfers, Behavior Change Communication and Child Nutrition: Evidence from Bangladesh,” World Bank Econ Rev, vol. 39, no. 2, pp. 439–472, 2025, doi: 10.1093/wber/lhae023.
[13] D. B. Abitew, A. W. Yalew, A. M. Bezabih, and A. N. Bazzano, “Comparison of Mid-Upper-Arm Circumference and Weight-For-Height Z -Score in Identifying Severe Acute Malnutrition among Children Aged 6 – 59 Months in South Gondar Zone , Ethiopia,” J Nutr Metab, vol. 2021, pp. 1–10, 2021, doi: 10.1155/2021/8830494.
[14] N. Kelly, J. Shepherd, and S. B. Heymsfield, “Digital Anthropometric Evaluation of Young Children: Comparison to Results Acquired with Conventional Anthropometry,” Eur J Clin Nutr, vol. 76, no. 2, pp. 251–260, 2022, doi: 10.1038/s41430-021-00938-x.Digital.
[15] C. Li, J. Wang, S. Wang, and Y. Zhang, “A review of IoT applications in healthcare,” Neurocomputing, vol. 565, p. 127017, 2024, doi: 10.1016/j.neucom.2023.127017.
[16] P. T. N. An, Pham Duc, “Controlling Board Prototype for a Smart Weighting Device Using Ultrasonics and Loadcell Sensors,” Proceedings of the International Conference on Advanced Mechanical Engineering, Automation, and Sustainable Development 2021 (AMAS2021), pp. 872–876, 2022, doi: 10.1007/978-3-030-99666-6_127.
[17] A. H. Angguh Gubawa, Tomy Abuzairi, “Electronic system design for clinical applications of stunting case,” in AIP Conference Proceedings, AIP Publishing. Accessed: Jun. 17, 2025. [Online]. Available: https://pubs.aip.org/aip/acp/article-abstract/2344/1/050004/748853/Electronic-system-design-for-clinical-applications
[18] B. M. Carvalho, “Baby Date: a mobile application for teaching nursing care to newborns in primary care,” Rev Lat Am Enfermagem, vol. 32, p. e4164, 2024, doi: 10.1590/1518-8345.7022.4164.
[19] K. Widatama and P. Wahyu Setyaningsih, “The Using of Information Systems to Calculate Z-Score and to Determination of Stunting Categories In Toddlers,” bit-Tech, vol. 6, no. 2, pp. 152–160, 2023, doi: 10.32877/bt.v6i2.1013.
[20] A. Lan, “A microcontroller-based system for body mass index,” Journal of Innovation Science and Technology, vol. 2, no. 1, 2025.
[21] P. E. Mensah, “Design and Implementation of a Load Sensor in a Bearing Adapter Assembly for Freight Railcar Applications,” Master’s Thesis, The University of Texas Rio Grande Valley, 2023.
[22] A. Sujiwa, S. H. Prajitno, and B. T. Marta, “Baby Weight and Length Based on Arduino Uno with Combination of Ultrasonic Sensor Hc-Sr04 and Weight Sensor (Load Cell),” Journal of Applied Electrical & Science Technology, vol. 6, no. 1, pp. 7–13, 2024, doi: 10.36456/best.vol6.no1.8822.
[23] C. L. Mills, “The Design and Implementation of a LowCost High-Precision 3D-Printed Translation Stage Using an Optimized PID Controller for Optical Applications,” The Pennsylvania State University, 2022.
[24] T. Ewetumo, K. D. Adedayo, Y. B. Lawal, A. T. Edun, and J. E. Orokhe, “Development of an Automatic Body Mass Index Measurement Machine,” FUOYE Journal of Engineering and Technology, vol. 4, no. 2, 2020, doi: 10.46792/fuoyejet.v4i2.373.
[25] Y. Nurwati, Y. Nurwati, S. A. Marliyanti, B. I. Santoso, and D. Anggraini, “Effects of Maternal Anthropometry on Infant Anthropometry: A Cross-sectional Study at Public Hospital X in Ternate, Indonesia,” Jurnal Kesehatan Masyarakat Nasional, vol. 19, no. 1, pp. 59–66, 2024, doi: 10.21109/kesmas.v19i1.7336.
[26] S. A. Thurstans, “Sex Differences in Risk and Outcomes from Severe Malnutrition: Implications for Management,” PhD Thesis, London School of Hygiene & Tropical Medicine, 2024. doi: https://doi.org/10.17037/PUBS.04672595.
[27] N. T. Simorangkir, ““Optimization of a Decision Support System for Monitoring Growth and Development Using the Z-Score Method at Cempaka Health Post,” Proceedings of the Multidisciplinary Research Community, vol. 1, no. 1, pp. 176–182, 2024.
[28] A. M. El Shafie et al., “Development of LMS and Z Score Growth References for Egyptian Children from Birth Up to 5 Years,” Front Pediatr, vol. 8, no. January, pp. 1–15, 2021, doi: 10.3389/fped.2020.598499.
[29] A. H. Fajrian, R. R. Nurmalasari, L. Kamelia, and P. D. Fitriani, “ANTIS: Automatic and Anthropometric Measurement and Weight IoT-Monitoring for Enhanced Infant Nutrition Assessment Using Dual Sensor and Fuzzy Logic,” in 2024 10th International Conference on Wireless and Telematics (ICWT), 2024, pp. 1–6. doi: 10.1109/ICWT62080.2024.10674673.
[30] S. Mannolkar, S. M. George, M. R, N. P, and D. P. Bharathi, “Assistive System for Monitoring Malnutrition in Children,” in 2025 10th International Conference on Signal Processing and Communication (ICSC), 2025, pp. 761–766. doi: 10.1109/ICSC64553.2025.10968423.
[31] N. F. Tsani, D. Marfuah, I. Prasojo, and S. Aprilia, “Detection of overweight based on body weight in children aged 2-5 years based on Arduino Uno,” AIP Conf Proc, vol. 3142, no. 1, p. 020120, Mar. 2025, doi: 10.1063/5.0262367.
[32] M. Wang, Y. Song, X. Zhao, Y. Wang, and M. Zhang, “Utilizing Anthropometric Measurements and 3D Scanning for Health Assessment in Clinical Practice,” 2024, Ubiquity Press. doi: 10.5334/paah.379.
[33] D. Kurnianingtyas, N. Daud, A. W. Widodo, and T. Herawan, “Performance Evaluation of Different Classification Algorithms Applied for Identifying Maternal Nutritional Status by Anthropometric Measurements,” International Journal of Integrated Engineering, vol. 17, no. 1, pp. 463–475, 2025, doi: 10.30880/ijie.2025.17.01.037.
[34] E. Borghi and H. S. Sachdev, “Should a single growth standard be used to judge the nutritional status of children under age 5 years globally: Yes,” Am J Clin Nutr, vol. 120, no. 4, pp. 764–768, 2024, doi: https://doi.org/10.1016/j.ajcnut.2024.04.019.
Copyright (c) 2025 Yunidar Yunidar, Melinda Melinda, Rina Ridara, Nurlida Basir (Author)

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlikel 4.0 International (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).





