Peer-reviewed article
PROCOMIDA, a Food-Assisted Maternal and Child Health and Nutrition Program, Reduces Child Stunting in Guatemala: A Cluster-Randomized Controlled Intervention Trial
Deanna Kelly Olney, Jef L J P Leroy, Lilia Bliznashka, Marie T. Ruel ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study tested PROCOMIDA, a food-assisted maternal and child health and nutrition program run by Mercy Corps in Guatemala. Families received food rations from pregnancy through the child's second birthday, and the researchers compared them with a control group in a cluster-randomized trial. Several versions of the program reduced stunting (low length-for-age) in children aged 1 to 24 months, and the effect grew as children got older. Large family rations combined with corn-soy blend or micronutrient powder for the child worked best. The authors conclude that such programs can reduce stunting even where food security is relatively good.
Key points
- Stunting was significantly lower than in the control group at age 1 month in the FFR + CSB, RFR + CSB and FFR + MNP groups (5.05, 4.06 and 3.82 percentage points).
- By age 24 months the stunting reduction was 11.1 pp for FFR + CSB and 6.5 pp for FFR + MNP compared with control.
- Among CSB recipients, the full family ration reduced stunting by 6.47-9.68 pp more than the reduced or no family ration.
- CSB reduced stunting significantly more than LNS at age 24 months (8.12 pp).
- The widening impact with age suggests the importance of intervening throughout the full first 1000 days.
Limitations
The abstract does not report effects for the FFR + LNS group against control, nor details on attrition, adherence or costs. The findings are specific to Guatemala and to the ration types tested.
Abstract
Background: Food-assisted maternal and child health and nutrition (FA-MCHN) programs may foster child growth during the first 1000 d (pregnancy and the first 2 y of a child's life), but evidence is scant. Objective: We evaluated the impact of an FA-MCHN program, PROCOMIDA, on linear growth (stunting [length-for-age z score (LAZ) < -2] and length-for-age difference [LAD]) among children aged 1-24 mo. PROCOMIDA was implemented in Guatemala by Mercy Corps and was available to beneficiaries throughout the first 1000 d. Methods: We used a longitudinal, cluster-randomized controlled trial with groups varying in family ration sizes [full (FFR), reduced (RFR), and none (NFR)] and individual ration types provided to mothers (pregnancy to 6 mo postpartum) and children (6-24 mo of age) [corn-soy blend (CSB), lipid-based nutrient supplement (LNS), micronutrient powder (MNP)]: 1) FFR + CSB (n = 576); 2) RFR + CSB (n = 575); 3) NFR + CSB (n = 542); 4) FFR + LNS (n = 550); 5) FFR + MNP (n = 587); 6) control (n = 574). Program impacts compared with control, and differential impacts between groups varying family ration size or individual ration type, were assessed through the use of linear mixed-effects models and post hoc simple effect tests (significant if P < 0.05). Results: PROCOMIDA significantly reduced stunting at age 1 mo in FFR + CSB, RFR + CSB, and FFR + MNP groups compared with control [5.05, 4.06, and 3.82 percentage points (pp), respectively]. Stunting impact increased by age 24 mo in FFR + CSB and FFR + MNP relative to control (impact = 11.1 and 6.5 pp at age 24 mo, respectively). For CSB recipients, the FFR compared with RFR or NFR significantly reduced stunting (6.47-9.68 pp). CSB reduced stunting significantly more than LNS at age 24 mo (8.12 pp). Conclusions: FA-MCHN programs can reduce stunting during the first 1000 d, even in relatively energy/food-secure populations. Large family rations with individual rations of CSB or MNP were most effective. The widening of impact as children age highlights the importance of intervening throughout the full first 1000 d. This trial was registered at clinicaltrials.gov as NCT01072279.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- PROCOMIDA food-assisted maternal and child health and nutrition program: family food rations of varying size plus individual rations (corn-soy blend, lipid-based nutrient supplement or micronutrient powder) for mothers from pregnancy to 6 months postpartum and children aged 6-24 months
- Population
- Children aged 1-24 months and their mothers in Guatemala (about 575 per group across six groups)
Key finding
Stunting reduced at 1 month by 5.05 pp (FFR + CSB), 4.06 pp (RFR + CSB) and 3.82 pp (FFR + MNP) versus control
Olney et al. · OpenAlex · 21 Jun 2018