The Role of feeding programs in achieving Millennium Development Goals (MDGs) One and Two: The School and Preschool feeding exemplar

Poster
2010 Keystone
Francis D1, Kristjansson E1, Benkhalti M2, Batal M3, Jama S4, Petticrew M5, Welch V1, Tugwell P1
1Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
2Global Health, University of Ottawa, Ottawa, Ontario, Canada
3Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
4University of Ottawa, Ottawa, Canada
5Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
Background: In 2004, in developing countries, more than 126 million children under five years of age were underweight and 147 million were stunted. Throughout the life cycle, under-nutrition contributes to mortality, increased risks of infection, lowered cognitive performance and chronic disease in adulthood. The consequences of under-nutrition in early childhood are particularly severe. Estimates suggest that more than 50% of deaths in children under 5yrs are attributable to under-nutrition. Systematic reviews (SRs) provides well need evidence to support policy development. Objective: This paper will explore the role SRs on the use of school and preschool feeding programs in achievingMDGs One and Two (Eradicating Extreme Poverty and Hunger and Achieving Universal Primary Education). Methods: Findings were extracted from two Cochrane/Campbell SRs on the effectiveness of school and preschool feeding programmes for improving health of disadvantaged children and reducing health inequities. The first review included children 5 13yrs and the second included children 2 5yrs. Outcomes included psychosocial development, nutritional status, and school achievement and attendance. Data from reviews were stratified on two levels; within country by SES (where available) and by High and Upper Middle Income Countries (HUMIC) and Low and Lower Middle Income Countries (LLMICs). Results: Findings from the first SR revealed, in LLMIC s, significant positive changes in mean: weight (0.48kg; 95%CI 0.16-0.80), school attendance (2.5%; 95%CI 1.06 3.94), math score (0.13 SMD; 95%CI 0.02 0.24), and IQ (4.01 WMD; 95%CI1.07 6.95). All outcomes except for attendance (0.8 2.8%; SD not-reported) within HUMIC s did not show any significant changes. Results from SR II are in progress. Analysis will explore the influence of supplementary feeding programmes on socioeconomically disadvantaged children in LLMICs. Conclusion: Increasing the capacity of these supplementary feeding programmesmay improve attainability of the MDGs 1 and 2, particularly in at risk LLMICs. SRs are useful tools for informing development of policies in LLMICs.