Filling the Gaps for Enhancing the Effectiveness of Community-Based Programs Combining Treatment and Prevention of Child Malnutrition: Results from the Rainbow Project 2015–17 in Zambia

Abstract

Background: Child malnutrition, in all its forms, is a public health priority in Zambia. After implementations based on a previous evaluation in 2012–14 were made, the efficacy of the Rainbow Project Supplementary Feeding Programs (SFPs) for the integrated management of severe acute malnutrition (SAM), moderate acute malnutrition (MAM), and underweight was reassessed in 2015–17. Methods: The outcomes were compared with International Standards and with those of 2012–14. Cox proportional risk regression analysis was performed to identify predictors of mortality and defaulting. Results: The data for 900 under-five year-old malnourished children were analyzed. Rainbow’s 2015–17 outcomes met International Standards, for total and also when stratified for different type of malnutrition. A better performance than 2012–14 was noted in the main areas previously identified as critical: mortality rates were halved (5.6% vs. 3.1%, p = 0.01); significant improvements in average weight gain and mean length of stay were registered for recovered children (p < 0.001). HIV infection (5.5; 1.9–15.9), WAZ <–3 (4.6; 1.3–16.1), and kwashiorkor (3.5; 1.2–9.5) remained the major predictors of mortality. Secondly, training community volunteers consistently increased the awareness of a child’s HIV status (+30%; p < 0.001). Conclusion: Rainbow SFPs provide an integrated community-based approach for the treatment and prevention of child malnutrition in Zambia, with its effectiveness significantly enhanced after the gaps in activities were filled.

Determinants of treatment outcomes of severe acute malnutrition among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

“…The present study is in line with a retrospective cohort study done in Zambia and Debre Berhan referral hospital, Enat general hospital and Mehal Meda primary hospital (25,26,39). However, pneumonia was not a signi cant predictor of nutritional recovery time in a retrospective cohort study done in Southern Ethiopia, Wolaita Zone and Bahir Dar city (11,23,40).…”

Recovery time from severe acute malnutrition and associated factors among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

“…This can be explained in terms of the synergistic relationship between pneumonia and malnutrition. The present study aligns with the results of retrospective cohort studies done in Zambia and at Debre Berhan Referral Hospital, Enat General Hospital, and Mehal Meda Primary Hospital [19,36,37]. However, pneumonia was not a significant predictor of nutritional recovery time in retrospective cohort studies performed in Southern Ethiopia, the Wolaita Zone, and Bahir Dar [18,26,44].…”

“…The median nutritional recovery time was consistent with the median recovery time reported in studies performed in Bahir Dar, at Wolisso St. Luke Catholic Hospital, at Dilla University Referral Hospital, and in Zambia [18,21,30,36]. However, it was longer Table 2.…”

A study on implementation of ‘Kuposhan Mukt Gujarat Maha-Abhiyan’ (KMGA) in Vadodara district, Gujarat

“…The effectiveness of the CMAM is mostly observed in African countries, including Malawi, Ghana, Ethiopia, Sudan, Kenya, and Sambia. 8,9 Apart from that some of the Asian countries like Sri Lanka and Bangladesh have also explored the same. 10 More evidence and case studies are needed in the Indian setting.…”