An impact evaluation was conducted on an integrated nutrition, health, hygiene and supplementary feeding program which functions in over 1500 poor communities throughout Peru (South America). The evaluation used a pretest-posttest-control group design, with 1393 children under age 5 from 105 randomly selected communities at baseline in 1997 and 1531 case and control children from 54 of those communities in 1999. Findings showed differences in program effect on child nutritional status by level of maternal education within poor communities. Chronic malnutrition in children 24-59 months improved most among those whose mothers had primary level or more education, but not among children of uneducated mothers, associated with better feeding practices, especially greater frequency of feeds, by educated mothers. General malnutrition was significantly improved in all age groups of children between 12 and 59 months, in all strata of maternal education among program participants. The improvement in children of illiterate mothers was associated with their greater exclusive breastfeeding, improved hand-washing and sanitation practices, subsequent lower prevalence of diarrhea, improved home treatment of diarrhea, as well as greater use of formal health care for diarrhea. It was hypothesized that poverty prevented mothers without education to fully apply knowledge on better feeding practices. Multivariate analysis showed primary determinants of chronic malnutrition in intervened children 24-59 months of age to be low maternal education, interview in Quechua, small size at birth, and, secondarily, water and hygiene variables. Recommendations are given on priorities for PL-480 programs and rural health and nutrition programs in developing countries.
Learning Objectives: Identify determinants of chronic malnutrition in an extreme poverty population receiving an integrated MCH, hygiene, home administration and food supplementation intervention. Identify behavioral changes in program beneficiaries that impact on nutritional status in children, by level of maternal education
Keywords: Nutrition, Developing Countries
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: ADRA (Adventist Development and Relief Agency) under contract with USAID/PERU Office of Food for Development
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA