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IYCF inteventions impact on Stunting

This question was posted the Infant and young child feeding interventions forum area and has 7 replies. You can also reply via email – be sure to leave the subject unchanged.

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Melaku Begashaw

Normal user

26 Jun 2012, 09:40

Dear friends,

I really appreciate If you can provide me list of documented success stories where IYCF programmes implemented and 'significant' gains in reduction of Stunting observed. I am particularly interested to see examples where the country in focus is in Sub-Saharan context.

Thanks in advance for your help

Alexandra Rutishauser-Perera

International Medical Corps

Normal user

26 Jun 2012, 10:25

I think that you will be able to find a lot of information on the care group website:

http://www.caregroupinfo.org/blog/

Melaku Begashaw

Normal user

26 Jun 2012, 20:40

Thank you!

Melaku Begashaw

Normal user

3 Jul 2012, 05:47

This helped me: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001157/

Anonymous 81

Public Health Nutritionist

Normal user

8 Jul 2012, 12:49

Dear Melaku,

Are you sure the sources one your referring helped you? I don't think so. Your question was the Impact of IYCF programes on the reduction of Stunting whereas the this article you are referring is about the impact of LINKAGES IYCF project (1999 to 2003) on the improvement of infant feeding practices particularly exclusive breast feeding and intiation of breast feeding. as per the article, the significant change was obseved only in initiation of breast feeding. I think improvement of initiation of breast feeding is not assurance or guarantee to reduction of stunting. I am sure you know the works of LINKAGES in Ethiopia (2004 - 2006) with the same impact.
So, i am expecting your initial question is still open for other to repond

Melaku Begashaw

Normal user

8 Jul 2012, 14:32

Thank you Anonymous 81. Indeed, it does not say about reduction of stunting. But am really happy to see behavioral changes to achieve optimal feeding practices. The reason was I did not usually see a measurable changes in this indicators (IYCF) despite a lot of interventions. So it has helped me at least in the sense that this kind of social behavioral changes are achievable. Also as you have said I will be really happy to see this kind of examples and this question is still open and I am glad to learn a community based success in reduction of stunting.

Recently The Lancet released a research paper that says changes in Stunting and underweight are lagging behind the MD goals. In their own words: New research published suggests that developing countries have a less than 5% chance of meeting the UN’s Millennium Development Goal target for the reduction of child malnutrition by 2015. The Article analyses trends in the weight and height of more than 7•7 million children worldwide between 1985 and 2011, and is the first large-scale study to provide a detailed examination of trends in children’s weight and growth in all developing countries." http://ow.ly/c1JZw

I read the success of ESHE projects in Ethiopia but I have seen that the gains are reversed in some of the places-it seems difficult to sustain the changes in the face of fast demographic transitions. Any help in this regards is quite welcome and I really eager to learn. Also If you send me the link for this Linkage programmes and results It is most welcome.

Thank you very much

Anonymous 81

Public Health Nutritionist

Normal user

8 Jul 2012, 15:38

Dear Melaku,

Look at the title of your post. it speaks itself, "IYCF intervetions impact on Stunting". In the main body it is also stated as follow "success stories where IYCF programmes implemented and 'significant' gains in reduction of Stunting observed"

Thanks for sharing the Lancet research paper (i also received from the one you shared to MANTF members). As per the article, regadles of MDG1 target, overall i think there has been amazing improvement. look at the findings, significant reduction of stunting from 47•2% (44•0 to 50•3) to 29•9% (27•1 to 32•9) and underweight from 30•1% (26•7 to 33•3) to 19•4% (16•5 to 22•2). the issue i can see is in sub-saharan countries. if you look at data of sub saharan Africa (other sources), you can easily identify where the issue is.

With regard to MDG targets - Much has been said on the limitation of MDG. Some of the limitations of MDG are:
1. The aggregated target ignore inequities - same targer accross the board.
2. No clear implementation plan
3. Inadequately resourced (poor countires)
4. Poor data on targets and indicators
5. Top down initiative

Melaku Begashaw

Normal user

8 Jul 2012, 18:17

Dear Anonymous 81,

I understood your question and I still really need to see sucess stories in Sub-Sharan African Countries. And your sugesstions are still valid and I want to hear more.

The Lancet helped me in the sense that there are no reall progress in our continent when compared to others. The answer is what you have said and it really need a comprehensive development than an IYCF programme alone. From the article:
"Panel 1
Children's nutrition: a tale of three continents (and four countries)
In 1985, Burkina Faso, Brazil, China, and Ghana had mean height-for-age Z scores (HAZ) ranging from -1·34 to -1·67 and prevalences of moderate-and-severe stunting that ranged from 34% to 40%, with China faring slightly worse than the other three countries (appendix pp 88—89). Over the subsequent 26 years, they had very different trajectories in children's nutritional status and growth. Brazilian and Chinese children experienced large improvements throughout the period such that, by 2011, mean HAZ had reached -0·33 to -0·42 and the prevalence of moderate-and-severe stunting was 9—13% (figure appendix 1, appendix pp 90—231). By contrast with these success stories, nutritional status of children in Burkina Faso worsened for over a decade before improving slowly after the late 1990s. As a result, children's nutritional status in 2011 was only slightly better than it had been 26 years earlier, and was much worse than those of children in Brazil and China. These three countries exemplify the experiences of their respective regions, and the regionalisation of child undernutrition. Yet some countries like Ghana, one of Africa's best governed nations with strong commitment to agriculture and nutrition, defied the negative trends of the late 1980s and 1990s in sub-Saharan Africa and achieved steady, although slow, improvements.
Even in these countries with moderately rich data it is hard to identify the precise contributions of specific determinants of trends, perhaps because children's growth is multifaceted and affected by a complex, dynamic, and interactive array of social, environmental, nutritional, and health-care determinants.19, 20 The existing evidence collectively suggests that improving children's anthropometric status requires enhancing nutrition, the living environment, and health care for the poor through equitable economic development, maternal education, and pro-poor agriculture, food, and health-care policies and programmes."

The quoted example clearly shows that changes are achievable (Like the China example), but I have been really thinking whether reduction of stunting is a viable target. Forgive my pesimism. The China progress is a lesson for me that it is biologically achivable. I have been following an intensive programme of IYCF that aims to reduce stunting and give lessons for other programmes. The results show there are changes in IYCF practices but stunting has shown a worsening trend. This programme was supposed to test the effectiveness of IYCF programmes in reducing stunting in our country's setting. It has been shown that it did not and I think more should be done alongside IYCF programmes to reduce stunting. That being said an effective model programme will really help me and others to understand what works in our context and any advise is welcome. I am learning this things and thank you for dropping what you have.

Melaku

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