Evaluation of a national food and nutrition program in Ecuador on child growth and micronutrient status

Abstract

Since 2000, the Ministry of Public Health of Ecuador has targeted a national food and nutrition program (PANN 2000) to children 6–24 months living in poor communities. The goal is to prevent growth retardation and micronutrient deficiencies by simultaneously improving feeding behaviors and access to a nutrient-dense complementary food (Mi Papilla). We used a longitudinal quasi-experimental design to compare program (P) to control (C) children with respect to breastfeeding and complementary feeding practices, diet, growth, micronutrient status, and morbidity. Among 171 P infants 6–12 mo followed for 13 mo, underweight remained the same (12%) but more than doubled among 150 C children, from 10% to 24% (p<0.001). Anemia fell from 76% to 27% among P children but fell to only 44% among C children (p<0.01). P children consumed significantly more energy, protein, fat, Fe, Zn, Ca, and vitamins C and A than C children because of their consumption of Mi Papilla, which they consumed 72% of the time. Mi Papilla did not replace energy or Fe from the diet but was an addition to usual intake. Mi Papilla, an instant product, did not result in increased diarrhea. Linear growth retardation, highly prevalent at baseline, was not affected by PANN 2000 nor were feeding behaviors. We conclude that the significant reduction in anemia and lack of further deterioration in underweight among P children were due to improved dietary intake because of Mi Papilla. The Micronutrient Initiative (MI) funded this evaluation.