Design and Baseline Characteristics of a Study Comparing Four Supplementary Foods in the Prevention of Stunting and Wasting Among Children 6–23 Months in Burkina Faso
Authors: Cliffer Ilana , Langlois Breanne , Suri Devika , Walton Shelley , Ouedraogo Laetitia , Zeba Augustin , Lanou Hermann , Garanet Franck , Webb Patrick , Rogers Beatrice 
Published: November 2023

Objective

The Food Aid Quality Review (FAQR), a study implemented by Tufts University, recommended improvements in the formulations and programming of existing Title II supplementary foods. To test these recommendations, we are examining the effectiveness and cost‐effectiveness of four different supplementary foods in the prevention of stunting and wasting in children age 6 to 23 months in Burkina Faso. The objective of this report is to describe the study methods and baseline characteristics of the sample, including baseline measures of stunting and wasting.

Methods

This is a longitudinal cluster‐randomized effectiveness trial comparing three corn soy blends and one lipid based nutritional supplement: Supercereal (CSB+) and Corn Soy Whey Blend (CSWB), Supercereal Plus (SC+), and Ready‐to‐Use Supplementary Food (RUSF). The CSWB is a new formulation based on recommendations by the FAQR. Children whose mothers had participated in a blanket supplementary feeding program while pregnant were eligible for enrollment when the ration was transferred to them, typically at age 6 months. Enrollment occurred from August 2014‐June 2015 when the required total sample size of 6,000 children was reached. Anthropometric measurements and morbidity data were collected during the intervention, and for three subsequent months post‐intervention, as children exited the program at age 24 months. Baseline descriptive statistics were calculated for the overall sample and stratified by study group. Food security was assessed using the Household Food Insecurity Access Scale (HFIAS). Prevalence of wasting and stunting were calculated using weight for length z‐scores, and height for age z‐scores. Data were analyzed using SAS 9.4.

Results

There are 6,117 children in the sample; 1,520, 1,505, 1,565, and 1,527 children in the CSB+, CSWB, SC+, and RUSF branches respectively. Average age at enrollment was 6.1 months overall, and 5.9 (CSB+), 6.3 (CSWB), 6.3 (SC+), and 6.1 (RUSF) by study branch. Females make up 48.9% of the total sample. The population was 43% food secure, 16.6% mildly food insecure, 24.9% moderately food insecure, and 14.1% severely food insecure. The arm with the highest proportion of subjects categorized as severely food insecure was CSB+ (15.6%), and the lowest was SC+ (13.5%). Overall, 8.1% of the sample was wasted and 8.9% was stunted at baseline. By study branch, prevalence of wasting at baseline was: CSB+: 8.2%, CSWB: 8.4%, SC+: 7.3%, RUSF: 8.4%, and prevalence of stunting was 9.9%, 9.1%, 7.4%, and 9.1% in the CSB+, CSWB, SC+ and RUSF branches respectively.

Conclusions

The results of preliminary descriptive analyses indicate relative demographic homogeneity across the four study arms. This descriptive exploration will serve as the basis for building regression models to test associations between identified variables of interest and the primary outcomes of stunting and wasting.

Support or Funding Information

USAID/Food For Peace