A Mixed-Methods Assessment of a Nutrition Program Targeting Childhood Undernutrition

To assess the Food Support Program (Programa de Apoyo Alimentario) implemented by the government of Montevideo to address childhood undernutrition.

A mixed-methods design. Quantitative data were collected through telephone surveys and medical records and analyzed using a prepost design. Qualitative data were collected through interviews with mothers of beneficiary children.

Montevideo, Uruguay.

A total of 120 children participants of the Food Support Program and their mothers.

Household food insecurity, children's food consumption frequency of 17 categories in the week before the survey, anthropometric data (weight-for-age, length-for-age, and weight-for-length z-scores), and mothers' perceptions about the program.

Mixed linear models and content analysis of interviews.

Average household food insecurity score decreased by 1.5 points (P < 0.001) after 12 months. Average frequency of milk and cheese consumption increased by 1.3 days (P < 0.001), frequency of adding oil to meals by 1.0 days (P = 0.002), and consumption frequency of sugary foods by 1.4 days (P < 0.001). Average z-scores for weight-for-age and weight-for-length increased 0.37 (P < 0.001) and 0.31 (P = 0.001), respectively. However, length-for-age showed no significant change (P = 0.90). Mothers of beneficiary children valued economic support but highlighted gaps in program communication and education, and counseling activities.

The program showed potential to alleviate immediate nutritional deficiencies, but additional and sustained integrated efforts are needed to address chronic undernutrition, food insecurity, and diet quality. In particular, the persistence of food insecurity in half of the households after 12 months underscores the need to reassess the adequacy of the cash transfer amount relative to the affordability of a healthy food basket in the country.