title: Most children who took part in a comprehensive malnutrition programme in Madagascar reached and maintained the recovery threshold.
abstract: OBJECTIVE
  The benefits of including nutritional education in programmes that tackle moderate and severe acute malnutrition remain poorly documented. This study in Madagascar evaluated the nutritional status of children who took part in an innovative programme that included maternal education, on completion and after a year.
  
  
  METHODS
  Each year, this outpatient programme admits 2400 malnourished children from six months to 59 months in the lower districts of Antananarivo, Madagascar. Children were drawn by lots, and their anthropometric data were measured. A descriptive retrospective longitudinal study was conducted on 573 children who took part between 2010 and 2013.
  
  
  RESULTS
  The programme lasted an average of 38 days and, on completion, 82.2% had reached the recovery threshold, and 16.2% had moved up to mild malnutrition. This was achieved with food supplements of 720 kcal per day, despite the Malagasy Public Health recommendation of 1000-1500 kcal per day. After one year, 79.1% were still above the recovery threshold, and 15% had mild malnutrition. The recovery rate was higher for children under 24 months of age (odds ratio 2.9, 95% confidence interval 1.93-4.59).
  
  
  CONCLUSIONS
  Most children who attended this malnutrition programme with maternal education in Madagascar reached the recovery threshold on completion and had maintained it after one year.
authors.affiliation: Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland.
authors.forename: Margot
authors.initials: M
authors.lastname: Magnin
authors.affiliation: Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland.
authors.forename: Beat
authors.initials: B
authors.lastname: Stoll
authors.affiliation: Medical Dispensary, Maternity Ward and CRENAM (Outpatient Nutritional Recovery and Education Centres Which Deal with Moderate Acute Cases of Malnutrition) of Anosizato and Miray Association, Antananarivo, Madagascar.
authors.forename: Rajaobelina
authors.initials: R
authors.lastname: Voahangy
authors.affiliation: Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland.|School of Health Sciences, University of Applied Sciences and Arts, Western Switzerland, Geneva, Switzerland.
authors.forename: Emilien
authors.initials: E
authors.lastname: Jeannot
mesh_terms: D015362:Child Nutrition Disorders / Q000178:diet therapy*; D002675:Child, Preschool; D005260:Female; D006266:Health Education; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008270:Madagascar; D008297:Male; D044342:Malnutrition / Q000178:diet therapy*; D008425:Maternal Behavior; D009752:Nutritional Status; D012189:Retrospective Studies
keywords: Acute malnutrition; Food supplements; Madagascar; Maternal education; Moderate malnutrition