The Bulacan Nutrition and Health Study: A Summary Report of a Longitudinal Study in Infants

A longitudinal study conducted from 1975-79 on 544 infants in the Bulacan Province in the Philippines to measure impact of health and nutrition interventions reveals that the choice of a nutritional index is important in evaluating the effectiveness of interventions (education and education with immunization food or sanitation). The food intervention consisted of Nutripak (rice milk powder bean powder or fish powder) and was provided to furnish 1/4 of the energy and protein requirements. The sanitation intervention consisted of safe water for the infant through furnishing of a chlorine solution with instructions on proper use. Immunization consisted of BCG DPT and measles at appropriate age. Education consisted of lessons to the mother on a 1-to-1 basis. Subjects included malnutrition breastfeeding supplementary foods feeding the sick child meal planning 1st aid personal hygiene and sanitation. When % of standard weight for age alone was the index food with education was most effective during weaning (5-11 months) followed by immunization with education. Education alone was effective throughout the intervention period (5-17 months) and follow-up (18-26 months) but education with sanitation was no more effective than education alone. When both height and weight were used in a nutritional index which best describes their relationship during normal growth in infants food as an intervention proved highly effective as did immunization. The impact of education alone was less than noted when weight alone served as the index. In terms of cost-effectiveness the index describing proper height and weight relationships during infancy revealed food to be the most cost-effective in early life (up to 11 months). The importance of body weight in early infancy as a good indicator of later performance was noted in Guatemalan infants. The socioeconomic impact on the height of infants is steady and persistent. The results confirm the importance of food and education.