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This analysis assessed whether caregivers’ reports about the amount of oil added to corn soy blend (CSB) porridge were consistent with lab analysis and whether reported sharing of CSB porridge was consistent with direct observation. This was a secondary analysis of a feasibility study assessing 2 programmatic changes in a supplementary feeding program for treatment of moderate acute malnutrition (MAM) in southern Malawi. Intervention groups received standard monthly rations of CSB with increased oil along with social behavior change communication (SBCC) to increase the amount of oil added to CSB porridge and reduce sharing. A control group received the standard CSB and oil ration. Self-reported data collected through structured interviews with caregivers were compared with laboratory analysis of CSB porridge samples and in-home observation over a 5-day period. On average, participants overreported the amount of oil used in prepared CSB porridge; self-report tended to be closer than the lab-assessed values to the amount recommended in the SBCC. Self-reported and observed sharing appeared consistent across groups. Overall, the self-reported and direct measures showed the same relationships among the groups. Self-report and objective measures were inconsistent but conveyed the same overall message. [ABSTRACT FROM AUTHOR]

Corn Soy Blend (CSB) porridge is commonly prepared with oil for treatment of moderate acute malnutrition (MAM). A recent review recommended that 30 g of oil be used with 100 g of CSB to increase energy density and micronutrient absorption. This study assessed the effectiveness and cost-effectiveness of program changes aimed at achieving that target oil:CSB ratio in prepared porridge. Caregivers of children in MAM supplementary feeding programs were assigned to three groups: a control group received monthly rations of 1 L oil, 8 kg CSB in bulk, and social and behavior change communication (SBCC); intervention groups received 2.6 L oil, 8 kg CSB provided either in bulk (Group 1) or four 2-kg packages with printed messages (Group 2), and enhanced SBCC emphasizing the target oil:CSB ratio. Compared to the control, both intervention groups had higher mean added oil per 100 g CSB (18 g, p < 0.01, and 13 g, p= 0.04, higher in groups 1 and 2, respectively), and greater odds of meeting or exceeding the target ratio (28.4, p< 0.01, and 12.7, p= 0.02, in groups 1 and 2, respectively). Cost per caregiver reaching the target ratio was most favorable in Group 1 ($391 in Group 1, $527 in Group 2, and $1,666 in the control). Enhanced SBCC combined with increased oil ration resulted in increased use of oil in CSB porridge in a supplementary feeding program. Modified packaging did not improve effectiveness. However, both interventions were more cost-effective than standard programming. [ABSTRACT FROM AUTHOR]

Background: In 2014, an intervention aimed at increasing the oil in corn soy blend (CSB) porridge prepared by caregivers of children with moderate acute malnutrition was implemented in Southern Malawi. This analysis describes the flow of key messages delivered through the Care Group model during this intervention.Methods: The intervention provided a supplementary food ration of CSB and oil and used a Care Group model in which healthcare workers were trained to deliver social and behavior change communication (SBCC) to care group volunteers who then delivered messages to caregivers of beneficiary children. Healthcare workers also delivered messages to caregivers directly. Interviews and focus groups were conducted with all three groups in order to determine the exchange of key messages about ingredient use, storage, and purpose, which were analyzed descriptively.Results: Analysis of SBCC flow and information exchange showed that 100% of caregivers reported learning about the amounts of oil and CSB to use while preparing porridge and over 90% of caregivers, healthcare workers, and care group volunteers reported talking about it. Focus groups confirmed an effective flow of communication among these three groups.Conclusion: This analysis evaluated the flow of key SBCC messages through multiple, overlapping lines of communication among healthcare workers, care group volunteers, and caregivers; the effective transmission of these SBCC messages through this model may contribute to the success of a supplementary feeding intervention program.Trial Registration: The study was registered at ClinicalTrials.gov ( NCT01873196 ). [ABSTRACT FROM AUTHOR]