%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Adubra, L.
%A Le Port, A.
%A Kameli, Yves
%A Fortin, Sonia
%A Mahamadou, T.
%A Ruel, M. T.
%A Martin-Prével, Yves
%A Savy, Mathilde
%T Conditional cash transfer and/or lipid-based nutrient supplement targeting the first 1000 d of life increased attendance at preventive care services but did not improve linear growth in young children in rural Mali : results of a cluster-randomized controlled trial
%D 2019
%L fdi:010077742
%G ENG
%J American Journal of Clinical Nutrition
%@ 0002-9165
%K conditional cash transfer ; lipid-based nutrient supplement ; community ; health center ; linear growth ; children ; Mali
%K MALI
%K KAYES REGION
%M ISI:000504095200025
%N 6
%P 1476-1490
%R 10.1093/ajcn/nqz238
%U https://www.documentation.ird.fr/hor/fdi:010077742
%> https://www.documentation.ird.fr/intranet/publi/2020/01/010077742.pdf
%V 110
%W Horizon (IRD)
%X Background: In 2014, the World Food Programme added to an ongoing health and nutrition program named "Sante Nutritionnelle a Assise Communautaire dans la region de Kayes" (SNACK), the distribution of cash to mothers and/or lipid-based nutrient supplement (LNS) to children aged 6-23 mo, conditional upon attendance at community health centers (CHCs) during the first 1000 d of life. Objective: We evaluated the additional impact of the distribution of cash and/or LNS on mean height-for-age z scores (HAZ; primary outcome), stunting (HAZ < -2), and on intermediate outcomes along the program impact pathways. Methods: In a cluster-randomized controlled trial using a 2 x 2 factorial design, 76 CHCs were randomly assigned to deliver either SNACK, SNACK + Cash, SNACK + LNS, or SNACK + Cash + LNS. Cross-sectional surveys among 12- to 42-mo-old children and their mothers were conducted at baseline (2013, n = 5046) and at endline (2016, n = 5098). Results: Factorial analysis showed no interaction between cash and LNS treatments for HAZ, but found an antagonistic interaction for stunting (OR: 1.55; 95% CI: 1.05, 2.31; P = 0.03). There were no impacts of the cash, LNS, or cash + LNS treatments, compared with the SNACK alone, on either HAZ or stunting (treatment x time interaction). There were significant impacts of the LNS and cash + LNS treatments on attendance at =1 growth monitoring (GM) session (OR: 3.95; 95% CI: 1.69, 9.24; OR: 3.90; 95% CI: 1.73, 8.81, respectively) and half the expected sessions (OR: 4.72; 95% CI: 1.47, 15.17; OR: 5.25; 95% CI: 1.82, 15.11, respectively), mothers' knowledge on importance of GM (OR: 1.98; 95% CI: 1.16, 3.39; OR: 3.12; 95% CI: 1.60, 6.09, respectively), and, only for the LNS group, appropriate timing for complementary feeding (OR: 1.62; 95% CI: 1.09, 2.41). Conclusions: Implementation constraints and suboptimal participation in program activities may explain the lack of impact on child linear growth in this rural region of Mali.
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