Effectiveness of maternal and child health (MCH) supplementary feeding programs : an analysis of performance in the 1980"s and potential role in the 1990"s

If this role is to continue, however, major changes will need to be made in program orientation, design, funding, and implementation, according to this report. The study, which assesses MCH feeding programs from 1976-1989 and examines their potential for the 1990"s, found that programs which are properly designed and implemented can be effective in improving the nutritional status of the recipients. In addition, while the need for MCH supplementary feeding is increasing (particularly in sub-Saharan Africa), the number of programs and beneficiaries is on the decline. The report identifies the following as key elements of program success: (1) adequate initial assessment of the magnitude and causes of the nutrition problems; (2) locally appropriate project designs; (3) community participation (especially by women); (4) sustained supply of culturally appropriate food; (5) strong administrative capacity of the implementing agency; (6) complementary inputs, e.g., education and primary health care; (7) feasible, cost-effective targeting of those in need; and (8) functioning logistics and monitoring/evaluation systems. Major program constraints are also listed: (1) inadequate needs assessment and design; (2) inadequate implementation and evaluation; (3) insufficient resources of the implementing organization; (4) the low priority accorded supplementary feeding by PVO"s and governments; (5) funding gaps unmet by host governments or donors; and (6) cumbersome administrative requirements. Twelve specific recommendations are provided.