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Enhancements to nutrition program in Indian integrated child development services increased growth and energy intake of children.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Avula, Rasmi Frongillo, Edward A. Arabi, Mandana Sharma, Sheel Schultink, Werner
Spatial Coverage	India
Description	Country affiliation: United States Author Affiliation: Avula R ( Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.)
Abstract	The Indian Integrated Child Development Services (ICDS) provides supplemental food to children aged 6 mo to 6 y. This study assessed the impact of enhancements to the existing Supplemental Nutrition Program of local production of supplemental food, home fortification with a micronutrient powder, and improved program monitoring. A quasi-experimental longitudinal design was used. Data were collected from 15 Anganwadi centers randomly selected from the enhanced program and 15 from the usual program. Multilevel linear regression was used to examine changes over time between the 2 groups accounting for village-level variation in intent-to-treat analysis. Children in the enhanced program initially aged 12-18 mo gained 0.72 (P = 0.02) greater height-for-age Z-score. Significant differences were observed in gain in weight-for-age Z-score among those initially aged 9-11 (2.48; P = 0.01), 12-18 (0.76; P = 0.01), and 19-24 mo old (0.73; P = 0.01), and gain in weight-for-height Z-score among 9-11 (2.66; P = 0.04) and 19-24 mo old (0.99; P = 0.01). For these age groups, the prevalence of stunting, underweight, or wasting averted ranged from 20.3 to 33.4%. Energy intake in the enhanced program was significantly greater for boys initially aged 12-18 mo (575.1 kJ/d; P = 0.03). Results from a qualitative substudy supported the plausibility of observed outcomes. ICDS would be more effective in improving child nutrition if it included these enhancements. The enhancements studied may be useful in improving program delivery and uptake of other similar programs.
File Format	HTM / HTML
ISSN	00223166
Issue Number	4
Volume Number	141
e-ISSN	15416100
Journal	Journal of Nutrition
Language	English
Publisher	American Society for Nutrition
Publisher Date	2011-04-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Research Support, Non-u.s. Gov't Body Weight Child Nutritional Physiological Phenomena Humans Child, Preschool Infant Male Energy Intake Journal Article India Body Height Female Child Development Discipline Nutrition Longitudinal Studies
Content Type	Text
Resource Type	Article
Subject	Nutrition and Dietetics Medicine

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