(PTFS11-04-25) Effectiveness of Locally Produced Nutrient-Rich Energy Bars in Management of Children With Acute Malnutrition in Humanitarian Settings of Myanmar

Objectives: With ongoing armed conflicts since the military takeover in 2021, Myanmar has been suffering from prolonged food insecurity, and the risk of childhood malnutrition is on the rise. Karenni is a highly food-insecure region in Myanmar, and it might worsen with the continuous crisis. Due to restrictions on accessing external food and nutrition assistance, efforts for community-driven nutrition interventions are in high demand. This work aims to test the effectiveness of locally produced energy bars in treating malnourished children by trained community members in humanitarian settings in Karenni, Myanmar.

Methods: Nutrient values of energy bars made from local ingredients were tested at the laboratory of the National Institute of Nutrition, Mahidol University, Thailand. Community volunteers were trained for infant and young child feeding (IYCF) and community-based management of acute malnutrition (CMAM). In May 2024, trained volunteers conducted a baseline assessment in Karenni for weight, height, and mid-upper arm circumference (MUAC) measurements of under 5-year children and interviews with caregivers on food security and IYCF practices. Energy bars were provided: one pack daily for moderately wasted children, 2 packs daily for severely wasted children, and 5 packs monthly for normal children. Monthly follow-up visits were made to recheck weight and MUAC and provide nutrition education and IYCF counseling. A midline assessment was made in September 2024.

Results: A pack (60g) of energy bars provides energy 306 Kcal, protein 12g, fat 16g, iron 2.1g, zinc 1.4g, calcium 66.3g. At baseline, 77.1% of households were food insecure, 603 children between 0-59 months were recruited, 243 were between 0-23 months, and 200 remained between 0-23 months in midline. From baseline (BL) to midline (ML), wasting and underweight declined from 8.8% to 3.6% and 22.6% to 13.6%, but stunting increased from 34.2% to 36.9%. Minimum dietary diversity was 44.9% vs. 41.6%, minimum meal frequency 76.7% vs. 75.7%, and minimum acceptable diet 33.5% vs. 27.6% at BL and ML, respectively.

Conclusions: Locally produced energy bars could effectively manage acute malnutrition in Myanmar's crisis settings, although improving IYCF remains challenging. Additional interventions, such as micronutrient powder, are still needed to tackle chronic undernutrition in children.

Funding Sources: USAID