TY - JOUR
T1 - Program changes are effective and cost-effective in increasing the amount of oil used in preparing corn soy blend porridge for treatment of moderate acute malnutrition in Malawi
AU - Rogers, Beatrice Lorge
AU - Wilner, Lauren B.
AU - Maganga, Gray
AU - Walton, Shelley Marcus
AU - Suri, Devika J.
AU - Langlois, Breanne K.
AU - Chui, Kenneth Kwan Ho
AU - Boiteau, Jocelyn M.
AU - Vosti, Stephen A.
AU - Webb, Patrick
N1 - Funding Information:
This research was made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Tufts University under the terms of Contracts AFP‐C‐00‐09‐00016‐00 and
Funding Information:
This research would not have been possible without the collaboration between Tufts University, University of Malawi‐Center for Social Research, Catholic Relief Service, Save the Children, Project Concern International, Africare, and Pakachere Institute for Health and Development Communication. The Government of Malawi, specifically, the National Health Science Research committee, Malawi Government Department for Nutrition, Technical Nutrition Panel and the Ministry of Health personnel in Lilongwe, Mulanje, Zomba, Machinga, Balaka and Chiradzulu districts provided us the programmatic platform and all support needed to carry out this study. We also acknowledge research support provided by Kristine Caiafa fromTufts University. We gratefully acknowledge the work of our dedicated data collection team in Malawi and the respondents who generously provided information.
Publisher Copyright:
© 2017 The Authors Maternal & Child Nutrition Published by John Wiley & Sons Ltd
PY - 2017/10
Y1 - 2017/10
N2 - Corn Soy Blend (CSB) porridge is commonly prepared with oil for treatment of moderate acute malnutrition (MAM). A recent review recommended that 30 g of oil be used with 100 g of CSB to increase energy density and micronutrient absorption. This study assessed the effectiveness and cost-effectiveness of program changes aimed at achieving that target oil:CSB ratio in prepared porridge. Caregivers of children in MAM supplementary feeding programs were assigned to three groups: a control group received monthly rations of 1 L oil, 8 kg CSB in bulk, and social and behavior change communication (SBCC); intervention groups received 2.6 L oil, 8 kg CSB provided either in bulk (Group 1) or four 2-kg packages with printed messages (Group 2), and enhanced SBCC emphasizing the target oil:CSB ratio. Compared to the control, both intervention groups had higher mean added oil per 100 g CSB (18 g, p < 0.01, and 13 g, p= 0.04, higher in groups 1 and 2, respectively), and greater odds of meeting or exceeding the target ratio (28.4, p< 0.01, and 12.7, p= 0.02, in groups 1 and 2, respectively). Cost per caregiver reaching the target ratio was most favorable in Group 1 ($391 in Group 1, $527 in Group 2, and $1,666 in the control). Enhanced SBCC combined with increased oil ration resulted in increased use of oil in CSB porridge in a supplementary feeding program. Modified packaging did not improve effectiveness. However, both interventions were more cost-effective than standard programming.
AB - Corn Soy Blend (CSB) porridge is commonly prepared with oil for treatment of moderate acute malnutrition (MAM). A recent review recommended that 30 g of oil be used with 100 g of CSB to increase energy density and micronutrient absorption. This study assessed the effectiveness and cost-effectiveness of program changes aimed at achieving that target oil:CSB ratio in prepared porridge. Caregivers of children in MAM supplementary feeding programs were assigned to three groups: a control group received monthly rations of 1 L oil, 8 kg CSB in bulk, and social and behavior change communication (SBCC); intervention groups received 2.6 L oil, 8 kg CSB provided either in bulk (Group 1) or four 2-kg packages with printed messages (Group 2), and enhanced SBCC emphasizing the target oil:CSB ratio. Compared to the control, both intervention groups had higher mean added oil per 100 g CSB (18 g, p < 0.01, and 13 g, p= 0.04, higher in groups 1 and 2, respectively), and greater odds of meeting or exceeding the target ratio (28.4, p< 0.01, and 12.7, p= 0.02, in groups 1 and 2, respectively). Cost per caregiver reaching the target ratio was most favorable in Group 1 ($391 in Group 1, $527 in Group 2, and $1,666 in the control). Enhanced SBCC combined with increased oil ration resulted in increased use of oil in CSB porridge in a supplementary feeding program. Modified packaging did not improve effectiveness. However, both interventions were more cost-effective than standard programming.
KW - Moderate acute malnutrition
KW - corn soy blend
KW - food aid
KW - fortified blended food
KW - social and behavior change communication
KW - supplementary feeding
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U2 - 10.1111/mcn.12393
DO - 10.1111/mcn.12393
M3 - Article
C2 - 28083927
AN - SCOPUS:85029215608
SN - 1740-8695
VL - 13
JO - Maternal and Child Nutrition
JF - Maternal and Child Nutrition
IS - 4
M1 - e12393
ER -