Child malnutrition study shows
Study shows more benefit from reaching all at-risk children under age 2 with nutrition, versus starting assistance among the malnourished up to age 5 Port-au-Prince, Haiti., Feb. 14, 2008
early prevention is best
— Ensuring adequate nutrition for children younger than 2 is more beneficial than intervening with food assistance after young children show signs of malnourishment, according to a study published in the Feb. 16 issue of the Lancet
, a leading medical journal.
Communities where children under age 2 received food through a preventive program benefited more from nutritional aid than those who received assistance only after showing signs of being moderately undernourished, in a three-year program comparison.
The study compared the impact of two approaches implemented by U.S. government-funded World Vision programs in Haiti. Researchers found that indicators of malnutrition—stunting, wasting and underweight—were 4 to 6 percentage points lower in poor communities that participated in preventive programs, compared with those that used a recuperative approach.
“This has demonstrated that the preventive approach is more effective that the curative one,” said Dr. Lesly Michaud, coordinator of maternal and child health for World Vision Haiti. “This study changed our approach to fighting childhood malnutrition. Based on the research findings, World Vision now targets its food assistance and maternal and child health and nutrition programs to all children under two years of age in poor communities in Haiti.”
The publication is part of the Lancet’s ongoing focus on maternal and child nutrition. The study provides evidence supporting early intervention to reduce the effects of malnutrition on child development and an example of how to develop, strengthen and monitor such programs in real-life conditions. Some have been hesitant to adopt a “universal” approach targeting infants amid higher front-end costs and a lack of evidence proving its superiority in large-scale programs.
The research was conducted by the International Food Policy Research Institute
(IFPRI) and Cornell University in conjunction with World Vision Haiti and the U.S. Agency for International Development’s Food and Nutrition Technical Assistance project of the Academy for Educational Development. World Vision, a Christian relief and development organization operating in nearly 100 countries, specializes in child-focused, community-based programs to alleviate the root causes of poverty and injustice.
In the two types of childhood nutrition programs, one approach provided nine months of assistance to children 6 months to 5 years of age once they became underweight. The second targeted all children from 6 months to 2 years old, until they reached two years of age. Both programs, done in areas with high rates of child malnutrition, also targeted pregnant women, breastfeeding mothers and all severely malnourished children.
“If nutrition programs wait until children have already become malnourished, their benefits are significantly diminished,” said Marie Ruel, lead author of the study and director of the Food Consumption and Nutrition Division at IFPRI. Of the comparative results, she said, “While these numbers may not seem dramatic, the differences between the groups are substantial, especially considering the challenges of improving childhood nutrition in poor communities."
World Vision’s Michaud also noted other benefits of shifting the focus of nutrition programs:
“In specific situations where malnutrition and poverty are very high and lack of economic resources is an issue, implementing a curative approach alone may be seen by community members as a coping mechanism: their perception is that kids must be malnourished in order to be accepted into a nutrition program. In that context, child malnutrition may be seen by households as a ticket for the family to access the food assistance program. But with a preventive focus, the message is that they have to fight malnutrition instead of seeing it as a benefit, because the criteria for admission is no longer malnutrition. The message is much more positive, and the earlier intervention gives us more time to educate them in healthier behaviors and about better nutrition.”
The study was conducted in the context of a five-year development program implemented by World Vision in the Central Plateau region of Haiti. Twenty clusters of rural communities were selected for participation. The research was funded by the USAID, FANTA, World Vision Haiti, the German government and the United Nations World Food Programme.
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