Evaluating the Effectiveness of a Pediatric Nutrition Intervention Program in La Estancia, El Salvador

Background: Childhood malnutrition remains a serious global public health burden. It contributes to childhood morbidity and mortality and interferes with childhood development. This study is a pilot intervention conducted by a local nongovernmental organization and the World Food Program (WFP). Purpose: Evaluate the effectiveness of a community based multimodal program to reduce undernutrition in children under the age of two. Methods: The study population was a convenience sample of 190 children from birth to 30 months of age from nine villages in Estancia who were continuously enrolled from July 2013 - July 2014. Participating families attended educational lectures and received a supply of rice, beans, corn, and Super cereal plus. Enrolled children were measured (weight, height/length) every other month. Results: There was an increase in mean WHZ score from 0.14 to 0.43 (p=0.012, CI), but there was no significant change from the baseline mean HAZ score of -1.70 to the final one of -1.83 (p=0.35). The average WHZ score increased by 0.0315 (p=0.006) per month after baseline measurement. No participants qualified as wasted at the beginning or end of the study. The average HAZ score decreased by 0.017 (p=0.14) per month after baseline measurement. The final stunting prevalence of 45.3% was a statistically non-significant change from baseline 37.9%. Conclusions: The study detected an overall improvement in acute nutritional status. The lack of effect on HAZ scores and increase in stunting rates could be the result of insufficient follow up time or small samples size. Continued assessment of different approaches will help to characterize whether new approaches or increased nutritional supplementation will help to alleviate malnutrition in this rural, isolated Salvadoran community.