NUTRITION PROGRAMS REACH CHILDREN TOO LATE

by Abra Pollock

(IPS) WASHINGTON -- Nutrition programs offered to children who are both sick and well are noticeably more effective in reducing the overall prevalence of malnutrition than programs offered only to children who are already malnourished, according to a study published this week in The Lancet, a leading medical journal.

Using research based on nutritional assistance programs in Haiti that are run by World Vision, a Christian humanitarian organization, experts found that preventative programs offered to children of all health levels had a greater impact than "recuperative" programs.

Throughout the past two decades, most development agencies have focused their efforts on recuperative programs, said Marie Ruel, the study's lead author and the director of the Food Consumption and Nutrition division of the International Food Research and Policy Institute (IFPRI), which cosponsored the report, along with several other groups.

Agencies have been wary to fund preventative programs because this "umbrella" model treats all children of a certain age range within a community, without a sense of which of them would otherwise become malnourished, she explained.

In addition, evidence demonstrating why aid should be invested in preventative programs has been scant -- until now.

Authors of the study underscored the importance of delivering nutritional assistance to younger children.

Most recuperative nutrition programs serve underweight children up until the age of 5. Yet, "biologically, we have shown that after two years of age -- or maybe three -- you can feed children and they will not recuperate, certainly in terms of height," Ruel said. "After [age] 3, interventions have been shown not to benefit children."

Purnima Menon, co-author of study and a New Delhi-based research fellow for the International Food Research and Policy Institute, said, "The findings from Haiti are of global significance because all children, no matter where they live, have the same nutritional needs in their first two years of life for proper growth and development."

According to the Global Alliance for Improved Nutrition, vitamin and mineral deficiencies each year cause 1 million children to die before the age of 5 and cause 100,000 infants to be born with preventable physical defects.

Other recent studies at several U.S. universities link poor nutrition and the stress of poverty among infants and toddlers with impairment in the brain's development, including deficiencies in memory and language abilities, the Financial Times reported this week.

Although Haiti was the site of the IFPRI study, its findings could have ramifications for several other developing regions, experts agree.

"The study is particularly relevant for South Asia, which has both the highest rates of malnutrition in the world and is home to the greatest number of undernourished children," Menon said.

According to IFPRI, in India approximately 47 percent of children are underweight, and nutritional deficiencies affecting young children also remain notably high in the rural areas of Central America and the Andean region.

Not only is it critical for these regions to address malnutrition from a health perspective, but better early childhood nutrition can also result in economic benefits later in life, according to a separate IFPRI published in January 2008.

The 35-year study based in Guatemala found that giving children a high-energy, high-protein supplement called atole during their first two years of life significantly boosted their earnings later on in life.

"This research demonstrates that early childhood nutrition is not only crucial for the physical growth of children, but is also a wise, long-term economic investment," said Renaldo Martorell, a professor of International Nutrition at Emory University who was one of the researchers who conducted the original study in Guatemala. "Just as we need to invest in infrastructure, we need to invest in children."

For now, development agencies and private voluntary organizations such as World Vision seem to be taking some notice of the most recent study's results.

World Vision, which is world's largest aid distributor for the United Nations' World Food Program, has already contacted IFPRI about implementing the preventative model in Ethiopia and parts of Latin America, Ruel said.

And an e-mail noting the recent study's results was circulated by the staff of the World Food Program, as well as the U.S. Agency for International Development, to all of their country officers in the field.

"Now [these agencies] see that World Vision was able to implement this program," Ruel said. "In Haiti, all the [private voluntary organizations] have now switched without asking any more questions."

According to Lesly Michaud, a maternal and child health coordinator for World Vision-Haiti, "This study completely changed our approach to fighting childhood malnutrition."

Armed with evidence that points to the increased impact and effectiveness of this changed approach, experts now hope to convince funders that when it comes to childhood malnutrition, it is crucial to take a preventative approach to treat the disease and not the symptoms.