Nutritional impact of Kinshasa programs for young children : a study of varied approaches

480 Title II. Special evaluation covers the period 7/81-8/83 and is based site visits and reviews of child growth records and other documents, supplemented by earlier Centre National de Planification de Nutrition (CEPLANUT) survey data from three zones. Focus is on the relative impacts of various approaches to child malnutrition. Although CEPLANUT survey data show that overall malnutrition in recipient children aged 0-5 decreased significantly between 9/78 and 12/82, child malnutrition is still alarmingly high. In 12/82, the four largest child nutrition programs - sponsored by the Catholic Archdiocese (CA), Catholic Relief Services (CRS), Mama Yemo Hospital, and the Salvation Army (SA) - were reaching 64,000 children aged 0-5, of whom 18% were malnourished. These figures, however, represent only 14% of Kinshasa"s children and only 7% of malnourished children. Most nutrition-related programs are connected to health centers. One type, preschool consultations (PC"s), offers weight and growth measurements, nutrition and health education, health services, and low-priced take-home food, during monthly visits. CRS PC"s offer minimal on-site feeding and large amounts of take-home food, whereas, CA centers offer very small amounts of take-home food. Analysis of attendance and growth records (the latter were not consistently well maintained) showed that neither type of PC reduced child malnutrition. A second type of nutrition program (sponsored primarily by CA, SA, and CEPLANUT) consists of special sessions for malnourished children, who come to the centers 1-6 days a week for weighing, nutrition counseling and education, intensive on-site feeding, and small amounts of take-home food. Comparisons of growth records for children participating in these sessions with those for children in PC programs showed that children in the special sessions did far better. Differences were most striking for younger children (aged 12-17 months) and for the severely malnourished (65% weight for age or less). Difference in type of nutrition program center, however, had no effect on levels of malnutrition in immediately surrounding neighborhoods.