PILOT NUTRITION PROJECT - MAFRAQ

Special PES covers the period 7/77-7/80; no methodology is stated. The project, implemented by CARE/Jordan, conducted cost-effectiveness studies involving children from both the on-site and the take-home programs plus a control group receiving no food supplements. The on-site program provided one daily ration per child, and the take-home program provided five daily rations per family. Both included health/nutrition education. Approximately 500 children from each group were examined before the project and 18 months later. The initial survey revealed "stunting" (i.e., insufficient height to age ratio) among 27% of the children but essentially no "wasting" (i.e., low weight to height ratio) -- wasting raises morbidity and mortality, stunting does not. Although the second examination showed no difference among the three groups, USAID felt the results were inconclusive because the time period was too short; a broad definition of malnutrition was applied; families were included whose participation was irregular (13% did not regularly participate); education programs were introduced late and there was a high turnover among trainers; and children aged 6-24 months were not surveyed. Despite the equal cost and impact of the two programs, USAID favors the take-home program because it was preferred by villagers; it supplemented family income 17%-28% (versus 3%-4% for the on-site program); more food was distributed; feeding center staff were unnecessary; and it was better at reaching young children. Among the recommendations are institute a child screening system to orient the program to wasted children; initiate complementary health interventions (e.g., immunization); combine food distribution with education on the same day; continue to use food as an incentive to other development activities; explore techniques to increase participation (e.g., a survey of mothers); and further analyze or study baseline data on Mafraq, dietary intake, stunting, and supplemental weaning foods.