Dietary outcomes of moderately wasted children treated in a food voucher program in Cameroon's Far North: a three-month longitudinal study.

Abstract

Background: Many interventions in Cameroon focus on addressing severe wasting rather than targeting moderate wasting, although the latter is more prevalent. The objective of the study was to evaluate dietary outcomes in a program designed to treat moderate wasting using a food voucher program (FVP) tested in the Far North, examining the factors associated with dietary outcomes.

Methods: A three-month longitudinal study was carried out by an independent team of researchers within the context of a one-year humanitarian project designed to treat children with moderate wasting (middle-upper arm circumference [MUAC] measures 115-125 mm) by providing caretakers with a bi-weekly voucher to redeem for a predefined basket of foods together with essential hygiene and nutrition education. A sample of 474 children were randomly selected from the cohort enrolled in the program for inclusion in the study. Using a pre/post-test design, we evaluate the effect of the receipt of food vouchers on dietary outcomes using as indicators minimum dietary diversity (MDD) for children aged 6-23 months and dietary diversity scores (DDS) for children aged 24-53 months. Mixed logistic and linear regressions were used to identify factors from socio-demographic data and program activities (cooking demonstrations and nutrition education, perception of food safety, food basket sharing, and lasting) associated with these variables. Life table analysis was employed to assess the likelihood of achieving MDD among children aged 6-23 months.

Results: The likelihood of children aged 6-23 months meeting MDD increased from 19.9% at the beginning of the study to 100% after 12 weeks. Among older children, average DDS increased from 3.2 at entry to 5.1 at the two-week mark and remained constant for the duration of the study. A negative perception among caregivers of the safety of redeemed food items was negatively associated with achieving MDD (adjusted RR = 0.50, p = 0.012). The consumption of food basket contents by other family members was negatively associated with DDS (adjusted coef. = 0.33, p = 0.047).

Conclusion: The FVP was effective in improving the dietary diversity of MAM children aged between 6 and 59 months in Cameroon's Far North.