Supplementary Feeding Programs Research Articles

An Optimization Tool to Formulate Diets within a Supplementary Nutrition Program for Children

BackgroundIn large supplementary feeding programs for children, it is challenging to create and sustain contextual, acceptable, nutritionally complete, and diverse supplemental foods. For example, the Indian Supplementary Nutrition Program (SNP) supplements the dietary intake of children, pregnant and lactating women, and severely acutely malnourished (SAM) children by offering dry take home rations (THRs) or hot cooked meals (HCMs) across India, but an optimization tool is necessary to create local contextual recipes for acceptable and nutritionally adequate products. ObjectivesThis study aimed to create a linear programming (LP) model to optimize diverse food provisions for a SNP to meet its program guidelines, using locally available foods, within budgetary allocations. MethodsA LP algorithm with appropriate constraints was used to generate an optimal THR based on raw foods, or an optimal weekly HCM menu comprised of a lunch meal with mid-morning snacks, based on user choices of foods and recipes. The database of foods used was created by a prospective survey conducted across all states of India for this purpose, such that the recipe and food optimization was diverse and specific to the guidelines for each beneficiary group. ResultsAn interactive web-based app, which can optimize feeding programs at any population level, was developed for use by program implementers and is hosted at https://www.datatools.sjri.res.in/SNP/. In the Indian example analyzed here, the recommended optimized diets met the guidelines for diversified and nutritionally complete SNP provision but at a cost that was almost 25% higher than the present Indian budget allocation. ConclusionsThe optimization model developed demonstrates that contextual SNP diets can be created to meet macronutrient and most essential micronutrient needs of large-scale feeding programs, but appropriate diversification entails additional costs.

Analysis of Vitamin C Content and Preferences for Modisco Pudding with the Addition of Crystal Guava Juice (Psidium guajava L Cultivar Kristal)

Background: Indonesia has made progress in achieving the target of reducing malnutrition cases, but 10.2% are still malnourished, according to data from The Global Nutrition Report 2020. Intake of micronutrients, one of which is vitamin C, affects the incidence of malnutrition cases. Vitamin C has the function of maintaining health through the immune system. One supplementary feeding program that can overcome cases of malnutrition is Modified Dietetic Skimmed Milk and Coconut Oil (Modisco). Modisco's reception is not very good, especially for toddlers, because it is in the form of liquid. Modisco pudding, with the addition of crystal guava juice, aims to improve the taste and increase the nutritional value of Vitamin C. Objective: The objective of the study is to analyze the content of Vitamin C in the preference test of Modisco pudding with the addition of crystal guava juice at 0%, 15%, 30%, and 45% concentration. Methods: This study used a quasi experimental design involving 4 treatments and 3 replications. The research subjects were 25 panelists of elementary school students. Results: The results showed the levels of Vitamin C in various proportions to be significantly different (p ≤ 0,05). The results of the preference test showed significant differences in the color, aroma, taste, and texture of the modisco pudding with the addition of crystal guava juice (p ≤ 0,05). Conclusion: The results showed that with more addition of crystal guava juice, the level of vitamin C increased, but the level of preference decreased. The most preferred Modisco pudding was X1 (addition of 15%) with a vitamin C content of 14,4 mg.

Analysis of The Implementation of Countermeasure Policies Against Stunting

Introduction: Stunting is a major nutrition problem worldwide, especially in poor and developing countries. This problem leads to children's suboptimal brain, mental, and cognitive development. The stunting rate globally was 32.6% in 2000, and by 2017, around 150.8 million people were suffering from malnutrition and stunting. This research aims to determine the implementation of stunting prevention policies in the Puskesmas (Public Health Centre) Blang Cut working area.Methods: The research used a qualitative method with a descriptive approach to analyze the implementation of countermeasure policies to reduce stunting. The Health Belief Model was used as the theoretical framework. The methodological orientation of this research was discourse analysis. The study used an interview guide and a voice recorder to collect information from 9 informants.Results: Puskesmas Blang Cut has implemented several countermeasure policies to reduce stunting. These include increasing awareness about the importance of proper nutrition and hygiene, training healthcare workers on stunting prevention, and monitoring children's growth regularly. Implementing these policies has led to a significant reduction in the prevalence of stunting. However, some challenges still need to be addressed, such as increasing access to healthcare services and improving the quality of healthcare facilities.Conclusion: Communication factors related to implementing Countermeasure Policies in Stunting Reduction have been running well. The puskesmas has carried out all stunting reduction program activities, but the more dominant one is the Supplementary Feeding Program for those affected by stunting.

Implementasi Program Pemberian Makanan Tambahan Pemulihan (PMT-P) pada Balita untuk Menurunkan Prevalensi Stunting di Puskesmas Kabupaten Jember

Jember Regency is included in the five cities/regencies with the highest prevalence of stunting in East Java, with a percentage ranging from 40-45%. One of the interventions for toddlers to reduce the prevalence of stunting is the Recovery Supplemental Feeding (PMT-P). The study aimed to study the implementation of the Recovery Supplemental Feeding (PMT-P) program for toddlers to reduce the prevalence of stunting. This is a qualitative approach. The data was collected by in-depth interviews and documentation. The results showed that the implementation of the PMT-P Program was not fully in accordance with the 2011 PMT-P Guidelines from the Indonesian Ministry of Health, the program implementers had good insight, knowledge, and response in implementing the PMT-P program. The output of the PMT-P program implementation was not in accordance with David C. Korten's theory of suitability. It is suggested to cook together among midwives, cadres, and mothers of target toddlers, create a community of toddlers’ mothers as a sharing platform about the implementation of Recovery Supplemental Food, and increase monitoring in the provision program for toddlers to ensure that supplemental food is actually consumed by the target toddlers.

Before and after study of a national complementary and supplementary feeding programme in Rwanda, 2017-2021.

To address high rates of malnutrition among children from vulnerable households in Rwanda, the government initiated a national food supplementation programme. A before and after evaluation, using repeat cross-sectional surveys in randomly selected villageswas conducted; aimed at assessing the effectiveness of providing fortified blended food (FBF) to children 18-23 months of age, pregnant and lactating women in the lowest tier of Rwanda's social support system. Data were collected in 2017, 2018and 2021 through interviews with caregivers; anthropometric measurements and a capillary blood sample were obtained from children. The primary statistical analysis compared the nutritional status of children before and after the introduction of FBF. We enroled 724 children during each survey. The prevalence of stunting declined from 47% to 35% between 2017 and 2021; in 2018, the prevalence of stunting was 43%. Children had a 42% reduction in the odds of being stunted (adjusted odds ratio [AOR]: 0.58, 95% confidence interval [CI]: 0.47-0.74, p < 0.001) from 2017 to 2021 even after adjusting for inherent, distal, proximal, and intermediate covariates. The reduction in stunting observed within the first year of the programme was not statistically significant (AOR: 0.83, 95%CI: 0.67-1.03, p < 0.091). We observed meaningful reductions in the prevalence of stunting among children which coincided with the introduction of Government-led initiative to reduce malnutrition. The Rwandan Government has committed to improving the living conditions of vulnerable households and has made strong investments in reducing malnutrition. The impact of these investments can be seen in the overall trend towards improved nutritional status highlighted in this evaluation.

The Management of the School' Supplementary Feeding Programmes in Bulawayo Metropolitan Province

The Management of the School' Supplementary Feeding Programmes in Bulawayo Metropolitan Province

Evaluation of Local Supplementary Feeding Program in Toddler Nutrition Recovery House (Pelita) in Kedung Banteng District, Tegal Regency

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;One approach taken to reduce the prevalence of stunting is by providing additional recovery food to malnourished toddlers. The Rumah Pelita supplementary food program has been running in Kedung Banteng District since 2020. In the implementation of the Rumah Pelita Program, there are still existing cases of stunting and the nutritional status of targets and there has never been an evaluation of the Rumah Pelita program. The aim of the research is to determine the evaluation of the supplementary feeding program made from local food in Kedungbanteng District, Tegal Regency in terms of input, process and output aspects. This research method is qualitative research which is descriptive and evaluative in nature. The research period is January-March 2023. The research was conducted in 5 villages in the Kedungbanteng Community Health Center area. The main informants were 1 nutrition officer and 5 village midwives, and triangulation informants were 5 Rumah Pelita cadres and 5 mothers of toddlers. Data collection used in-depth interviews, while the source triangulation method was used to validate the data. Research data analysis is data reduction, data presentation and drawing conclusions. The results of the research show that the number of cadres is still insufficient, and there are still villages that have not budgeted for equipment rental and transportation for cadres, there are deficiencies in reporting and recording and there are still toddlers who experience stunting. There needs to be integration of central and regional government policies regarding handling stunting in toddlers, so that there is a division of the budget for handling stunting. and it is recommended that health workers provide health education about stunting prevention and routinely monitor the development of toddlers. &lt;/em&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keyword: Stunting, Policy, Nutrition, Provision of supplementary food, Toddler&lt;/em&gt;&lt;/strong&gt;

The Impact of the Use of Village Funds on Stunting Prevention Policies in Nagari Padang Lua, Agam Regency

This descriptive qualitative research examines the impact of village funds on stunting prevention policies in Nagari Padang Lua, Agam Regency. Data were collected from relevant agencies and parties in the village through interviews, observations, and documentation studies, then reduced to obtain accurate conclusions. The results show that the Nagari government has conducted stunting socialization, integrated healthcare center services for pregnant women and toddlers, and provision of the Supplementary Feeding Program (PMT) for toddlers. However, these programs have not been effective in preventing stunting due to the lack of involvement of pregnant women and parents of toddlers as the main targets, limited integrated healthcare center facilities and infrastructure, and low community participation and awareness.

How age and sex affect treatment outcomes for children with severe malnutrition: A multi-country secondary data analysis.

Age and sex influence the risk of childhood wasting. We aimed to determine if wasting treatment outcomes differ by age and sex in children under 5 years, enroled in therapeutic and supplementary feeding programmes. Utilising data from stage 1 of the ComPAS trial, we used logistic regression to assess the association between age, sex and wasting treatment outcomes (recovery, death, default, non-response, and transfer), modelling the likelihood of recovery versus all other outcomes. We used linear regression to calculate differences in mean length of stay (LOS) and mean daily weight gain by age and sex. Data from 6929 children from Kenya, Chad, Yemen and South Sudan was analysed. Girls in therapeutic feeding programmes were less likely to recover than boys (pooled odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.72-0.97, p = 0.018). This association was statistically significant in Chad (OR: 0.61, 95% CI: 0.39-0.95, p = 0.030) and Yemen (OR: 0.47, 95% CI: 0.27-0.81, p = 0.006), but not in Kenya and South Sudan. Multinomial analysis, however, showed no difference in recovery between sexes. There was no difference between sexes for LOS, but older children (24-59 months) had a shorter mean LOS than younger children (6-23 months). Mean daily weight gain was consistently lower in boys compared with girls. We found few differences in wasting treatment outcomes by sex and age. The results do not indicate a need to change current programme inclusion requirements or treatment protocols on the basis of sex or age, but future research in other settings should continue to investigate the aetiology of differences in recovery and implications for treatment protocols.

A Prospective Comparison of Standard and Modified Acute Malnutrition Treatment Protocols during COVID-19 in South Sudan

A non-randomized prospective cohort study was conducted in 2022 to compare recovery rate and length of stay (LoS) for acutely malnourished children treated under South Sudan’s standard Community Management of Acute Malnutrition (CMAM) protocol and a COVID-modified protocol. Children aged 6–59 months received acute malnutrition (AM) treatment under the standard or modified protocol (mid-upper-arm circumference-only entry/exit criteria and simplified dosing). Primary (recovery rate and LoS) were compared for outpatient therapeutic (OTP) and therapeutic supplementary feeding programs (TSFP) using descriptive statistics and mixed-effects models. Children admitted to OTP under both protocols were similar in age and sex; children admitted to TSFP were significantly older under the modified protocol than the standard protocol. Shorter LoS and higher recovery rates were observed under the modified protocol for both OTP (recovery: 93.3% vs. 87.2%; LoS: 38.3 vs. 42.8 days) and TSFP (recovery: 79.8% vs. 72.7%; LoS: 54.0 vs. 61.9 days). After adjusting for site and child characteristics, neither differences in adjusted odds of recovery [OTP: 2.63; TSFP 1.80] nor LoS [OTP −10.0; TSFP −7.8] remained significant. Modified protocols for AM performed well. Adjusted models indicate similar treatment outcomes to the standard protocol. Adopting simplified protocols could be beneficial post-pandemic; however, recovery and relapse will need to be monitored.

Magnitude and Factors Associated with Gestational Weight Gain Adequacy among Pregnant Women in South Gondar Zone, Northwest Ethiopia

BackgroundWeight gain during pregnancy depends on the maternal prepregnancy weight and height. Inappropriate weight gain has negative consequences, including the health care system and society because of its adverse birth outcomes. ObjectiveThis study aimed to assess the magnitude and factors associated with gestational weight gain in Northwest Ethiopia. MethodsFrom September 2018 to June 2019, a community-based prospective follow-up study was conducted in Northwest Ethiopia. A total of 422 pregnant women were followed from conception to delivery and the data were collected using a multistage sampling technique. Stata 14 standard edition (SE) software was used for data analysis. Multinomial logistic regression was used to determine the relationship between dependent and independent variables. P value of ≤0.05 was used to determine statistical significance. ResultsMajority of the participants had normal weight gain [65.12%, 95% confidence interval (CI): 60.08, 69.85]. Besides this, the rate of inadequate and overadequate weight gain was 21.53% (95% CI: 17.60, 26.05) and 13.35% (95% CI: 10.22, 17.25), respectively. Inadequate weight gain was linked to meal frequency [adjusted odd ratio (AOR): 0.52, 95% CI: 0.28, 0.97], targeted supplementary feeding program (TSFP) enrollment (AOR: 2.47; 95% CI: 1.35, 4.50), parity (AOR: 0.18; 95% CI: 0.05, 0.62), and alcohol consumption history (AOR: 0.47; 95% CI: 0.25, 0.88), whereas overadequate weight gain was associated with residency (AOR: 5.22; 95% CI: 2.43, 11.22) and TSFP status (AOR: 2.22; 95% CI: 1.08, 4.57). ConclusionsThis study revealed a notable magnitude of both inadequate and overadequate weight gain. It found that good meal frequency, alcohol consumption, parity, and TSFP enrollment were associated with a reduced risk of inadequate weight gain during pregnancy. In addition, the study identified residence and TSFP enrollment as factors linked to overadequate weight gain during pregnancy.

RELATIONSHIP BETWEEN MOTHER'S ATTITUDE AND SOCIO-CULTURE WITH THE INCIDENCE OF LACK NUTRITION IN UNDER-FREE (12-59 MONTHS)

Nutrition is crucial for supporting the growth and development of toddlers. The government program aimed at preventing undernutrition is the Supplementary Feeding Program (SFP). The nutritional status can be determined through laboratory tests and anthropometric measurements. The rapid developmental stage of children aged 1-5 years makes them vulnerable to undernutrition if not supported by balanced nutrition. The objective of this study was to examine the relationship between maternal attitudes, socio-cultural factors, and the occurrence of undernutrition in toddlers (12-59 months) in the village of Karangan Seberang. This research employed a descriptive correlational survey design with a cross-sectional approach. The total population of toddlers aged 12-59 months was 100 individuals, with a sample size of 86. The sampling technique used was accidental sampling. The univariate analysis revealed that 31 (36%) respondents experienced undernutrition, while 55 (64.0%) respondents did not. The bivariate analysis using the chi-square test showed a p-value of 0.000 &lt; α value of 0.05, indicating a significant relationship between maternal attitudes, parental education, economic factors, and parental knowledge with undernutrition in toddlers (12-59 months) in the village of Karangan Seberang. There is a significant relationship between maternal attitudes, parental education, economic factors, and parental knowledge with undernutrition in toddlers (12-59 months) in the village of Karangan Seberang. Close collaboration among the government, healthcare institutions, education sector, and the community is needed to address the issue of undernutrition in children. Effective coordination and synergy between these sectors can help enhance awareness, knowledge, and effective actions in combating undernutrition.

EVALUATION OF THE SUPPLEMENTARY FEEDING PROGRAM FOR TODDLERS

Background: Malnutrition in children under five is still a matter of concern because it not only harms the child, but also harms the country. Malnourished toddlers if not treated properly can have an impact until adulthood. &#x0D; Objective: This study aims to evaluate the Supplementary Feeding Program (PMT) for toddlers at Puskesmas Somba Opu, Gowa Regency. &#x0D; Methods: The research method used was a cross sectional design with a quantitative approach. The population in this study were mothers who had toddlers and followed the PMT program at Puskesmas Somba Opu as many as 135 people. The sampling technique used proportionate stratified random sampling technique. The research was conducted at the Somba Opu Health Center in January-June 2023. Data analysis techniques used were univariate and bivariate using the Fisher test and contingency coefficient. &#x0D; Results: the input aspect for the funding component is still lacking. The process aspect of the recording component is still lacking. The output aspect is said to be sufficient in maternal attitudes and the coverage of Supplementary Feeding performance. There was a relationship between process and maternal attitude (p=0.000). &#x0D; Conclusion: the funding and recording components are still lacking and there is a relationship between the process and the mother's attitude in the implementation of the Supplementary Feeding program at Puskesmas Somba Opu, Gowa Regency. It is recommended to provide funds for the implementation of the PMT program for toddlers in the working area of Puskesmas Somba Opu, Gowa Regency

Potencial de producción de cabras locales en pastoreo y su progenie bajo un programa de alimentación complementaria pre y post parto

The production of goat's milk under extensive grazing is very important to ensure an adequate growth of the progeny, but the productivity of local does and their progeny is not accurately characterized, particularly in the semi–arid Region of Northern Mexico. The aim was to evaluate the productive potential performance of local does and their offspring, when does are offered a supplementary feeding program in pre and post–partum period. Twenty–four local does and their progeny (n=40) were used and divided into two groups: 1) Control group; does fed exclusively on grazing, 2) Supplemented group; does were supplemented at 1.5% of live weight 45 d before and 45 d after parturition. Differences due to treatment were found (P&lt;0.05) for kid´s weight at sale (KWS), kid´s age at sale (KAS), kid´s daily weight gain (KDWG) and doe’s milk production (DMP). Kid’s mortality percentage and birth weight, milk fat content and doe’s live weight did not differ between treatments (P&gt;0.05). High positive correlations between kid´s weight at birth (KWB) and KWS and KDWG were found (P&lt;0.0001), but it was negative with KAS. On the other hand, KWS was positively correlated (P&lt;0.05) with KDWG and DMP. Finally, KAS was negatively correlated with KDWG (P&lt;0.0001) as well as KDWG with DMP (P&lt;0.001) and protein content (P&lt;0.05). Its concluded that pre and postpartum supplementation in local does helps to express the productive potential for milk production, plus protein and lactose contents at starting of lactation, which in turn enhanced the performance of their progeny.

Reducing Stunting Through Specific Nutrition Interventions in Action to Prevent Stunting Program (ACS) and Supplementary Feeding Program (PMT)

Stunting is one of the nutritional problems that is a priority and must be addressed. Specific nutrition interventions in the ACS and PMT programs both have an effect on reducing stunting. Objective: To find out the differences in the effect of specific nutrition interventions in the ACS and PMT programs on reducing stunting. This research is a comparative research, cross-sectional research design. Sample: This study consisted of 60 stunted toddlers, consisting of 30 stunted toddlers in Jabung Village ad 30 stunted toddlers in Ngiliran Village. Analysis of differential effects: Independent Sample t-test. Results showed that specific nutrition interventions in the ACS program showed that 15% of toddlers passed stunting and 35% of toddlers did not pass stunting, while during the PMT implementation, 10% of toddlers passed stunting and 40% of toddlers did not pass stunting. The Independent Sample t-test concluded that there were differences in the effect of specific nutrition interventions on the ACS and PMT programs on stunting reduction. Concluded tha there were differences in the effect of specific nutrition interventions in the ACS and PMT programs had an effect on reducing stunting. So it is suggested that the handling of stunting in the ACS program can be disseminated and replicated on other places to reduce the incidence of stunting.

Posyandu Financing at The District Stunting Management Locus: A Qualitative Study

The prevalence of stunting among under-fives in Indonesia is still high, including in Tegal Regency, one of the loci for stunting reduction. To prevent stunting, the growth and development of children under five are monitored at integrated service posts (posyandu). Some problems in posyandu include an inadequate budget allocation for cadre incentives and the supplementary feeding program and inadequate tools and supporting facilities. This study aims to investigate posyandu funding in the district locus for reducing stunting. This research employed a qualitative approach. Data were collected by document studies and in-depth interviews using a semi-structured interview. Data saturation was achieved after involving ten informants. The informants were posyandu program holders (main informants), sub-coordinators of the Health Office, heads of the community health centre (puskesmas) from four puskesmas, i.e., two puskesmas with a high prevalence of stunting and two puskesmas with a low prevalence of stunting. Three themes were generated in this study: funding sources, funding allocations, and efforts to fulfil funding. The results revealed that posyandu funds come from the government, the business sector, and the community. Posyandu's funds are allocated for the incentives and training of cadres, the fulfilment of standardized anthropometric supporting tools and facilities, and the supplementary feeding program. Advocacy for posyandu funding was conducted through development planning meetings, Healthy Village Houses, stunting discussions, and cross-sector coordination. Overall, the variety in posyandu finance is consistent with the norms and circumstances of the locals in each area. Cross-sector cooperation must also be strengthened to address the posyandu's operational requirements.

An Assessment of Parental Involvement in the Supplementary Feeding Programme in Early Childhood Development in Rural Southern Africa

This conceptual discourse interrogates the contributions and challenges faced by parents in supporting the supplementary feeding programme at the Early Childhood Development (ECD) level in rural Southern Africa. This conceptual paper is a literature review study that relies on secondary data to draw the findings. The research hinges on Maslow’s hierarchy of needs and Epstein’s theory of overlapping spheres of influence. The study notes that parents play an important role in supporting the programme through activities such as the construction of cooking sheds, providing relish, fetching firewood, cleaning, and serving meals. Factors such as lack of knowledge, financial constraints, lack of cooperation, poor communication, and time constraints hinder their ability to make a sustained and effective contribution to the programme. The study recommends that parents be educated about the benefits of the supplementary feeding programme, empowered with various projects to improve their economic status, and encouraged to contribute to the programme. Another recommendation is that the school should build strong relationships with the corporate world, government, and non-governmental organisations so that they can work with parents to participate fully in the programme.

Upaya Pencegahan dan Penanggulangan Stunting di Desa Muncanglarang, Kabupaten Tegal

Stunting is currently one of the problems in the world, including Indonesia. According to WHO (2017), Indonesia is the third country with the highest stunting problem in the Southeast Asia region. Tegal Regency, Central Java is one of the areas in Indonesia that has a stunting problem, especially in Muncanglarang Village which has a variety of potential resources. The potential in Muncanglarang Village can be used as processed food such as supplementary feeding program (SFP) from ingredients that are easy to find in the village such as corn to make it easier for parents to provide additional food for toddlers at affordable prices. This community service activity begins with socialization, followed by demonstrations, validation, interviews, measurements, and mapping of stunting toddler locations. The result of this activity is that 20 pregnant women know about stunting and how to prevent it, mothers with toddlers know the importance of PMT and can process corn into PMT. An update on stunting data has been carried out at the puskesmas to assist the government in recording public health status. Validation was also carried out in conjunction with digital mapping to describe the location of the suspected stunted child's home using Google My Maps. The activity has achieved the goal of preventing and overcoming stunting, through providing information to pregnant women, updating and validating data and providing supplementary food.

Outcomes of a food voucher program and factors associated with the recovery rate of children with moderate acute malnutrition in Far North Cameroon

BackgroundResearch on moderate acute malnutrition (MAM) is limited, despite its high prevalence. This study examined outcomes of bi-weekly locally available foods provided via a food voucher program (FVP) on nutritional recovery [mid-upper arm circumference (MUAC) ≥ 125 mm] from MAM (defined as MUAC between 115 and 124 mm) and identified the factors associated with recovery rate in Kaélé health district, Far North Region of Cameroon.MethodsThis was a prospective study with 474 MAM children aged 6–59 months. Food voucher distribution and MUAC screening were conducted at 6 bi-weekly visits or until the child was recovered. Time to recovery was evaluated with multivariate Cox proportional regression hazard models with associations quantified using adjusted hazard ratio (aHR). The trend for MUAC, including its determinants, was examined with multivariate linear mixed effect models.ResultsThe recovery rate was 78.3% by 6 weeks after the first food basket; 3.4% remained MAM, and 5.9% were transferred for treatment for severe acute malnutrition (SAM defined as MUAC < 115 mm). Boys were 34% more likely to recover from MAM than girls [aHR = 1.34, 95%CI (1.09, 1.67)]. Children aged 24–53 months were 30% more likely to recover than those aged 6–11 months [aHR = 1.30, 95%CI (0.99, 1.70)]. A one unit increase in weight-for-height Z-score (WHZ) was associated with 1.89-fold greater likelihood of recovery [aHR = 1.89, 95%CI (1.66, 2.14)]. Male children had on average 1.82 mm greater increase in MUAC than female children (p < 0.001). One unit increase in WHZ was associated with 3.42 mm increase in MUAC (p = 0.025). Children aged 12–23 and 24–53 months had 1.03 mm and 2.44 mm, respectively, greater increase in MUAC over the program than children aged 6–11 months (all p < 0.01).ConclusionThe recovery rate of MAM children treated with the FVP met the Sphere standards for targeted supplementary feeding programs (> 75%). Child’s WHZ, gender and age were significant factors associated with MUAC increase and recovery from MAM in the FVP. These findings indicate the FVP approach shows promise as an effective alternative treatment for MAM with consideration of associated factors and merits further evaluation.

Pendidikan dan Pelatihan Pembuatan Makanan Sehat dan Bergizi pada Ibu Balita dan Kader Posyandu Bojong Kupa Sukamaju Kaler Kota Tasikmalaya

Introduction: Nutrition is an important factor in the formation of quality, healthy, intelligent and productive human resources (HR). One of the efforts that can be made to improve the nutritional status of toddlers is by holding a supplementary feeding program. Tasikmalaya city is the second higest prevalence in West Java Province. Cases of stunting are still found in the Indihiang Health Center area about 11.18% with most cases of stunting at the Indihiang Health Center were in the Sukamaju Kaler Village, with 103 toddlers. To create a healthy Indonesian society is to empower the community or cadres and mothers who are willing to voluntarily get involved in posyandu issues.&#x0D; Objective: The purpose of this service was to increase nutrition knowledge and equip the skills of mothers and cadres in preparing a healthy supplemenentary food to prevent stunting.&#x0D; Method: This public service was conducted by lectured about nutrition knowledge and demonstrated healthy and nutritious supplementary food for toddler.&#x0D; Result: There was an increase in nutritional knowledge (p = 0.016) and the participants enthusiastically took part in the healthy and nutritious food-making training.&#x0D; Conclusion: Communities empowerment and utilization of local food in research and community service activities can be a nutritional problem solution especially stunting.