Abstract
Introduction Reducing wasting in children under 5 years is a challenge in Sri Lanka. Management strategy of moderate acute malnutrition (MAM) is to have target food supplementation as energy dense snacks. Objectives To assess the feasibility, acceptability and effectiveness, of a homemade supplementary food (HMSF) in the management of moderate acute malnutrition in 2-5 year old children. Methods A community based quasi experimental study was carried out from October to December 2014. The test population (n=275) were 2-5 year old children with MAM from Kopay MOH area. The control group (n=285) were children of similar age with MAM from Uduvil, Nallur area. HMSF consisted of a pre-packed cereal mixture (50g), with sugar (20g) and scraped coconut (20g) added at home (calorie content =500 kcal/90g), as a daily snack to the intervention group. Baseline weight and monthly weight gain was measured using standard calibrated weighing scales. Compliance and any acute illnesses were monitored weekly by calling or visiting households. Average weight gain of both groups was analysed using independent sample t–test. The acceptability and feasibility of the HMSF was assessed by focus group discussions with the PHMs and the mothers. Results: Mean age of test group and control group was 42.6 months and 43.1 months respectively. There was no difference in the baseline weight of the two groups (95%CI -0.059-0.416: p=0.14). The mean weight gain in the test group and control group after 3 months was 688.5g (SD=437gm) and 583g (SD=461gm) respectively (p=0.006). The mean gain in length in the test group and control group after 3 months was 1.5cm (SD=0.93cm) and 1.66cm (SD 1.3 cm) (p=0.234) respectively. Conclusions and Recommendations: This HMSF was effective, feasible and acceptable in improving weight in MAM children under the age of five years.
Highlights
IntroductionIntroduction Reducing wasting in children under5 years is a challenge in Sri Lanka. Management strategy of moderate acute malnutrition (MAM) is to have target food supplementation as energy dense snacks
Introduction Reducing wasting in children under5 years is a challenge in Sri Lanka
This study aims to assess the feasibility, acceptability and effectiveness of a homemade supplementary food (HMSF) to improve weight gain in children between the ages two to five years with moderate acute malnutrition (MAM)
Summary
Introduction Reducing wasting in children under5 years is a challenge in Sri Lanka. Management strategy of moderate acute malnutrition (MAM) is to have target food supplementation as energy dense snacks. Undernutrition is defined as insufficient provision of energy and nutrients (such as good quality proteins with an adequate balance of essential amino acids, vitamins and minerals) and an inability to meet the requirements necessary to ensure growth, maintenance and specific functions of the body [1]. Acute undernutrition in children has two main manifestations; (i) macronutrient deficiency presenting as protein energy malnutrition (ii) micronutrient deficiencies, commonly iron, iodine, vitamin A and zinc deficiency. Acute undernutrition affects weight in a short period of time and is referred to as wasting. If uncorrected, wasting leads to chronic undernutrition, and affects length/height, which is referred to as stunting. Moderate acute undernutrition in children is defined as a weight for height below -2SD (standard deviation) but above -3SD of the median of the WHO child growth standard. Prevention of early childhood undernutrition leads to important health, education and economic benefits [4]
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