Improving treatment of malnutrition to support child development in the context of climate change: the BrightSAM study

Project summary

All commitments are on the condition of the Danish Parliament’s approval of adequate funds for development research in the upcoming 2023 Finance Bill.
Final grant amount TBA.

Almost half of the World Food Programme’s emergency operations are now in response to climate-related disasters. Child malnutrition is a major consequence of climate change threatening health and development in low-income countries. Every year, 15 million children are affected by severe acute malnutrition (SAM). The introduction of ready-to-use therapeutic food (RUTF) has improved survival of children with SAM, but their development is affected even many years after nutritional recovery. These children have poorer school performance and lower income in adult life, which causes harm not only to the children, but also the societies they live in.

The development of the young child’s brain is dependent on dietary intake of nutrients that include B12, choline and n-3 essential fatty acids. Recent research show that treatment with the current RUTF do not result in optimal status of these nutrients in malnourished children. In addition, families exposed to malnutrition are often also affected by psychological distress and children are likely to be offered little stimulation in their households. Lack of responsive caregiving often exacerbates the negative impact of malnutrition on children’s development.

Usually, the success of SAM treatment is measured by nutritional recovery indicated by children’s growth. However, these anthropometric outcomes are merely proxies of children’s health and do not inform us about their capacity to thrive long term. There is now a move towards ensuring that children not only survive, but also thrive after recovering from malnutrition. This calls for research into the effects of treatment on functional outcomes, including cognitive and psycho-emotional development.

In the present study, we will test the effects of an optimized RUTF and/or family support for responsive caregiving in a randomised 2x2 factorial trial. We will assess effects on children’s attention, cognitive, motor, language and psycho-emotional development and the potential pathways of these effects. As part of the study, we will also evaluate the implementation and environmental sustainability of the interventions and strengthen research capacity at the Tanzanian partner institutions.

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