Collections > Electronic Theses and Dissertations > Assessment of Supplemental Feeding with a Locally-Produced Ready-to-Use-Food: The Byokulia Bisemeye mu Bantu Program in Bundibugyo, Uganda
pdf

Background. Low quality complementary foods and caregiver feeding practices contribute to child growth faltering throughout the developing world. Ready-to-use foods (RUF) are energy dense products that do not require cooking and have been effectively used to treat malnutrition. However, studies report low consumption of distributed rations by targeted children. The factors that affect RUF consumption rates and the impact of RUF supplementation on caregiver feeding practices and children's dietary adequacy are not well understood. Methods. This study was conducted among participants in the Byokulia Bisemeye mu Bantu (BBB) supplemental feeding program in Bundibugyo, Uganda. First, to identify the key factors that affect home-based RUF consumption we interviewed caregivers (n=30), RUF producers (n=8) and program staff (n=10) involved in the BBB program. Secondly, to examine RUF consumption patterns and the demographic predictors of RUF consumption, we conducted 24-hour dietary recalls from 135 children during supplementation. Thirdly, we assessed the program impact on caregiver feeding practices and children's diet adequacy by conducting dietary recalls and a feeding practice survey among 61 Post-Program and 61 Comparison caregiver-child dyads. Results. RUF was offered to targeted children by 86% of caregivers, and was included in 46% of targeted children's meals. Program children were offered 35% of the 128 g/day RUF supplement. Qualitative findings indicate that intrahousehold RUF sharing may compromise the nutrient delivery to targeted children. Logistic regression analysis indicates that caregivers with more birth children were less likely to offer RUF to targeted children, and that more frequent program attendance was associated with a greater likelihood of feeding RUF. Post Program children were more likely to meet their dietary requirements, were fed more frequently, and had greater dietary diversity than Comparisons. The diet adequacy of Program children's diet adequacy did not change significantly after RUF rations were discontinued. Conclusions. RUF is well received by caregivers of underweight children; however, a large proportion of distributed RUF may fail to reach targeted children. Caregivers are challenged to feed RUF to targeted children, especially in larger households. Programs that offer complementary feeding education with RUF may promote lasting benefits to child feeding practices and dietary adequacy.