Tubaramure, a Food-Assisted Maternal and Child Health and Nutrition Program in Burundi, Increased Household Food Security and Energy and Micronutrient Consumption, and Maternal and Child Dietary Diversity: A Cluster-Randomized Controlled Trial.
Burundi
Child Health Services
Cluster Analysis
Diet
Energy Intake
Family Characteristics
Female
Food Assistance
Food Supply
Humans
Infant
Infant Nutritional Physiological Phenomena
Maternal Nutritional Physiological Phenomena
Maternal-Child Health Services
Micronutrients
/ administration & dosage
Program Evaluation
children
dietary diversity
food consumption
household
infant and young child feeding practices
mothers
Journal
The Journal of nutrition
ISSN: 1541-6100
Titre abrégé: J Nutr
Pays: United States
ID NLM: 0404243
Informations de publication
Date de publication:
01 04 2020
01 04 2020
Historique:
received:
02
08
2019
revised:
26
09
2019
accepted:
08
11
2019
pubmed:
21
12
2019
medline:
15
8
2020
entrez:
21
12
2019
Statut:
ppublish
Résumé
Food-assisted maternal and child health and nutrition programs are a widely used approach to address undernutrition. Little is known about the effects of these programs' combined household and individual food rations on household and individual food consumption. Tubaramure in Burundi targeted women and children during the first 1000 d of life, and included: 1) food rations (corn-soy blend and micronutrient-fortified vegetable oil); 2) health services strengthening and promotion of their use; and 3) behavior change communication on nutrition, hygiene, and health practices. The objectives were: 1) to assess Tubaramure's impact on household food consumption and food security, maternal dietary diversity, and infant and young child feeding practices; 2) to explore the role of the food rations; and 3) assess 6-8 mo impacts around 8 mo after the end of the program. We used a 4-arm cluster-randomized controlled repeated cross-sectional design (11,906 observations). The treatment arms received the same food ration but differed in the ration timing and duration: 1) the first 1000 d; 2) from pregnancy through 17.9 mo of age; or 3) from birth through 23.9 mo of age. Tubaramure significantly (P < 0.05) improved the percentage of food secure households [from 4.5 to 7.3 percentage points (pp)], and increased household energy consumption (from 17% to 20%) and micronutrient consumption. The program had a positive effect on maternal dietary diversity (+0.4 food groups, P < 0.05) and increased the proportion of children aged 6-23.9 mo consuming ≥4 food groups (from 8.0 to 9.6 pp, P < 0.05). The effects on many outcomes were attributable to the food rations. Postprogram effects (P < 0.05) were found on household food security, maternal dietary diversity, and younger sibling's complementary feeding practices. Programs such as Tubaramure have the potential to improve food security and household and individual energy and micronutrient consumption in severely resource-constrained populations, as seen in rural Burundi. This trial was registered at clinicaltrials.gov as NCT01072279.
Sections du résumé
BACKGROUND
Food-assisted maternal and child health and nutrition programs are a widely used approach to address undernutrition. Little is known about the effects of these programs' combined household and individual food rations on household and individual food consumption. Tubaramure in Burundi targeted women and children during the first 1000 d of life, and included: 1) food rations (corn-soy blend and micronutrient-fortified vegetable oil); 2) health services strengthening and promotion of their use; and 3) behavior change communication on nutrition, hygiene, and health practices.
OBJECTIVES
The objectives were: 1) to assess Tubaramure's impact on household food consumption and food security, maternal dietary diversity, and infant and young child feeding practices; 2) to explore the role of the food rations; and 3) assess 6-8 mo impacts around 8 mo after the end of the program.
METHODS
We used a 4-arm cluster-randomized controlled repeated cross-sectional design (11,906 observations). The treatment arms received the same food ration but differed in the ration timing and duration: 1) the first 1000 d; 2) from pregnancy through 17.9 mo of age; or 3) from birth through 23.9 mo of age.
RESULTS
Tubaramure significantly (P < 0.05) improved the percentage of food secure households [from 4.5 to 7.3 percentage points (pp)], and increased household energy consumption (from 17% to 20%) and micronutrient consumption. The program had a positive effect on maternal dietary diversity (+0.4 food groups, P < 0.05) and increased the proportion of children aged 6-23.9 mo consuming ≥4 food groups (from 8.0 to 9.6 pp, P < 0.05). The effects on many outcomes were attributable to the food rations. Postprogram effects (P < 0.05) were found on household food security, maternal dietary diversity, and younger sibling's complementary feeding practices.
CONCLUSIONS
Programs such as Tubaramure have the potential to improve food security and household and individual energy and micronutrient consumption in severely resource-constrained populations, as seen in rural Burundi. This trial was registered at clinicaltrials.gov as NCT01072279.
Identifiants
pubmed: 31858128
pii: S0022-3166(22)02109-5
doi: 10.1093/jn/nxz295
pmc: PMC7138675
doi:
Substances chimiques
Micronutrients
0
Banques de données
ClinicalTrials.gov
['NCT01072279']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
945-957Informations de copyright
Copyright © The Author(s) 2019.
Références
Cochrane Database Syst Rev. 2015 Mar 05;(3):CD009924
pubmed: 25739460
Lancet. 2013 Aug 3;382(9890):427-451
pubmed: 23746772
Matern Child Nutr. 2008 Apr;4 Suppl 1:24-85
pubmed: 18289157
Adv Nutr. 2019 Mar 1;10(2):196-204
pubmed: 30801614
J Nutr. 2016 Aug;146(8):1601-8
pubmed: 27412269
Food Nutr Bull. 2004 Mar;25(1 Suppl 2):S99-203
pubmed: 18046856
J Clin Epidemiol. 2010 Aug;63(8):e1-37
pubmed: 20346624
J Nutr. 2018 Mar 1;148(3):445-452
pubmed: 29546306
J Nutr. 2019 Oct 1;149(10):1833-1842
pubmed: 31268132