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The effects on weight and attendance of a supplementary feeding programme operating in two under-5 clinics in Lesotho
W E Tjon a Ten1, J A Kusin, C de With
1St James Mission Hospital, Mantsonyane, Lesotho.
Insights
Child growth in Lesotho slowed significantly after 3 months, despite supplementary feeding programs. While feeding did not improve weight, it boosted clinic attendance for essential services like immunizations.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Childhood growth faltering is a major public health concern in low-income settings.
- Under-nutrition and disease are suspected contributors to poor growth trajectories.
- The efficacy of supplementary feeding programs in improving child weight requires ongoing evaluation.
Purpose of the Study:
- To analyze growth curves of preschool children in Lesotho.
- To assess the impact of supplementary feeding on child weight and clinic attendance.
Main Methods:
- Utilized routinely collected weight data from 2202 children (1978-1983).
- Calculated growth curves and compared them to the National Center for Health Statistics (NCHS) reference.
- Evaluated the effect of supplementary feeding on weight gain and clinic attendance.
Main Results:
- Growth curves exceeded NCHS reference up to 5 months, then declined, stabilizing at the 10th percentile by 11-13 months.
- No significant positive impact of supplementary feeding on child weight was observed.
- Supplementary feeding positively influenced clinic attendance rates, enhancing coverage of other services.
Conclusions:
- Environmental factors like under-nutrition and disease likely contributed to growth deceleration.
- Supplementary feeding did not improve child weight in this cohort.
- The program's value in improving attendance and service coverage warrants further cost-benefit analysis.
Abstract:
The routinely collected weight data of 2202 pre-school children who visited two under-5 clinics in Lesotho between 1978 and 1983 were used to calculate growth curves and to assess the effects of supplementary feeding. Up to the age of 5 months growth curves were above the NCHS reference. Growth started to decrease at the age of 3 months and stabilized at 11-13 months at the 10th percentile of the reference. The decrease of growth might have been due to environmental factors such as under-nutrition and disease. If this was the case, supplementary feeding might have had a positive impact on weight, but such an effect was not observed in this study. Supplementary feeding had, however, a positive effect on attendance rates and hence contributed to higher coverage of other under-5 clinic activities, such as immunization, health and nutrition education, and growth monitoring. Whether this positive effect warrants its extra cost remains open to question.