Feasibility and effectiveness of supplementation with locally available foods in prevention of child malnutrition in Kenya

Abstract

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 land 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-far-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.