Feasibility and effectiveness of supplementation with locally available foods in prevention of child malnutrition in Kenya.
OBJECTIVE: To establish the operational feasibility and effectiveness of using locally available foods to prevent malnutrition and improve child growth in Kenyan children.
DESIGN: Quasi-experimental design with an intervention group of children in all villages in one region and a non-intervention group of children in all villages in an adjacent region. The intervention was the distribution of a monthly food ration for the index child, a separate family ration, and group education on appropriate complementary feeding and hygiene.
SETTING: Rural villages in the arid lands of eastern Kenya with a high prevalence of child malnutrition.
SUBJECTS: All children in the target villages aged 6-20 months with weight-for-length Z-score (WHZ) greater than -2 at baseline.
RESULTS: Children in the intervention and non-intervention groups had similar baseline anthropometric measures. The caregivers in the intervention group confirmed that the intended amounts of food supplements were received and child nutrient intake improved. During the 7-month intervention period there were significant group differences in pre-post Z-score changes between the intervention and non-intervention groups for weight-for-age (0·82, P < 0·001) and weight-for-height (1·19, P < 0·001), but not for height-for-age (-0·20, P = 0·09), after adjusting for multiple covariates. Compared with the non-intervention group, the intervention group had a lower prevalence of wasting (0% v. 8·9%, P = 0·0002) and underweight (6·3% v. 23·0%, P < 0·0001). Infectious morbidity was similar in both groups.
CONCLUSIONS: The findings suggest that the distribution of locally available foods is operationally feasible and improves child weight gain and decreases acute malnutrition in Kenyan children.