Failure of a supplementary feeding programme to improve the health of young children - abstract

Each year the world devotes over $300 million to supplementary feeding projects. Yet there are few truly empirical studies on the impact of particular schemes. In St. Lucia an evaluation was made of a three-year World Food Programme clinic-based handout project. The objectives were to prevent and to treat childhood malnutrition and to increase the average birth weight by improving the diet of pregnant women. The evaluation showed that (1) faulty classification of children had led to inadequate coverage of the target groups (2) mean birth weights of babies of supplemented and unsupplemented mothers were 93.3 percent and 93.9 percent of Harvard Standard respectively (3) The proportion of infants offered breast-milk before and after the intervention was similar, but bottle-feeding was more prevalent after. The introduction of the "family pot" mixed diet was correspondingly delayed (4) intakes of energy and of protein were higher in the supplemented group, but differences were negligible after one year of age (5) despite, or because of, their supplements, children in this group had an average 2.4 percent diarrhoea rate (6) since well-nourished children were receiving supplementary food while many who were undernourished were not, we were presented fortuitously with an ideal design for comparison. Between 6 months and 2 years of age, the increase in the number of malnourished children was greater in the supplemented than in the unsupplemented group. Analysis of the reasons for the above findings should lead to changes in the World Food Programme's policies for distribution of dried milk and other foods in the Caribbean (AU)