The impact of Ready-to-Use Supplementary Food (RUSF) in targeted supplementation of children with moderate acute malnutrition (MAM) in South Africa

Abstract

Objective: To describe catch-up growth in children with moderate acute malnutrition (MAM) on targeted supplementation using Ready-to-Use Supplementary Food (RUSF).

Methods: An impact study was done to determine anthropometric changes in children aged 12–60 months who received RUSF (175 kcal/kg/day) for six weeks, managed as outpatients and followed up for 12 weeks until a final assessment.

Results: Default rates were high, with 30% of children returning to the primary healthcare facility for follow-up only once or twice. Despite significant improvement in height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), weight-for-height Z-score (WHZ) and mid-upper arm circumference (MUAC), 70.5% of the sample remained in the same malnutrition classification and only 26% recovered. The growth velocity of children with a lower initial WHZ was significantly higher (r = –0.15, p < 0.05) than those with less wasting, but only 20% grew at a rate to achieve catch-up growth. The mean growth velocity decreased as the intervention period continued.

Conclusion: All median anthropometric indicators improved with RUSF supplementation. However, catch-up growth or recovery occurred in only 20–25% of children included in the study. These findings create questions about the value of supplementation in the absence of blanket food distribution or other interventions to address food security.