Evaluation of a community-level complementary-food safety and hygiene, and nutrition intervention - the MaaCiwara study

Food safety is imperative, especially for infants and young children because of their underdeveloped immune systems. This requires adequate nutritious food with appropriate amounts of macro- and micronutrients. Currently, a well-established system for infant food is enforced by the regulatory bodies, but no clear system exists for complementary food, which is consumed by children from the age of 6 month to 24 months. As the child grows beyond 6 months, the need for nutrients increases, and if the nutritional needs are not fulfilled, it can lead to health problems, such as stunted growth, weak immune system, and cardiovascular diseases. Hence, it is important to have regulatory bodies monitoring complementary food in a similar capacity as is required for infant formula. The objective of this review is to provide an overview of the existing regulatory bodies, such as the Codex Alimentarius, International Standard Organization (ISO), Food and Drug Administration (FDA), etc., and their regulations specifically for infant formula that can be adopted for complementary foods. This study focuses on the development of a hazard analysis and risk-based preventive controls (HARPC)-based food safety plan to ensure safe food processing and prevent any possible outbreaks.

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Protocol for a cluster randomised trial to evaluate a community level complementary food safety and hygiene and nutrition intervention in Mali: The MaaCiwara study

10.1101/2021.12.15.21267512 ◽

2021 ◽

Author(s):

Samuel I Watson ◽

Evans A Asamane ◽

Richard J Lilford ◽

Karla Hemming ◽

Cheick Sidibe ◽

...

Keyword(s):

Food Safety ◽

Structural Equation ◽

Diarrheal Disease ◽

Controlled Trial ◽

Randomised Trial ◽

Complementary Food ◽

Cluster Randomised Trial ◽

Enteric Infection ◽

Community Based ◽

Cluster Randomised

Background Diarrheal disease remains a significant cause of morbidity and mortality among the under-fives in many low- and middle-income countries. Changes to food safety practices and feeding methods around the weaning period, alongside improved nutrition, may significantly reduce the risk of disease and improve development for infants. This article describes a protocol for a cluster randomized trial to evaluate the effectiveness of a multi-faceted community-based educational intervention that aims to improve food safety and hygiene behaviours and enhance child nutrition. Methods We will conduct a mixed-methods, parallel cluster randomised controlled trial with baseline measures. 120 clusters comprising small urban and rural communities will be recruited in equal numbers and randomly allocated in a 1:1 ratio to either treatment or control arms. Participants will be mother-child dyads (27 per cluster period) with children aged 6 to 24 months. Data collection will comprise a day of observation and interviews with each participating mother-child pair and will take place at baseline and four and 15 months post-intervention. The primary analysis will estimate the effectiveness of the intervention on changes to complementary food safety and preparation behaviours, food and water contamination, and diarrhoea. Secondary outcomes include maternal autonomy, enteric infection, nutritional content of meals, and child anthropometry. A secondary structural equation analysis will be conducted to examine the causal relationships between the different outcomes. Conclusions The trial will provide evidence on the effectiveness of community-based behavioural change and educational interventions designed to reduce the burden of diarrhoeal disease in the under fives, and how effectiveness varies across different contexts.

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Effect of an Integrated Child Nutrition Intervention on the Complementary Food Intake of Young Children in Rural North Viet Nam

Food and Nutrition Bulletin ◽

10.1177/15648265020234s109 ◽

2002 ◽

Vol 23 (4_suppl_1) ◽

pp. 59-66 ◽

Cited By ~ 2

Author(s):

Helena Pachón ◽

Dirk G. Schroeder ◽

David R. Marsh ◽

Kirk A. Dearden ◽

Tran Thu Ha ◽

...

Keyword(s):

Food Intake ◽

Young Children ◽

Child Nutrition ◽

Nutrition Intervention ◽

Complementary Food ◽

Viet Nam

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Integrated Multisectoral Nutrition Intervention at the Community Level

Nutrition Policy Implementation ◽

10.1007/978-1-4684-4091-1_14 ◽

1982 ◽

pp. 231-245

Author(s):

Luis Fajardo

Keyword(s):

Community Level ◽

Nutrition Intervention

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Effect of an Integrated Child Nutrition Intervention on the Complementary Food Intake of Young Children in Rural North Viet Nam

Food and Nutrition Bulletin ◽

10.1177/15648265020234s209 ◽

2002 ◽

Vol 23 (4_suppl2) ◽

pp. 59-66 ◽

Cited By ~ 19

Author(s):

Helena Pachón ◽

Dirk G. Schroeder ◽

David R. Marsh ◽

Kirk A. Dearden ◽

Tran Thu Ha ◽

...

Keyword(s):

Food Intake ◽

Young Children ◽

Energy Intake ◽

Child Nutrition ◽

Food Composition ◽

Nutrition Intervention ◽

Complementary Food ◽

Energy Requirements ◽

Daily Energy ◽

Food Consumed

Forty-two percent of Vietnamese children are stunted by two years of age. Since 1990, Save the Children Federation/US (SC) has implemented integrated nutrition programs targeting young children. We evaluated the effect of SC's nutrition program on the complementary food intake of young rural Vietnamese children. Using a longitudinal, prospective, randomized design, we followed 238 children (119 each from intervention and comparison communes) age 5 to 25 months old for six months with a re-survey at 12 months. We gathered 24-hour recall data at baseline and at months 2, 4, 6, and 12. Dietary energy intake was calculated using the 1972 Vietnamese food composition table. Key outcomes were daily frequency of consuming intervention-promoted food and non-breastmilk liquids and food, daily quantity of non-breastmilk liquids and food consumed, daily energy intake, and proportion of children meeting daily median energy requirements. Young rural children exposed to SC's program consumed intervention-promoted and any foods more frequently, ate a greater quantity of any food, consumed more energy, and were more likely to meet their daily energy requirements than comparison children. Some effects were only observed during the intensive intervention period; others persisted into or were evident only at the 12-month follow-up, approximately four months after program completion. Based on the mothers' reports, the intervention did not apparently compromise breastfeeding prevalence or frequency. The intervention improved children's food and energy intake and protected them from declining as rapidly as comparison children in meeting their energy requirements.

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