Abstract
Background: According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years. The Integrated Nutrition Programme (INP) was introduced in 1994 to address malnutrition in South Africa. There had been no systematic evaluation of how well clinics perform regarding nutritional services. Malnutrition rates worsened in the Free State from 3.9% in 2009 to 10.7% in 2013. This study aimed to assess the effectiveness of the INP Supplementary Feeding Programme in primary healthcare facilities in the Mangaung University of the Free State Community Partnership Project, known as MUCPP, catchment area of Bloemfontein, Free State, in children aged six months to five years.
 
 Methods: This was a retrospective, descriptive cohort study. All children between six months and five years entering the feeding scheme between July 2014 and June 2015 at the MUCPP, which is the hub of the feeding scheme, and three primary healthcare clinics were included. Data were collected from September to November 2015 from the INP registers and captured on dataextraction forms.
 
 Results: In total, 730 children were included in the study, 38.8% at risk for malnutrition and 61.2% malnourished. Most of the children (80.7%) stopped attending before change was seen. Only 14.1% exited the INP successfully with a normal weight for age and 3.0% deteriorated despite nutrition interventions. Of all children with one or more follow-up visits, 50.4% (119/236) improved from severe malnutrition to underweight or exited at target weight.
 
 Conclusions: The follow-up of the children and the monitoring and implementation of the INP are inadequate. There is some evidence that children who attend the INP regularly benefit from the programme.
 
 (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp)
 
 S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.1340252
Highlights
According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years.[1]
There is some evidence that children who attend the Integrated Nutrition Programme (INP) regularly benefit from the programme
Data were collected for all 730 children in the INP programme during the study period
Summary
According to the World Health Organization (WHO), malnutrition can be linked to 45% of deaths in children under the age of five years.[1] There are many definitions of child malnutrition, but Ge and Chang summarised it as:. There is often a limited intake of fruits, vegetables, legumes, and few or no animal products in the diet.[8] These diets have insufficient nutrients and minerals, which may lead to malnutrition It is especially important for infants and young children to receive proper nutrition as they are more vulnerable to undernutrition and subsequent impaired growth, due to their high nutritional needs.[9] The first 1 000 days of life are considered the most important for nutrition and, if malnutrition is not addressed by the age of five years, the child is unlikely to reach his/her full potential in life.[10,11]. There is some evidence that children who attend the INP regularly benefit from the programme
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