The impact of food supplementation on infant weight gain in rural Bangladesh; an assessment of the Bangladesh Integrated Nutritional Program (BINP).
OBJECTIVE
To examine the efficiency of the Bangladesh Integrated Nutritional Program (BINP) in identifying which infants should be supplemented, whether full supplementation was given for the stipulated period of time, and whether the correct exit criteria from the supplementation programme were used. To test whether targeted food supplementation of infants between 6-12 months of age resulted in enhanced weight gain.


METHODS
Mallickbari Union, Bhaluka, a rural area located about 100 km north of Dhaka, Bangladesh.


METHODS
Five hundred and twenty-six 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 was incorrectly identified for supplementation. In addition, less than a quarter of the infants received the full 90 days of supplementation and close to half of the infants exited the programme without the requisite weight gain. Infants were assigned to one of four groups: correctly supplemented, correctly non-supplemented, incorrectly supplemented or incorrectly non-supplemented. This classification provided natural controls; the correctly supplemented infants versus the incorrectly non-supplemented infants, and the correctly non-supplemented infants versus 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 there any evidence of growth faltering in the incorrectly non-supplemented group.


CONCLUSIONS
This study found serious programmatic deficiencies - inability to identify growth faltering in 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.
Begum
Housne Ara
HA
Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh.
Mascie-Taylor
Cgn
C
Nahar
Shamsun
S
D001459:Bangladesh; D002657:Child Development / Q000502:physiology*; D003906:Developing Countries; D019587:Dietary Supplements; D002523:Edible Grain; D005260:Female; D005527:Food, Fortified; D006128:Growth; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation; D018570:Risk Assessment / Q000379:methods*; D015430:Weight Gain / Q000502:physiology*