This study was funded by Grand Challenges Canada Grant 0462-03-10 and Fundación Exito. Orazio Attanasio was partly funded by ERC Advanced Grant AdG-695300. Costas Meghir was partly funded by the NIH grant R01HD7210, the Cowles Foundation and ISPS at Yale. This trial is registered at the ISRCTN Registry, trial number ISRCTN93757590. The Universidad de los Andes ethics committee (No. 287/2014) and the University College London research ethics committee (No 2168/011) approved this study. We would like to thank the Instituto Colombiano de Bienestar Familiar (ICBF), ICBF program supervisors in Cundinamarca, Santander and Boyacá and program coordinators at Fundación Éxito for their cooperation in facilitating the intervention; the FAMI program providers, children and families who willingly participated in this study; all the study staff including our nine tutors and María Lucía Gómez, our field manager; all the research staff including Santiago Lacouture, Alejandro Sánchez and Sara Ramírez; the data collection team from IQuartil; and the experts from Grand Challenges Canada. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.
In Latin American countries, obesity prevalence has increased significantly as a result of rapid urbanization and an improvement in socioeconomic conditions. We report the prevalence of overweight and/or obesity and prevention efforts in five countries: Mexico, Colombia, Brazil, Peru, and Chile. In children, the highest and lowest rates of obesity are found in Chile (23 % in 6-year-olds) and Peru (1.8 % in those <5 years), respectively. In adults, Mexico and Chile present similar high rates of obesity (around 35 %), whereas in Brazil and Colombia, the rates are around 20 % and 16.5 %, respectively. In general, the highest prevalence occurs in low-income women. Every country has developed initiatives to target obesity, from the government to the private sector and academia, mainly at the health sector and school settings. Food labeling is being addressed, but has not been implemented yet. Two interventions are described, a community-based in Mexico and a school-based in Chile. Because the increase in chronic diseases, especially diabetes, has paralleled that of obesity, effective prevention efforts are urgently needed.
This study was funded by Grand Challenges Canada Grant 0462-03-10 and Fundación Exito. Orazio Attanasio was partly funded by ERC Advanced Grant AdG-695300. Costas Meghir was partly funded by the NIH grant R01HD7210, the Cowles Foundation and ISPS at Yale. This trial is registered at the ISRCTN Registry, trial number ISRCTN93757590. The Universidad de los Andes ethics committee (No. 287/2014) and the University College London research ethics committee (No 2168/011) approved this study. We would like to thank the Instituto Colombiano de Bienestar Familiar (ICBF), ICBF program supervisors in Cundinamarca, Santander and Boyacá and program coordinators at Fundación Éxito for their cooperation in facilitating the intervention; the FAMI program providers, children and families who willingly participated in this study; all the study staff including our nine tutors and María Lucía Gómez, our field manager; all the research staff including Santiago Lacouture, Alejandro Sánchez and Sara Ramírez; the data collection team from IQuartil; and the experts from Grand Challenges Canada. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.
Early Childhood Development is becoming the focus of policy worldwide. However, the evidence on the effectiveness of scalable models is scant, particularly when it comes to infants in developing countries. In this paper we describe and evaluate with a cluster-RCT an intervention designed to improve the quality of child stimulation within the context of an existing parenting program in Colombia, known as FAMI. The intervention improved children’s development by 0.16 of a standard deviation (SD) and children’s nutritional status, as reflected in a reduction of 5.8 percentage points of children whose height-for-age is below -1 SD.
Background: As Bogotá is one of the regions with the highest prevalence of chronic malnutrition (13%) in Colombia, exceeding the national figure of 10.8%, a public-private alliance was established to address this situation within the framework of intersectoral action: the private organizations Fundación Santa Fe de Bogotá and Fundación Éxito, local government agencies of the Mayor's Office of Bogotá (Secretaría Distrital de Salud and the Secretariat de Integración Social) and agencies at the national level (Instituto Colombiano de Bienestar Familiar [Colombian Institute of Family Welfare], including its regional office in Bogotá). Therefore, the objective was to determine the effectiveness of an intersectoral public health intervention with the population under one year of age, classified as at risk of chronic malnutrition and with chronic malnutrition by anthropometry, residing in 3 prioritized territories of the Capital District. Methods: Pre-experimental, before and after study that sought to determine the magnitude of the change in nutritional status in children under one-year-old residing in 3 prioritized territories of Bogotá through a ten months public health nutrition intervention. Results: The intervention comprised 1126 children living in the following territories in Bogotá: Kennedy, San Cristóbal, and Engativá. A total of 43.3% children presented delay in height for age, and 56.7% presented risk of short stature. In the final measurement, data were obtained from 686 children, identifying that 17% of the children progressed from stunting to a stunting risk and that 4.5% recovered their growth trajectory, achieving an adequate height for their age. Conclusions: That children classified as at risk or stunting at the beginning of the intervention showed an increased probability of approaching or being in the appropriate growth trajectory according to the height-for-age indicator after the intervention. In addition, the risk of stunting is a reversible condition if interventions are implemented in a timely manner and with intersectoral action for which it is imperative to link the community itself as a key sector for direct action and to organize all actors and sectors having missionary purposes with this population.
Background According to the 2015 National Survey of the Nutritional Situation in Colombia the prevalence of stunting in children under 5 years of age was 10.8%. In terms of region, Bogotá, presented the highest prevalence rate (13%), a figure that exceeded national records. With the collaboration of local and national government, and nongovernmental it was decided to develop a pilot study involving a public health intervention with residents of Bogotá under 1 year of age with nutritional classification by anthropometry compatible with stunting risk or stunting. Methods Pre-experimental, before and after study that sought to determine the magnitude of the change in nutritional status through a 10 months public health nutrition intervention in children under one-year-old residing in 3 prioritized territories of Bogotá. Results The intervention comprised 1126 children living in the following territories in Bogotá: Kennedy, San Cristóbal, and Engativá. A total of 43.3% children presented delay in height for age, and 56.7% presented risk of short stature. In the final measurement, data were obtained from 686 children, identifying that 17% of the children progressed from stunting to a stunting risk and that 4.5% recovered their growth trajectory, achieving an adequate length for their age. Conclusion That children classified as at risk or stunting at the beginning of the intervention showed an increased probability of approaching or being in the appropriate growth trajectory according to the length-for-age indicator after the intervention.
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