Feasibility and effectiveness of supplementation with locally available foods in prevention of child malnutrition in Kenya

To establish the operational feasibility and effectiveness of using locally available foods to prevent malnutrition and improve child growth in Kenyan children. Quasi-experimental design with an intervention group of children in all villages in one region and a non-intervention group of children in all villages in an adjacent region. The intervention was the distribution of a monthly food ration for the index child, a separate family ration, and group education on appropriate complementary feeding and hygiene. Rural villages in the arid lands of eastern Kenya with a high prevalence of child malnutrition. All children in the target villages aged 6-20 months with weight-for-length Z-score (WHZ) greater than -2 at baseline. Children in the intervention and non-intervention groups had similar baseline anthropometric measures. The caregivers in the intervention group confirmed that the intended amounts of food supplements were received and child nutrient intake improved. During the 7-month intervention period there were significant group differences in pre-post Z-score changes between the intervention and non-intervention groups for weight-for-age (0·82, P < 0·001) and weight-for-height (1·19, P < 0·001), but not for height-for-age (-0·20, P = 0·09), after adjusting for multiple covariates. Compared with the non-intervention group, the intervention group had a lower prevalence of wasting (0% v. 8·9%, P = 0·0002) and underweight (6·3% v. 23·0%, P < 0·0001). Infectious morbidity was similar in both groups. The findings suggest that the distribution of locally available foods is operationally feasible and improves child weight gain and decreases acute malnutrition in Kenyan children.