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rdf:type |
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lifeskim:mentions |
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pubmed:issue |
4
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pubmed:dateCreated |
1991-2-8
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pubmed:abstractText |
Four Brazilian food and nutrition programs operating during some part of 1974-86 are evaluated for their effectiveness in curing or preventing infant and child malnutrition, including low birth weight when pregnant women were beneficiaries. Two programs distributed free food to identified clients: traditional commercial foods in one case and specially formulated supplements in the other. The other two programs subsidized four or more basic foodstuffs: one experiment quantitatively restricted a subsidy to identified families, and the other was unrestricted and open to all families patronizing certain shops. The programs were more effective at curing than at preventing malnutrition, and more effective at increasing weight than height. Many beneficiaries, even when initially underweight, showed no change, and some deteriorated despite the food transfer. Results were better after than during the first year of life, when deterioration is most likely. Donation programs including medical and educational components proved more effective than pure subsidies, showing that while poverty may be the chief cause of malnutrition, the problem should be seen as poor health rather than simply low food consumption. Evaluation also shows that programs were inefficient in transferring benefits, and that clients were deterred from participating by the costs of obtaining the food and its poor quality and small volume. Longer participation improved results, but more frequent participation in a given interval did not necessarily do so.
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pubmed:keyword |
http://linkedlifedata.com/resource/pubmed/keyword/Age Factors,
http://linkedlifedata.com/resource/pubmed/keyword/Americas,
http://linkedlifedata.com/resource/pubmed/keyword/BRAZIL,
http://linkedlifedata.com/resource/pubmed/keyword/Child Health,
http://linkedlifedata.com/resource/pubmed/keyword/Child Health Services,
http://linkedlifedata.com/resource/pubmed/keyword/Comparative Studies,
http://linkedlifedata.com/resource/pubmed/keyword/Critique,
http://linkedlifedata.com/resource/pubmed/keyword/Delivery Of Health Care,
http://linkedlifedata.com/resource/pubmed/keyword/Demographic Factors,
http://linkedlifedata.com/resource/pubmed/keyword/Developing Countries,
http://linkedlifedata.com/resource/pubmed/keyword/Diseases,
http://linkedlifedata.com/resource/pubmed/keyword/Distributional Activities,
http://linkedlifedata.com/resource/pubmed/keyword/Economic Factors,
http://linkedlifedata.com/resource/pubmed/keyword/Education,
http://linkedlifedata.com/resource/pubmed/keyword/HEALTH EDUCATION,
http://linkedlifedata.com/resource/pubmed/keyword/Health,
http://linkedlifedata.com/resource/pubmed/keyword/Health Services,
http://linkedlifedata.com/resource/pubmed/keyword/INTERNATIONAL AGENCIES,
http://linkedlifedata.com/resource/pubmed/keyword/Infant,
http://linkedlifedata.com/resource/pubmed/keyword/Latin America,
http://linkedlifedata.com/resource/pubmed/keyword/Malnutrition--prevention and control,
http://linkedlifedata.com/resource/pubmed/keyword/Maternal-child Health Services,
http://linkedlifedata.com/resource/pubmed/keyword/NUTRITION DISORDERS,
http://linkedlifedata.com/resource/pubmed/keyword/Nutrition,
http://linkedlifedata.com/resource/pubmed/keyword/Nutrition Indexes,
http://linkedlifedata.com/resource/pubmed/keyword/Nutrition Programs,
http://linkedlifedata.com/resource/pubmed/keyword/Organization And Administration,
http://linkedlifedata.com/resource/pubmed/keyword/Organizations,
http://linkedlifedata.com/resource/pubmed/keyword/POVERTY,
http://linkedlifedata.com/resource/pubmed/keyword/Paho,
http://linkedlifedata.com/resource/pubmed/keyword/Population,
http://linkedlifedata.com/resource/pubmed/keyword/Population Characteristics,
http://linkedlifedata.com/resource/pubmed/keyword/Primary Health Care,
http://linkedlifedata.com/resource/pubmed/keyword/Program Activities,
http://linkedlifedata.com/resource/pubmed/keyword/Program Effectiveness,
http://linkedlifedata.com/resource/pubmed/keyword/Program Evaluation,
http://linkedlifedata.com/resource/pubmed/keyword/Programs,
http://linkedlifedata.com/resource/pubmed/keyword/Research Methodology,
http://linkedlifedata.com/resource/pubmed/keyword/Research Report,
http://linkedlifedata.com/resource/pubmed/keyword/Socioeconomic Factors,
http://linkedlifedata.com/resource/pubmed/keyword/South America,
http://linkedlifedata.com/resource/pubmed/keyword/Studies,
http://linkedlifedata.com/resource/pubmed/keyword/Un,
http://linkedlifedata.com/resource/pubmed/keyword/Who,
http://linkedlifedata.com/resource/pubmed/keyword/World Bank,
http://linkedlifedata.com/resource/pubmed/keyword/Youth
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pubmed:language |
eng
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pubmed:journal |
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pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:issn |
0020-7314
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pubmed:author |
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pubmed:issnType |
Print
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pubmed:volume |
20
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
691-715
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pubmed:dateRevised |
2006-11-15
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pubmed:otherAbstract |
PIP: PAHO followed nutrition programs of Brazil, which have been supported almost exclusively from internal sources, since 1983 to provide technical assistance and to learn what may be applied to other countries. The PAHO program effectiveness evaluation study compared 2 ways of running nutrition programs which presumed that malnutrition was mainly caused by poverty--a subsidy of basic foods and direct distribution--between 1974-1986. 2 programs subsidized at least 4 basic foodstuffs with 1 program restricting the amount of food to identified families while the other allowed any family coming to stores in low income areas that participated in the program to take subsidized food. 2 other programs either gave free traditional commercial foods or specially formulated supplements to identified clients. The status of most well nourished or malnourished participants did not change despite intervals as long as 48 months. Moreover the nutritional status of a considerable percentage of participants deteriorated. Nevertheless moderate or severe malnourished children who started in a program tended to recover substantially, especially children 1 year old. Further the longer a client participated in a program the more likely the nutritional status would improve, yet frequent participation did not affect status. Thus the programs were more likely to cure than prevent malnutrition. Besides participants tended to not grow much, but weight status did improve. Those programs that also provided medical care and health education were more effective than those that just provided subsidies. This finding highlights how malnutrition is not just a problem of low income and low food consumption, but also a problem of poor health. The programs did not transfer benefits efficiently. In addition, the costs of securing the food, its poor quality, and insufficient volume discouraged beneficiary participation.
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pubmed:meshHeading |
pubmed-meshheading:2125029-Body Height,
pubmed-meshheading:2125029-Brazil,
pubmed-meshheading:2125029-Child, Preschool,
pubmed-meshheading:2125029-Child Nutrition Disorders,
pubmed-meshheading:2125029-Cost-Benefit Analysis,
pubmed-meshheading:2125029-Female,
pubmed-meshheading:2125029-Food, Formulated,
pubmed-meshheading:2125029-Food Services,
pubmed-meshheading:2125029-Humans,
pubmed-meshheading:2125029-Infant,
pubmed-meshheading:2125029-Infant, Low Birth Weight,
pubmed-meshheading:2125029-Infant, Newborn,
pubmed-meshheading:2125029-Infant Food,
pubmed-meshheading:2125029-Infant Nutrition Disorders,
pubmed-meshheading:2125029-National Health Programs,
pubmed-meshheading:2125029-Nutritional Status,
pubmed-meshheading:2125029-Pregnancy,
pubmed-meshheading:2125029-Program Evaluation,
pubmed-meshheading:2125029-Weight Gain
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pubmed:year |
1990
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pubmed:articleTitle |
Do nutrition programs make a difference? The case of Brazil.
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pubmed:affiliation |
Latin American Technical Department, World Bank, Washington, DC 20433.
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pubmed:publicationType |
Journal Article,
Comparative Study
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