Food voucher program improves the recovery rate of children aged 6-59 months suffering from moderate acute malnutrition (MAM) in the Far North Region of Cameroon

Background: Research on moderate acute malnutrition (MAM) is limited, despite its high prevalence. This study assessed recovery and associated factors among children treated through a food voucher program (FVP) enabling access to local foods in Cameroon's Far North. All children 6-59 months were screened by community health workers using middle-upper arm circumference (MUAC). Children identified with MAM were referred to health facilities for confirmed diagnosis and enrollment in the FVP. Methods: This longitudinal cohort study ran from March to August 2020 in Kaele health district. Study subjects were randomly selected among enrolled children using stratified sampling with the probability proportional to the size of each health area. At enrollment and bi-weekly follow-up examinations, health agents provided caretakers a voucher to redeem for a pre-defined food basket (milk, eggs, fruits, vegetables, red millet flour, sugar and oil) from pre-selected local vendors. Children remained in treatment until a MUAC measure of greater than 125 mm or the end of the 12-week program. Time-to-recovery was evaluated with multivariate Cox proportional regression hazard models with associations quantified using adjusted hazard ratio (aHR). The trend for MUAC, including its determinants, was studied with multivariate linear mixed effect models. Results: Among 474 children aged 6-53 months in the study, MUAC increased significantly over visits (P