Tubaramure, a food-assisted maternal and child health and nutrition program in Burundi, increased household food security and energy and micronutrient consumption, and maternal and child dietary diversity: A cluster-randomized controlled trial

cg.authorship.typesCGIAR single centre
cg.contributor.crpAgriculture for Nutrition and Health
cg.contributor.donorUnited States Agency for International Development
cg.coverage.countryBurundi
cg.coverage.iso3166-alpha2BI
cg.coverage.regionMiddle Africa
cg.coverage.regionWestern Africa
cg.coverage.regionAfrica
cg.coverage.regionSub-saharan Africa
cg.coverage.regionEastern Africa
cg.creator.identifierJef L Leroy: 0000-0001-9371-3832
cg.creator.identifierDeanna Olney: 0000-0002-2420-8565
cg.creator.identifierMarie Ruel: 0000-0002-9506-348X
cg.identifier.doihttps://doi.org/10.1093/jn/nxz295
cg.identifier.projectIFPRI - Poverty, Health, and Nutrition Division
cg.identifier.publicationRankA plus
cg.isijournalISI Journal
cg.issn0022-3166
cg.issue4
cg.journalJournal of Nutrition
cg.reviewStatusPeer Review
cg.volume150
dc.contributor.authorLeroy, Jef L.
dc.contributor.authorOlney, Deanna K.
dc.contributor.authorBliznashka, Lilia
dc.contributor.authorRuel, Marie T.
dc.date.accessioned2024-05-22T12:10:59Zen
dc.date.available2024-05-22T12:10:59Zen
dc.identifier.urihttps://hdl.handle.net/10568/142751
dc.titleTubaramure, a food-assisted maternal and child health and nutrition program in Burundi, increased household food security and energy and micronutrient consumption, and maternal and child dietary diversity: A cluster-randomized controlled trialen
dcterms.abstractBackground: Food-assisted maternal and child health and nutrition programs are a widely used approach to address undernutrition. Little is known about the effects of these programs' combined household and individual food rations on household and individual food consumption. Tubaramure in Burundi targeted women and children during the first 1000 d of life, and included: 1) food rations (corn-soy blend and micronutrient-fortified vegetable oil); 2) health services strengthening and promotion of their use; and 3) behavior change communication on nutrition, hygiene, and health practices. Objectives: The objectives were: 1) to assess Tubaramure's impact on household food consumption and food security, maternal dietary diversity, and infant and young child feeding practices; 2) to explore the role of the food rations; and 3) assess 6–8 mo impacts around 8 mo after the end of the program. Methods: We used a 4-arm cluster-randomized controlled repeated cross-sectional design (11,906 observations). The treatment arms received the same food ration but differed in the ration timing and duration: 1) the first 1000 d; 2) from pregnancy through 17.9 mo of age; or 3) from birth through 23.9 mo of age. Results: Tubaramure significantly (P < 0.05) improved the percentage of food secure households [from 4.5 to 7.3 percentage points (pp)], and increased household energy consumption (from 17% to 20%) and micronutrient consumption. The program had a positive effect on maternal dietary diversity (+0.4 food groups, P < 0.05) and increased the proportion of children aged 6–23.9 mo consuming ≥4 food groups (from 8.0 to 9.6 pp, P < 0.05). The effects on many outcomes were attributable to the food rations. Postprogram effects (P < 0.05) were found on household food security, maternal dietary diversity, and younger sibling's complementary feeding practices. Conclusions: Programs such as Tubaramure have the potential to improve food security and household and individual energy and micronutrient consumption in severely resource-constrained populations, as seen in rural Burundi. This trial was registered at clinicaltrials.gov as NCT01072279.en
dcterms.accessRightsOpen Access
dcterms.bibliographicCitationLeroy, Jef L.; Olney, Deanna K.; Bliznashka, Lilia; and Ruel, Marie T. 2020. Tubaramure, a food-assisted maternal and child health and nutrition program in Burundi, increased household food security and energy and micronutrient consumption, and maternal and child dietary diversity: A cluster-randomized controlled trial. Journal of Nutrition 150(4): 945–957. https://doi.org/10.1093/jn/nxz295en
dcterms.extentpp. 945-957
dcterms.issued2020-02-01
dcterms.languageen
dcterms.licenseCC-BY-4.0
dcterms.publisherAmerican Society for Nutrition
dcterms.relationhttps://doi.org/10.3945/jn.115.227462en
dcterms.relationhttps://doi.org/10.1093/jn/nxx063en
dcterms.replaceshttps://ebrary.ifpri.org/digital/collection/p15738coll5/id/7028
dcterms.subjectmaternal and child healthen
dcterms.subjectchild nutritionen
dcterms.subjecthealthen
dcterms.subjectchild healthen
dcterms.subjecthouseholdsen
dcterms.subjectmalnutritionen
dcterms.subjectnutritionen
dcterms.subjecttrace elementsen
dcterms.subjectmothersen
dcterms.subjectchild feedingen
dcterms.subjectinfant feedingen
dcterms.subjectchildrenen
dcterms.subjectfood securityen
dcterms.subjectfood consumptionen
dcterms.subjectmaternal nutritionen
dcterms.subjectdietary diversityen
dcterms.typeJournal Article

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