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142 Community-Based Follow-Up with/without Food Supplementation and/or Psychosocial Stimulation in the Management of Children with Moderate Acute Malnutrition in Bangladesh
  1. MI Hossain1,
  2. T Ahmed2,
  3. KH Brown3
  1. 1Centre for Nutrition and Food Security & Nutrition Unit, Dhaka Hospital, ICDDR, B
  2. 2Centre for Nutrition and Food Security, ICDDR, B, Dhaka, Bangladesh
  3. 3Department of Nutrition and Program in International and Community Nutrition, UC Davis, Davis, CA, USA

Abstract

Background and aims Moderate acute malnutrition (MAM) [WLZ: < –2 to –3] is a major health problem in Bangladesh and other low-income countries. This study was conducted to assess the effect of community-based follow-up care, with/without food supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up care of children with MAM.

Methods 227 children with MAM aged 6–24 months were randomly assigned to one of five regimens:

  1. fortnightly follow-up care (FFC) at the icddr, b’s outpatient-department, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49);

  2. FFC at community follow-up unit [established in the existing primary health care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53);

  3. as per C-C plus cereal-based supplementary food (SF) (C-SF, n=49);

  4. as per C-C plus psychosocial stimulation (PS) (C-PS, n=43); or

  5. as per C-C plus both SF+PS (C-SF+PS, n=33).

Results Baseline characteristics were similar among the groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea and fever than others. Children who attended at least five of the total six scheduled follow-up visits gained more in weight, length than those who attended fewer.

Conclusions Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of greater numbers of children with MAM compared to current hospital outpatients-based care.

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