Intensive nutrition education with or without supplementary feeding improves the nutritional status of moderately-malnourished children in Bangladesh.

This prospective randomized trial was carried out to test the efficacy of a specific intervention for reducing the extent of their malnutrition and to change behaviour of mothers relating to child-feeding practices, care-giving, and health-seeking practices under the Bangladesh Integrated Nutrition Project (BINP). The study was conducted in rural Bangladesh among 282 moderately-malnourished (weight-for-age between 61% and 75% of median of the National Center for Health Statistics standard) children aged 6-24 months. Mothers of the first intervention group received intensive nutrition education (INE group) twice a week for three months. The second intervention group received the same nutrition education, and their children received additional supplementary feeding (INE+SF group). The comparison group received nutrition education from the community nutrition promoters twice a month according to the standard routine service of BINP. The children were observed for a further six months. After three months of interventions, a significantly higher proportion of children in the INE and INE+SF groups improved (37% and 47% respectively) from moderate to mild or normal nutrition compared to the comparison group (18%) (p < 0.001). At the end of six months of observation, the nutritional status of children in the intervention groups improved further from moderate to mild or normal nutrition compared to the comparison group (59% and 86% vs 30%, p < 0.0001). As the intensive nutrition education and supplementation given were highly effective, more children improved from moderate malnutrition to mild or normal nutritional status despite a higher incidence of morbidity. The frequency of child feeding and home-based complementary feeding improved significantly (p < 0.001) in both the intervention groups after three months of interventions and six months of observation. Body-weight gain was positively associated with age, length-for-age, weight-for-length, frequency of feeding of khichuri, egg, and potato (p < 0.05). Ability of mothers to identify malnutrition improved from 15% to 99% in the INE group and from 15% to 100% in the INE+SF group, but reduced from 24% to 21% in the comparison group. Use of separate feed pots, frequency of feeding, and cooking of additional complementary feeds improved significantly in the INE and INE+SF groups compared to the comparison group after three months of interventions and six months of observation. It can be concluded from the findings of the study that intensive nutrition education significantly improves the status of moderately-malnourished children with or without supplementary feeding.

intervention programme for improving the nutritional status of children aged 2-5 years in Alexandria

We assessed the effect of a selected intervention on the nutritional status of 2-5-year-old children in day care centres. Using a longitudinal prospective pretest/post-test intervention design, 974 children from 3 day care centres in Alexandria were followed for 1 year. Anthropometric measurements and 3-day 24-hour recall data were gathered at base line and dietary intake was calculated and compared with recommended daily allowances. An intervention programme was implemented through the establishment of kitchens in the 3 centres, provision of 2 meals/day, nutrition education for parents and training of supervisors. Baseline data revealed deficient intake of most nutrients especially calcium, calories, vitamin C and iron. Post-intervention test revealed improvement in mothers' nutrition knowledge and the percentage of anaemic children decreased from 47.3% to 14.2%. A decrease in the percentage of underweight, stunted and wasted was also observed. The cost of the programme per child per year was US$ 20.5

Multidisciplinary intervention for reducing malnutrition among children in the Islamic Republic of Iran

A multidisciplinary intervention to reduce protein-energy malnutrition among children in rural areas was piloted in 3 provinces of the Islamic Republic of Iran. Based on an initial situation analysis, a range of interventions were implemented through local nongovernmental organizations, including nutrition, health and literacy education for mothers, improved growth monitoring and fostering rural cooperatives and income generation schemes. Malnutrition before and after the intervention [in 1996 and 1999] was assessed using anthropometric measurements of r and om samples of children aged 6-35 months in control and intervention areas. Three years into the intervention, all indicators of malnutrition had consistently decreased in all intervention areas and the prevalence of underweight and stunting was significantly lower. Control areas showed a mixed pattern of small increases and decreases in malnutrition indicators

Impact of nutrition and health education on rural pre-school children.

Pre-school children (n = 155) belonging to low socio-economic group from eight creches in villages around Chandigarh, were imparted nutrition and health education (NHE) for one year. Appropriate teaching material in the form of songs, rhymes and roleplays were scientifically developed for the purpose. For impact evaluation, objective tools in the form of checklists were formulated and used. NHE on three aspects, i.e., personal hygiene (PH), food hygiene (FH) and recognition of foods (RF) was imparted by Balsevikas (BSs) incharge of the creches, daily in a non-formal manner, for one year and evaluated periodically. On PH only, children of the lowest income group improved significantly. On FH and RF, all children registered significant improvement as these two aspects, were under the direct control of BSs who enthused and involved the children by providing an interacting and stimulating environment. The results are encouraging and indicate the pre-school children are educable in NHE provided participatory and appropriate material and methods are used.