title: Has the first implementation phase of the Community Nutrition Project in urban Senegal had an impact?
abstract: OBJECTIVE
  We evaluated the impact of the Community Nutrition Project (CNP) of Senegal, West Africa on the population. In poor urban districts, the CNP provided underweight 6- to 35-mo-old children with growth monitoring/promotion and food supplementation, and education for mothers for a period of 6 mo.
  
  
  METHODS
  A before/after intervention and intervention zone (IZ)/control zone (CZ) design was used to assess whether CNP had an impact 18 mo after it began in Diourbel. Exhaustive samples included children 6-35 mo old in the CZ (n = 895 before and 917 after) and IZ (n = 912 and 759). The impact was assessed by the differential effect of the zone on changes in underweight, wasting, and stunting defined by the threshold of -2 or -3 z scores.
  
  
  RESULTS
  The decrease in wasting was higher in the CZ (from 13.7% to 8.6% versus 11.3% to 10.8%, P = 0.042). Changes in stunting did not differ between zones (18.8% to 14.5% versus 15.1% to 14.7%, P = 0.21). However, in the IZ, severe wasting, stunting, and underweight disappeared in children 6-11 mo of age. In the CZ, the socioeconomic data and some outcomes in children reflected a favorable context independent of the CNP.
  
  
  CONCLUSIONS
  Despite a globally satisfactory decrease in malnutrition in the IZ, no impact was demonstrated because the same or an even larger decrease was observed in the CZ, highlighting the importance of relying on a quasi-experimental design. This may be explained in part by weaknesses in the process, which probably interfered with a potential impact, and by the high degree of population mobility, which could have interfered with efficiency assessed on a geographic scale.
authors.affiliation: Institute de Recherche pour le Développement (IRD), UR 106, Nutrition Unit (WHO Collaborating Centre for Nutrition), Montpellier, France. gartner@mpl.ird.fr
authors.forename: Agnès
authors.initials: A
authors.lastname: Gartner
authors.forename: Yves
authors.initials: Y
authors.lastname: Kameli
authors.forename: Pierre
authors.initials: P
authors.lastname: Traissac
authors.forename: Agnès
authors.initials: A
authors.lastname: Dhur
authors.forename: Francis
authors.initials: F
authors.lastname: Delpeuch
authors.forename: Bernard
authors.initials: B
authors.lastname: Maire
mesh_terms: D000328:Adult; D000886:Anthropometry; D002657:Child Development; D015362:Child Nutrition Disorders / Q000453:epidemiology / Q000517:prevention & control*; D053198:Child Nutrition Sciences / Q000193:education*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009035:Mothers / Q000193:education*; D009749:Nutrition Surveys; D015397:Program Evaluation; D012675:Senegal; D016896:Treatment Outcome