The nutritional impact of the world food programme-supported supplementary feeding programme on children less than five years in rural Tamale.

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July, 2007.
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Abstract
This study was a cross sectional evaluation study which sought to find out the nutritional impact of the supplementary feeding programme on the target population - children 6 months to 59 months. The study also looked at other factors (socio-economic and demographic) known to affect the nutritional status of children. The impact of the supplementary feeding programme was measured based on anthropometric indicators – height-for -age, weight –for – age, and weight-for-height. The study used multistage sampling techniques to select 400 children 6 to 59 months from the base-line study carried out at the beginning of the programme in 2003 by reviewing the existing baseline data. Four hundred (400) children 6 to 59 months old benefiting from the supplementary feeding programme as at August, 2007 were also selected using the register of beneficiary children in each community. Anthropometric measurements were taken of the sampled children (post intervention) while same was retrieved from the sampled baseline data (baseline). Mothers/ care-givers of the children were the subjects for interview, and similar information was sought out from the sampled baseline data. The results of the study were analyzed using Epi Info 3.4 software and presented in appropriate statistical graphs and tables The results of this study revealed that among all the under fives surveyed at the baseline, 57.9% of them were stunted, of which 26.2% were severely stunted; 66.7% were underweight with 30.7% being severely underweight, and 41.8% were wasted, with 8.8% severely wasted. At the post intervention four years later, stunting went up by11.2% to 69.1%, underweight also went up by 3.5% to70.2%.Wasting, however, reduced by 10.5% to 34.3%. Severe stunting, underweight and wasting also followed similar trends, with severe stunting increasing by10.0%, severe underweight increasing by 0.4%, and severe wasting dropping by 3.5%. This showed that there were increases in the proportions of stunting and underweight between the baseline and post intervention groups. Comparing the difference in the proportions of moderate and severe stunting at baseline and post intervention with 95% CI, it has been revealed that the increase was not significant ( i.e. moderate stunting, 0.12,-0.01; and severe stunting,0.05,-0.17). The difference in increase in the proportion of moderate and severe underweight was also not significant with 95% CI (i.e. moderate underweight, 0.03,-0.09; and severe underweight, 0.05,-0.06). However, the proportion of wasting reduced at the post intervention stage. Comparison of the proportion of reduction of moderate and severe wasting also indicated that the reduction was mild at 95% CI (i.e. moderate wasting, 0.11,-0.01; and severe wasting, 0.17,0.0004). This is an indication that the supplementary feeding project was only successful in reducing acute malnutrition (wasting) rather than chronic malnutrition.(stunting and underweight). Chronic malnutrition continued to increase over the project implementation period. Other factors that might affect nutritional status generally did not seem to bring about improvements in the proportion of stunting and underweight after the intervention. The difference in nutritional status by sex equally did not show any different trend. Stunting and underweight increased in both males and females after the intervention. Like in the general target group, wasting however decreased in both males and females after the intervention. Comparison of the differences in proportions of decrease in the stunting and underweight, and the proportion of reduction in wasting were equally not very significant at 95% confidence level. The study recommends among other things that supplementary feeding interventions should target severely malnourished children for rehabilitation with education while mothers/care-takers of moderately malnourished children are targeted with socio-economic interventions, education, and possibly take-home rations.
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A thesis presented to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirement for the award of a Master of Public Health degree in Population and Reproductive Health on
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