Jilcott S.B., Ickes S.B., Ammerman A.S., Myhre J.A.
Department of Public Health, Brody School of Medicine, East Carolina University, 1709 West Avenue, Greenville, NC 27834, United States; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; World Harvest Mission, Bundinutrition Program, P.O. Box 1142, Bundibugyo, Uganda
Jilcott, S.B., Department of Public Health, Brody School of Medicine, East Carolina University, 1709 West Avenue, Greenville, NC 27834, United States; Ickes, S.B., Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Ammerman, A.S., Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Myhre, J.A., World Harvest Mission, Bundinutrition Program, P.O. Box 1142, Bundibugyo, Uganda
Objective In this paper we describe the development, implementation, evaluation, and subsequent improvements of a supplemental feeding program that provides community-based care to underweight children in a rural East African setting, using a locally-sourced and produced ready-to-use food (RUF). Methods Production teams were trained to grind soybeans and groundnuts (peanuts), which were then mixed with moringa oleifera leaf powder to form an energy-dense supplemental food, designed for use as an RUF. Eligible children (based on low weight-for-age or mid-upper-arm circumference < 12 cm) received RUF of approximately 682 kcal per day for five weeks. Weekly growth monitoring and caregiver education were provided by trained health center staff and community volunteers. The program was evaluated by examining RUF nutrient composition, weight gain velocity, and qualitative data from key-informant interviews and home feeding observations. Results Locally-produced RUF had similar energy density but higher protein content than commercial RUTF (ready-to-use therapeutic food). Mean weight gain of children was 2.5 g/kg/day (range 0.9-6.0). Feeding observations revealed that caregivers were diluting the RUF fed to children. Production team members desired increased financial compensation for their work but were enthusiastic about the program as helpful to malnourished children. Conclusions Locally-produced RUF is a promising strategy for community-based care of moderately malnourished children. Through the production team's entrepreneurship, a small business was formed, whereby financial incentives encouraged continued RUF production. Future efforts are needed to educate caregivers on correct RUF use and improve commercial viability in local markets. © 2009 Springer Science+Business Media, LLC.
article; body weight; fast food; health care quality; human; infant; infant nutrition; interview; methodology; preschool child; program development; Uganda; Child, Preschool; Fast Foods; Humans; Infant; Infant Nutritional Physiological Phenomena; Interviews as Topic; Program Development; Program Evaluation; Thinness; Uganda