Acta Scientific Nutritional Health (ASNH)(ISSN: 2582-1423)

Research Article Volume 4 Issue 2

A Multisectoral Approach to Eradication of Malnutrition in Vulnerable Groups: A Cluster-randomized Trial

Robert Mpiira* and Patrick Okello

Research Coordinator and Cluster Research Head - Agriculture and Food Security at BRAC, Uganda

*Corresponding Author: Robert Mpiira, Research Coordinator and Cluster Research Head - Agriculture and Food Security at BRAC, Uganda.

Received: October 16, 2019; Published: January 11, 2020

×

Abstract

  Nutrition is essential for sustainable development and a cornerstone for the achievement of all the Sustainable Development Goals. Yet, malnutrition is still a challenge in Uganda especially among the vulnerable groups – pregnant women, lactating mothers, adolescents and children below 5 years of age. Malnutrition being a multidisciplinary issue, it requires a multisectoral approach for it to be addressed. This paper examines an integrated approach to improving food security and nutrition of children below 5 years old by increasing smallholders’ production and consumption of nutrient-rich staple crops in Uganda. The study was conducted in the districts of Ibanda, Sheema, Kalungu and Kyotera in southwestern Uganda using a cluster-randomized controlled design. 180 villages were randomly assigned to six treatment groups (30 villages per treatment group) and 30 villages were assigned to a control group. The results of the follow-up evaluation that was conducted two years after the baseline survey showed a statistically significant increase in food security in the treatment group that had both agricultural and health interventions and the voucher scheme for subsidized agricultural inputs. Wasting and underweight were significantly reduced in the treatment group that had agricultural and health interventions and the voucher scheme for subsidized agricultural inputs, and the treatment group with only health interventions. However, an increase in the prevalence of stunting that was significantly larger than that in the control group was noted in the treatment group that received only agricultural interventions. Hence, a contextual right mix of interventions is required, other factors remaining constant, to increase food security and reduce malnutrition among the vulnerable groups.

Keywords: Children; Malnutrition; Nutrition

×

References

  1. Bhutta ZA and RA Salam. “Global Nutrition Epidemiology and Trends”. Annals of Nutrition and Metabolism 61 (2012): 19-27.
  2. Akkermans MD., et al. “A Micronutrient-Fortified Young-Child Formula Improves the Iron and Vitamin D Status of Healthy Young European Children: A Randomized, Double-Blind Controlled Trial”. The American Journal of Clinical Nutrition 105 (2017): 391-399.
  3. Angeles-Agdeppa I., et al. “Weekly Micronutrient Supplementation to Build Iron Stores in Female Indonesian Adolescents”. The American Journal of Clinical Nutrition 66 (1997): 177-183.
  4. Bauernfeind JC., et al. “Vitamins a and E Nutrition via Intramuscular or Oral Route”. The American Journal of Clinical Nutrition 27 (1974): 234-253.
  5. Calvo MS., et al. “Vitamin d Fortification in the United States and Canada: Current Status and Data Needs”. The American Journal of Clinical Nutrition 80 (2004): 1710S-1716S. 
  6. Ahmed F. “Vitamin A Deficiency in Bangladesh: A Review and Recommendations for Improvement”. Public Health Nutrition 2 (1999): 1-14.
  7. Bhutta ZA. “Micronutrient Needs of Malnourished Children”. Current Opinion in Clinical Nutrition and Metabolic Care 11 (2008): 309-314.
  8. https://www.who.int/nutrition/databases/infantfeeding/data_source_inclusion_criteria/en/
  9. Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala, Uganda: UBOS and Calverton, Maryland: ICF International Inc (2012).
  10. Uganda Bureau of Statistics. Uganda National Household Survey 2009/2010: Socio-economic Module, Abridged Report (2010).
  11. Ministry of Agriculture, Animal Industry and Fisheries. Agriculture for Food and Income Security - Agriculture Sector Development Strategy and Investment Plan: 2010/11-2014/15 (2010).
  12. Government of Uganda. Uganda Nutrition Action Plan 2011-2016: Scaling Up Multi-Sectoral Efforts to Establish a Strong Nutrition Foundation for Uganda’s Development (2011).
  13. Ramakrishnan U. “Prevalence of micronutrient malnutrition worldwide”. Nutrition Review 60 (2012): S46-s52. 
  14. Uganda Bureau of Statistics. Statistical Abstract (2018).
  15. Prendergast AJ and Humphrey JH. “The stunting syndrome in developing countries”. Paediatrics and International Child Health 34 (2014): 250-265.
  16. Akombi BJ., et al. “Stunting, Wasting and Underweight in Sub-Saharan Africa: A Systematic Review”. International Journal of Environmental Research and Public Health 14 (2017).
  17. Guerrant RL., et al. “Micronutrients and infection: interactions and implications with enteric and other infections and future priorities”. Journal of Infection Disease 182 (2000): S134-138.
  18. Kapil Umesh and Bhavna A. Adverse effects of poor micronutrient status during childhood and adolescence (2002).
  19. Dwyer Johanna T., et al. “Fortification and Health: Challenges and Opportunities”. Advances in Nutrition 6 (2015): 124-131.
  20. Black LJ., et al. “Small Increments in Vitamin D Intake by Irish Adults over a Decade Show That Strategic Initiatives to Fortify the Food Supply Are Needed”. Journal of Nutrition 145 (2015): 969-976.
  21. Bhutta ZA., et al. “What Works? Interventions for Maternal and Child Undernutrition and Survival”. Lancet 371 (2008): 417-440.
  22. Girard AW., et al. “The Effects of Household Food Production Strategies on the Health and Nutrition Outcomes of Women and Young Children: A Systematic Review”. Paediatric and Perinatal Epidemiology 26 (2012): 205-222.
  23. Low JW., et al. “A food-based approach introducing orange-fleshed sweet potatoes increased vitamin A intake and serum retinol concentrations in young children in rural Mozambique”. Journal of Nutrition 137 (2007): 1320-1327.
×

Citation

Citation: Robert Mpiira and Patrick Okello. “A Multisectoral Approach to Eradication of Malnutrition in Vulnerable Groups: A Cluster-randomized Trial". Acta Scientific Nutritional Health 4.2 (2020): 82-88.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.316

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is November 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US