Effectiveness of a homemade supplementary food in the management of severe acute malnutrition in 2-5 year old children in the Kopay MOH area

Abstract

IntroductionReducing wasting in children under 5 years is a challenge in Sri Lanka. Management strategy of moderate acute malnutrition (MAM) is to have target food supplementation as energy dense snacks. Objectives To assess the feasibility, acceptability and effectiveness, of a homemade supplementary food (HMSF) in the management of moderate acute malnutrition in 2-5 year old children. Methods A community based quasi experimental study was carried out from October to December 2014. The test population (n=275) were 2-5 year old children with MAM from Kopay MOH area. The control group (n=285) were children of similar age with MAM from Uduvil, Nallur area. HMSF consisted of a pre-packed cereal mixture (50g), with sugar (20g) and scraped coconut (20g) added at home (calorie content =500 kcal/90g), as a daily snack to the intervention group. Baseline weight and monthly weight gain was measured using standard calibrated weighing scales. Compliance and any acute illnesses were monitored weekly by calling or visiting households. Average weight gain of both groups was analysed using independent sample t-test. The acceptability and feasibility of the HMSF was assessed by focus group discussions with the PHMs and the mothers. Results:Mean age of test group and control group was 42.6 months and 43.1 months respectively. There was no difference in the baseline weight of the two groups (95%CI -0.059-0.416: p=0.14). The mean weight gain in the test group and control group after 3 months was 688.5g (SD=437gm) and 583g (SD=461gm) respectively (p=0.006). The mean gain in length in the test group and control group after 3 months was 1.5cm (SD=0.93cm) and 1.66cm (SD 1.3 cm) (p=0.234) respectively. Conclusions and Recommendations:This HMSF was effective, feasible and acceptable in improving weight in MAM children under the age of five years.