News Release

Study shows preventive nutrition intervention program better than traditional recuperative model

Peer-Reviewed Publication

The Lancet_DELETED

A preventive nutrition intervention programme – which targets all children at risk earlier – pays better dividends than “damage limitation” recuperative programmes in which children already affected by undernutrition are treated. These are the conclusions of authors of an Article in this week’s edition of The Lancet, which follows up the recent Lancet Series on Maternal and Child Undernutrition.

Dr Marie Ruel, Food Consumption and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA, and colleagues did a randomised trial of both styles of intervention in Haiti. The preventive model targeted all children aged 6-23 months; while the recuperative model targeted underweight children only aged 6-60 months. Both models also targeted pregnant and lactating women. Clusters of communities were paired on access to services and other factors, and then randomly assigned to each model. Using two cross-sectional surveys, (at baseline and 3 years later), the authors tested differences in undernutrition in children aged 12-41 months (roughly 1500 per survey).

The researchers found no differences between programme groups at baseline. At follow-up, stunting, being underweight, and wasting were between 4-6 percentage points lower in preventive than in recuperative communities; and mean anthropometric indicators were also higher in the preventive group – weight for age and weight for height by 0.24 Z scores, Height for age was also higher by 0.14 Z scores in the preventive group, although this was not statistically significant. The effects of the preventive programme were greater in children exposed for the full span of 6-23 months than in children exposed for shorter durations. The quality of implementation did not differ between the two programmes, nor did use of services for maternal and child health and nutrition.

The authors conclude: “This study shows, using a cluster-randomised trial, that an age-based preventive model for delivering a package of food assistance and maternal and child health and nutrition interventions was more effective at reducing childhood undernutrition than the traditional, recuperative model based on targeting underweight children.”

In an accompanying Comment, Howard White, Independent Evaluation Group, World Bank, Washington, DC, USA, says the study showed a universal approached to be superior to a targeted one, and that randomised trials can be used for social programmes in developing countries. However, he also raises concerns about the design of the study, namely the lack of a control group and that the researchers did not examine whether implementation differences explain the relative underperformance of the recuperative model.

###

For Dr Marie Ruel, International Food Policy Research Institute (IFPRI), please contact Michael Rubinstein, Head of Media Relations, IFPRI, Washington, DC, USA T) +1 202-862-5670 E) m.rubinstein@cgiar.org / m.ruel@cgiar.org

Howard White, Independent Evaluation Group, World Bank, Washington, DC, USA (currently based in Cairo) T) + 20 22 668 222 E) hwhite@worldbank.org

PDF of article: http://multimedia.thelancet.com/pdf/press/Haiti.pdf


Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.