The Philani Mentor Mothers Intervention: neighbourhood wide impact on child growth in Cape Town’s peri-urban settlements

ABSTRACT

The purpose of this research was to determine whether or not routine home visiting (by the Philani Maternal Child Health and Nutrition Project) influences the prevalence of stunted, wasted and underweight children in Cape Town peri-urban settlements. The study was a cross-sectional cohort in which weight and height measurements were collected for all children from 24 matched neighbourhoods; three years earlier 12 of these neighbourhoods were randomized to receive the home visiting intervention and 12 did not. The research took place at all households located within the 24 neighbourhoods in Khayelitsha and Mfuleni peri-urban settlements. Participants included 8715 children aged 0–6 years old (4694 intervention; 4021 control). A total of 41.3% of children were stunted, 3.1% were underweight and 1.4% were wasted. Children in the intervention group were significantly less likely to be underweight or severely underweight for age than children in the control group. While the rates of stunting were also significantly lower in intervention areas, the effect was not clinically significant, and no significant differences were found between the study arms on the prevalence of wasting. The Philani model is effective in the prevention and rehabilitation of underweight children. Philani could strengthen their intervention by focussing specifically on screening for child stunting in addition to underweight children. The results also suggests that efforts to address the long-term adverse effects of undernutrition require structural and economic transformation, in addition to socio-medical interventions.

KEYWORDS:

• Child nutrition interventions
• child undernutrition
• stunting
• underweight
• community-based nutrition

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. The criteria for biologically implausible data are: weight-for-age z-score (ZWAZ) – ZWAZ < –6 or ZWAZ > 5; length/height-for-age z-score (ZHAZ) – ZHAZ < –6 or ZHAZ > 6; BMI-for-age z-score (ZBMI) – ZBMI < –5 or ZBMI > 5.

Additional information

Funding

MT is a lead investigator with the Centre of Excellence in Human Development, University Witwatersrand, South Africa, and is supported by the National Research Foundation, South Africa. This study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) [Grant number 1R01AA017104]. ClinicalTrials.gov registration number: NCT00972699. The NIAAA had no role in the design, analysis or writing of this article.