Effectiveness of UNICEF Multiple Micronutrient Powder on Child Stunting Rate and Influencing Factors in Kisangani
F. Lusamaki Mukunda
Department of Human Nutrition, Faculty of Medicine and Pharmacy, University of Kisangani, DR Congo.
E. Tebandite Kasai
Department of Pediatrics, University Hospital Centre, Kisangani, DR Congo.
J. Alworonga Opara
Department of Pediatrics, University Hospital Centre, Kisangani, DR Congo.
J. Posho Ikolonga
Department of Public Health, Faculty of Medicine and Pharmacy, University of Kisangani, DR Congo.
S. Batina Agasa
Department of Internal Medicine, Faculty of Medicine and Pharmacy, University of Kisangani, DR Congo.
A. Kayisu Kalenga
Department Chemistry and Food Industry, Institute of Agriculture Sciences, Yangambi, DR Congo.
J. Ntokamunda Kadima *
Department of Clinical Pharmacology, School of Medicine and Pharmacy, University of Rwanda, Rwanda.
*Author to whom correspondence should be addressed.
Abstract
Home fortification of foods with Multiple Micronutrient has been proposed to maintain normal growing and health of children living in chronic malnutrition conditions. In December 2014, the National Nutrition Programme, in partnership with UNICEF, introduced multiple micronutrient powder as food supplement for children aged 6 to 23 months in DR Congo to prevent negative impact of chronic malnutrition. This intervention was conducted in some municipalities in Kisangani city. The aim of this study was to evaluate the potential of that intervention to reduce at short term the rate of stunting and measure a possible impact of socio-demographic factors. This was a community based prospective cross-sectional survey conducted from April 14 to June 13, 2016. The prevalence of stunted children was compared among children aged 24-36 months in areas where the programme was administered and those living in areas where the intervention was not yet applied and between children treated and not treated in a same municipality. Two health zones, Mangobo representing areas where the intervention was conducted and Lubunga representing areas without intervention were selected. Three groups were constituted: (i) Mangobo-children who received the powder, (ii) Mangobo-children not given the powder and Lubunga- children not given the powder. The effectiveness indicator was the prevalence of stunted children in treated and untreated children. The stunting prevalence was 36.2% in group (i), 74.1% in group (ii), and 54.1% in group (iii). The global stunting rate was 49.5% for the entire population independently of the intervention. The difference was significant between untreated and treated children (p=0.001). Stunting was significantly higher among boys than girls and among children whose mothers were uneducated. The use of the multiple micronutrient powder showed some benefits in reducing stunting at short term. But to effectively solve the problem of chronic malnutrition, the strategies should address globally different causes including socio-economic assets of the family, food quality, maternal nutrition, sanitation and mothers’ education.
Keywords: Chronic malnutrition, child stunting, height-for-age index, multiple micronutrient.