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Impact of a home-based nutritional intervention program on nutritional status of preschool children: a cluster
Ansuya B1, Baby S Nayak2, Unnikrishnan B3
1Department of Community Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Insights
Home-based nutritional interventions significantly improved the nutritional status of under-five children in rural South India. This program, involving caregiver education and diet demonstration, reduced malnutrition rates and improved weight gain.
Area of Science:
- Public Health Nutrition
- Pediatric Nutrition
- Community Health Interventions
Background:
- Undernutrition in children under five is a major global health challenge, contributing to significant morbidity and mortality.
- Preschool children in rural South India are particularly vulnerable to nutritional deficiencies.
- Effective interventions are crucial to combat childhood malnutrition in underserved populations.
Purpose of the Study:
- To evaluate the effectiveness of a home-based nutritional intervention program.
- To assess the impact of this intervention on the nutritional status of preschool children.
- To determine changes in weight and malnutrition prevalence following the intervention.
Main Methods:
- A single-blinded cluster randomized controlled trial was conducted across 12 villages.
- 253 underweight preschool children were randomized into intervention (n=127) and control (n=126) groups.
- The intervention included health education and food preparation demonstrations, alongside standard care; the control group received only standard care.
Main Results:
- The intervention group showed a statistically significant increase in mean weight compared to the control group.
- Moderate malnutrition decreased from 41.5% to 24% and severe malnutrition from 8.69% to 3.16% in the intervention group.
- A notable 20.5% of malnourished children in the intervention group achieved normal nutritional status, with minimal changes observed in the control group.
Conclusions:
- Home-based nutritional interventions are effective in improving the nutritional status of preschool children.
- Educating mothers/caregivers on diet planning, preparation, and nutritional knowledge is key to successful interventions.
- The intervention demonstrated significant positive impacts on weight gain and reduction in malnutrition prevalence.
Background:
Undernutrition in under-five children remains a worldwide health issue and is considered one of the leading causes of increased morbidity and mortality. This study aims to assess the impact of home-based nutritional intervention on the nutritional status of preschool children living in rural areas of South India.
Methods:
A single-blinded cluster randomized controlled trial evaluated the impact of the intervention, with weight gain as the primary outcome. A cluster of 12 villages was randomized to intervention or control arms. A total of 253 underweight preschool children from 12 clusters (villages) were randomized to intervention (n = 127) and control arm (n = 126). The intervention was composed of a health-teaching program and a demonstration of nutritious food preparation in addition to the regular services provided at the Anganwadi centers. The control arm received only standard routine care provided in the Anganwadi centre. The anthropometric assessment was carried out at the baseline and every month for a year.
Result:
A significant increase in the mean weight kilograms was noted in the intervention group (11.9 ± 0.98 to 13.78 ± 0.89) compared to the control group (11.8 ± 1.03 to 12.96 ± 0.88). In the intervention group, at the baseline, 41.5% were moderately malnourished (> - 2SD-3SD), which decreased to 24% at the end of the year. Similarly, severe malnutrition decreased from 8.69 to 3.16%, while 20.5% of malnourished children achieved normal nutritional status. In the control group, undernourished children demonstrated minimal changes in nutritional status. Analysis of repeated measures of ANOVA results between the intervention and control groups on weight measurements (F (1, 251) = 15.42, p .001) and height measurements (F (2, 1258) = 1.540, p .001) revealed statistical significance.
Conclusion:
The nutritional status of preschool children is found to be improved by home-based intervention, which includes training mothers or caregivers in planning and preparing healthy nutritious diets, providing timely care, and gaining an understanding and knowledge of the nutritional status along with regular home-based diet preparation.
Trial Registration:
ctri@gov.in CTRI/2017/03/008273 [Registered on: 31/03/2017].
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