Evaluating interventions to improve child nutrition in Eastern Democratic Republic of Congo

Abstract

ObjectiveThe prevention of malnutrition in children under two approach (PM2A), women’s empowerment and agricultural interventions have not been widely evaluated in relation to child diet and nutrition outcomes. The present study evaluated the effectiveness of PM2A, women’s empowerment groups (WEG), farmer field schools (FFS) and farmer-to-farmer training (F2F).DesignCommunity-matched quasi-experimental design; outcome measures included children’s dietary diversity, stunting and underweight.SettingCommunities in South Kivu, Democratic Republic of the Congo.ParticipantsA total of 1312 children from 1113 households.ResultsAchievement of minimum dietary diversity ranged from 22·9 to 39·7 % and was significantly greater in the PM2A and FFS groups (P<0·05 for both comparisons). Fewer than 7·6 and 5·8 % of children in any group met minimum meal frequency and acceptable diet targets; only the PM2A group differed significantly from controls (P<0·05 for both comparisons). The endline stunting prevalence ranged from 54·7 % (PM2A) to 69·1 % (F2F) and underweight prevalence from 22·3 % (FFS) to 34·4 % (F2F). No significant differences were found between intervention groups and controls for nutrition measures; however, lower prevalences of stunting (PM2A, −4 %) and underweight (PM2A and FFS, −7 %) suggest potential impact on nutrition outcomes.ConclusionsChildren in the PM2A and FFS groups had better child diet measures and nutrition outcomes with the best results among PM2A beneficiaries. Interventions that address multiple aspects nutrition education, health, ration provision and income generation may be more effective in improving child diet and nutrition in resource-poor settings than stand-alone approaches.

Mental health symptoms and their relations with dietary diversity and nutritional status among mothers of young children in eastern Democratic Republic of the Congo

“…The extremely resource-limited context may have been an important factor contributing to the contrary findings. The results of the parent study found that stunting prevalence ranged from 55 to 70% among children in intervention group households and 47% of households were severely food insecure at endline, making this a particularly nutritionally deprived group [30,48]. In such a food insecure environment, opportunities to improve dietary diversity are limited, and differences in dietary diversity among participants with higher levels of mental health symptoms compared to those with less severe symptoms may be due to other underlying or modifying factors, such as social support and work burden.…”

Food Security and Nutrition Outcomes of Farmer Field Schools in Eastern Democratic Republic of the Congo

“…Additional findings, including a comparison of all interventions, are presented elsewhere, along with more detailed information about overall study methods and statistical analyses. 19 , 20 Here we summarize the methods relevant to the current research, as well as information specific to the FFS analysis.…”

“…Data were collected in 8 semiannual surveys (August/September and February/March) to account for seasonal variations in food security. 20 Both data collection periods were at the beginning of local rainy seasons. 21…”

“…Weight was measured using Tanita Mommy and Baby Infant Scales, Model 1582 (Arlington Heights, IL, USA), and Shorr Productions height boards (Olney, MD, USA); recumbent length was measured for children 6 to 23 months of age and height for children older than 24 months. 20 …”

“…Study participants received a small incentive, most often soap, worth approximately US$1, for participation in each survey. 20 …”