The impact of food supplementation on infant weight gain in rural Bangladesh; an assessment of the Bangladesh Integrated Nutritional Program (BINP)

Presenter: Housne Begum, University of Dhaka

Abstract

Objective: To examine the efficiency of the Bangladesh Integrated Nutritional Program (BINP) in identifying infants to be supplemented, effectiveness in administration of supplementation over entire stipulated period of time, and the correctness of exit criteria from the supplementation program that were used. Furthermore the study investigated whether targeted food supplementation of infants between 6-12 months of age resulted in enhanced weight gain.

Methodology:

Setting: Mallickbari Union, Bhaluka, a rural area located about 100 kms north of Dhaka, Bangladesh.

Participants: 526 infants followed for 6 to 12 months.

Results: Of the 526 infants studied, 368 should have received supplementation based on BINP criteria, but only 111 infants (30%) did so, while a further 13% were incorrectly given supplementation. So in total over half (52.8%) of the sample were incorrectly identified for supplementation. In addition less than a quarter of the infants received the full 90 days of supplementation and close to half the infants exited the program without the requisite weight gain. Infants were assigned to one of four groups; correctly supplemented and correctly non-supplemented, incorrectly supplemented and incorrectly non-supplemented. This classification provided natural controls; the correctly supplemented infants vs the incorrectly non-supplemented infants, and the correctly non-supplemented infants vs the incorrectly supplemented infants. There were no significant differences in weight gain between the correctly supplemented group and the incorrectly non-supplemented group or between the correctly non-supplemented and the incorrectly supplemented groups nor was any evidence of growth faltering in the incorrectly non-supplemented group.

Conclusions: This study found serious programmatic deficiencies - inability to identify growth faltering infants, failure to supplement for the full time period and incorrect exit procedures. There was no evidence that food supplementation had any impact on improving infant weight gain.