O Yaw Addo1, Katie Tripp2, Simeon Nanama3, Bope Albert4, Fanny Sandalinas5, Ambroise Nanema3, Maria Elena Jefferds2, Heather B Clayton2, Ralph D Whitehead2, Aashima Garg6, Roland Kupka6, Lindsey M Locks7. 1. Emory University Rollins School of Public, Hubert Department of Global Health & Global Health Institute, Atlanta, GA; McKing Consulting Corporation, Atlanta, GA; International Micronutrient Malnutrition Prevention and Control (IMMPaCT) Program, Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: Yaw.Addo@cdc.gov. 2. International Micronutrient Malnutrition Prevention and Control (IMMPaCT) Program, Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, GA. 3. UNICEF-DRC, Kinshasa and Lubumbashi, Democratic Republic of Congo, DRC. 4. National Statistics Institute, Lubumbashi, DRC. 5. UNICEF-WCARO, Dakar, Senegal. 6. United Nations Children's Fund (UNICEF) Headquarters, New York, NY. 7. Harvard TH Chan School of Public Health, Boston, MA, USA; United Nations Children's Fund (UNICEF) Headquarters, New York, NY.
Abstract
OBJECTIVE: To evaluate the impact of an infant, young child feeding practices-small-quantity lipid nutrient supplements (SQ-LNS) intervention on child development scores in children aged 6-18 months in the Katanga Province, Democratic Republic of Congo (DRC). STUDY DESIGN: We analyzed data of 2595 children from 2 health zones in a quasi-experimental design with preimplementation and postimplementation surveys to evaluate program impact on child development scores. Standard care was received in the comparison health zone and the intervention health zone received standard care plus enhanced infant, young child feeding practices with a monthly supply of 28 SQ-LNS sachets for up to 1 year. Program exposure and communication and motor domains of the Ages and Stages questionnaire were collected to assess changes in child development scores. A quasi-intent-to-treat and adjusted difference-in-difference analyses were used to quantify impact of the enhanced compared with the standard package. RESULTS: In adjusted models contrasting endline with baseline, there was a greater relative increase in proportion of children with normal communication (difference-in-difference, +13.7% [95%CI, 7.9-19.6; P < .001] and gross motor scores, +7.4% [95% CI: 1.3-13.5; P < .001]) in the intervention vs comparison health zones. Further, in separate analyses among children of intervention health zone at endline, each additional SQ-LNS distribution was associated with +0.09 (95% CI, 0.03-0.16) z-score unit increase in gross motor scores (P < .01). CONCLUSIONS: The integrated infant, young child feeding practice-SQ-LNS intervention was positively associated with larger relative improvements in measures of child communication and motor development in the Katanga province of DRC.
OBJECTIVE: To evaluate the impact of an infant, young child feeding practices-small-quantity lipid nutrient supplements (SQ-LNS) intervention on child development scores in children aged 6-18 months in the Katanga Province, Democratic Republic of Congo (DRC). STUDY DESIGN: We analyzed data of 2595 children from 2 health zones in a quasi-experimental design with preimplementation and postimplementation surveys to evaluate program impact on child development scores. Standard care was received in the comparison health zone and the intervention health zone received standard care plus enhanced infant, young child feeding practices with a monthly supply of 28 SQ-LNS sachets for up to 1 year. Program exposure and communication and motor domains of the Ages and Stages questionnaire were collected to assess changes in child development scores. A quasi-intent-to-treat and adjusted difference-in-difference analyses were used to quantify impact of the enhanced compared with the standard package. RESULTS: In adjusted models contrasting endline with baseline, there was a greater relative increase in proportion of children with normal communication (difference-in-difference, +13.7% [95%CI, 7.9-19.6; P < .001] and gross motor scores, +7.4% [95% CI: 1.3-13.5; P < .001]) in the intervention vs comparison health zones. Further, in separate analyses among children of intervention health zone at endline, each additional SQ-LNS distribution was associated with +0.09 (95% CI, 0.03-0.16) z-score unit increase in gross motor scores (P < .01). CONCLUSIONS: The integrated infant, young child feeding practice-SQ-LNS intervention was positively associated with larger relative improvements in measures of child communication and motor development in the Katanga province of DRC.
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Authors: Elizabeth L Prado; Souheila Abbeddou; Elizabeth Yakes Jimenez; Jérôme W Somé; Zinewendé P Ouédraogo; Steve A Vosti; Kathryn G Dewey; Kenneth H Brown; Sonja Y Hess; Jean-Bosco Ouédraogo Journal: J Nutr Date: 2016-03-09 Impact factor: 4.798
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