Young Haitian girl

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A study has shown that preventive rather than recuperative nutrition programmes are more effective at treating child undernutrition.

The research, published in The Lancet last week (16 February), compares the impact on child growth of a preventive and a recuperative maternal and child health and nutrition programme in Haiti. 

Previous studies have indicated that prevention is better than treatment, but voluntary organisations continue to assist children only once they become malnourished.

Both programmes were implemented by the voluntary organisation World Vision-Haiti in the Central Plateau region of the country and offer the same services to children, pregnant women and breastfeeding mothers, providing them with the same monthly food ration.

But while the recuperative programme only assisted underweight children up to five years of age for nine months, the preventive model targeted all children aged 6–24 months, providing 18 months of food assistance.

At the end of three years, researchers found that malnutrition indicators such as stunted growth, children being underweight, and wasting were 4–6 per cent lower among communities participating in preventive programmes than in recuperative ones.

"These differences may not seem very large, but they are in the order that is usually seen for nutrition programmes when they are successful," says Marie Ruel, lead author of the study and director of the Food Consumption and Nutrition Division at the International Food Policy Research Institute.

Following the results of the study, World Vision have decided to adopt the preventive model in some of their other nutrition programmes including Afghanistan, Burundi and Ethiopia, pending funding approvals.

"Programme implementers needed evidence that the preventive model is feasible in the field and that it does have a greater impact than the traditional model they have been using for years," says Ruel.

The researchers now plan to test whether or not the duration of 18 months — which has increased the cost of the intervention — is necessary, or whether smaller rations could be provided for 18 months with the same impact being achieved.

Link to the full paper in The Lancet*

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Reference: The Lancet 371, 588 (2008)