Impact on child acute malnutrition of integrating a preventative nutrition package into facility-based screening for acute malnutrition in Burkina Faso

View this article as a pdf

Research snapshot¹

The impact of community-based management of acute malnutrition (CMAM) is often limited by low coverage of screening for acute malnutrition, influenced by a perceived lack of benefits among caregivers. A cluster-randomised controlled trial was undertaken to test the impact of integrating a preventive nutrition package into routine, facility-based monthly screening of children under two years old in Burkina Faso on acute malnutrition screening and treatment coverage and acute malnutrition incidence and prevalence. Intervention and comparison groups (16 health centres each) had access to standard CMAM and facility-based well-baby consultation services. Caregivers in the intervention group also received age-appropriate monthly behaviour-change communication on health and nutrition and a monthly supply of small-quantity, lipid-based nutrient supplements (SQ-LNS) for children over six months of age. A repeated cross-sectional study of children aged 17 months old (n = 2,318 at baseline and 2,317 at endline two years later) was undertaken to assess impacts on acute malnutrition screening coverage, treatment coverage and prevalence. A longitudinal study of 2,113 children enrolled soon after birth and followed up monthly for 18 months was undertaken to assess impacts on acute malnutrition screening coverage, treatment coverage and incidence. Results showed that, relative to the comparison group, the intervention group had significantly higher monthly acute malnutrition screening coverage (cross-sectional study: +18 percentage points [pp], 95% confidence interval [CI] 10–26, P < 0.001; longitudinal study: +23 pp, 95% CI 17–29, P < 0.001). However, there were no impacts on acute malnutrition treatment coverage, acute malnutrition incidence or acute malnutrition prevalence. Further research is needed on remaining barriers to CMAM uptake and methods of integrating preventative and CMAM services.