Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.

Stunting and micronutrient malnutrition are persistent public health problems in refugee populations. UNHCR and its partner organisations implement blanket supplementary feeding programmes using a range of special nutritional products as one approach to address these issues. The evidence base for th...

Full description

Bibliographic Details
Main Authors: Sarah Style, Melody Tondeur, Carlos Grijalva-Eternod, Josephine Pringle, Ismail Kassim, Caroline Wilkinson, Allison Oman, Carmel Dolan, Paul Spiegel, Andrew Seal
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5462343?pdf=render
_version_ 1828305569250803712
author Sarah Style
Melody Tondeur
Carlos Grijalva-Eternod
Josephine Pringle
Ismail Kassim
Caroline Wilkinson
Allison Oman
Carmel Dolan
Paul Spiegel
Andrew Seal
author_facet Sarah Style
Melody Tondeur
Carlos Grijalva-Eternod
Josephine Pringle
Ismail Kassim
Caroline Wilkinson
Allison Oman
Carmel Dolan
Paul Spiegel
Andrew Seal
author_sort Sarah Style
collection DOAJ
description Stunting and micronutrient malnutrition are persistent public health problems in refugee populations. UNHCR and its partner organisations implement blanket supplementary feeding programmes using a range of special nutritional products as one approach to address these issues. The evidence base for the efficacy and effectiveness of a small quantity lipid-based nutrient supplement, Nutributter®, in reducing stunting and anaemia is limited. Secondary data analysis was used to assess the effectiveness of Nutributter® distribution on anaemia and stunting in children aged 6-23 months (programme target group) and 6-59 months (the standard age group sampled in routine nutrition surveys). Analysis was conducted using routine pre and post-intervention cross-sectional nutrition survey data collected between 2008-2011 in five refugee camps in Kenya and Djibouti. Changes in total anaemia (Haemoglobin<110g/L), anaemia categories (mild, moderate and severe), and stunting (height-for-age z-score <-2) were explored using available data on the Nutributter® programme and contextual factors. A significant reduction in the prevalence of anaemia in children aged 6-23 months and 6-59 months was seen in four of five, and in all five camps, respectively (p<0.05). Reductions ranged from 12.4 to 23.0, and 18.3 to 29.3 percentage points in each age group. Improvements were largely due to reductions in moderate and severe anaemia and occurred where the prevalence of acute malnutrition was stable or increasing. No change in stunting was observed in four of five camps. The replicability of findings across five sites strongly suggests that Nutributter® distribution was associated with a reduction in anaemia, but not stunting, among refugee children in the Horn of Africa. Benefits were not restricted to the 6-23 month target group targeted by the nutrition programme. However, even following this intervention anaemia remained a serious public health problem and additional work to define and evaluate an effective intervention package is warranted.
first_indexed 2024-04-13T14:31:13Z
format Article
id doaj.art-f3e6b23bcf994e0dba3bdc132a10d14d
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-04-13T14:31:13Z
publishDate 2017-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-f3e6b23bcf994e0dba3bdc132a10d14d2022-12-22T02:43:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01126e017755610.1371/journal.pone.0177556Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.Sarah StyleMelody TondeurCarlos Grijalva-EternodJosephine PringleIsmail KassimCaroline WilkinsonAllison OmanCarmel DolanPaul SpiegelAndrew SealStunting and micronutrient malnutrition are persistent public health problems in refugee populations. UNHCR and its partner organisations implement blanket supplementary feeding programmes using a range of special nutritional products as one approach to address these issues. The evidence base for the efficacy and effectiveness of a small quantity lipid-based nutrient supplement, Nutributter®, in reducing stunting and anaemia is limited. Secondary data analysis was used to assess the effectiveness of Nutributter® distribution on anaemia and stunting in children aged 6-23 months (programme target group) and 6-59 months (the standard age group sampled in routine nutrition surveys). Analysis was conducted using routine pre and post-intervention cross-sectional nutrition survey data collected between 2008-2011 in five refugee camps in Kenya and Djibouti. Changes in total anaemia (Haemoglobin<110g/L), anaemia categories (mild, moderate and severe), and stunting (height-for-age z-score <-2) were explored using available data on the Nutributter® programme and contextual factors. A significant reduction in the prevalence of anaemia in children aged 6-23 months and 6-59 months was seen in four of five, and in all five camps, respectively (p<0.05). Reductions ranged from 12.4 to 23.0, and 18.3 to 29.3 percentage points in each age group. Improvements were largely due to reductions in moderate and severe anaemia and occurred where the prevalence of acute malnutrition was stable or increasing. No change in stunting was observed in four of five camps. The replicability of findings across five sites strongly suggests that Nutributter® distribution was associated with a reduction in anaemia, but not stunting, among refugee children in the Horn of Africa. Benefits were not restricted to the 6-23 month target group targeted by the nutrition programme. However, even following this intervention anaemia remained a serious public health problem and additional work to define and evaluate an effective intervention package is warranted.http://europepmc.org/articles/PMC5462343?pdf=render
spellingShingle Sarah Style
Melody Tondeur
Carlos Grijalva-Eternod
Josephine Pringle
Ismail Kassim
Caroline Wilkinson
Allison Oman
Carmel Dolan
Paul Spiegel
Andrew Seal
Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.
PLoS ONE
title Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.
title_full Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.
title_fullStr Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.
title_full_unstemmed Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.
title_short Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.
title_sort assessment of the effectiveness of a small quantity lipid based nutrient supplement on reducing anaemia and stunting in refugee populations in the horn of africa secondary data analysis
url http://europepmc.org/articles/PMC5462343?pdf=render
work_keys_str_mv AT sarahstyle assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT melodytondeur assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT carlosgrijalvaeternod assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT josephinepringle assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT ismailkassim assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT carolinewilkinson assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT allisonoman assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT carmeldolan assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT paulspiegel assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis
AT andrewseal assessmentoftheeffectivenessofasmallquantitylipidbasednutrientsupplementonreducinganaemiaandstuntinginrefugeepopulationsinthehornofafricasecondarydataanalysis