In Niger, Médecins Sans Frontières (MSF) field staff observed that each year a dramatic rise in malnutrition cases would occur during the so-called ‘hunger gap’ – the lean period before the arrival of the new harvest.

MSF has been successful in treating children with malnutrition, but a new strategy has been developed to catch them before they reach this life-threatening condition by giving them enriched food supplements just before the start of the hunger gap. In effect this method can save children from becoming severely malnourished.

In 2007, MSF was able to pilot this new approach in its Maradi projects in Niger.

With outstanding results, new opportunities are opening up to defeat childhood malnutrition.

Why wait for a child to be on the brink of death to act?

According to an article recently published in the medical journal, PLoS One 1, MSF was able to curb the seasonal peak in severe malnutrition among 62,000 children from rural Niger during the 2007 ‘hunger gap’.

In this six-month lean period preceding the harvest, children aged six months to three years were given a milk-based fortified spread in addition to breastfeeding and the food they typically eat.

“What our intervention has shown is that in areas with high seasonal peaks of childhood malnutrition, we have to act early and ensure that children are getting the adequate nutrients they need, rather than wait for the kids to be treated for malnutrition, a condition which can lead to long term poor health, disabilities or death,” said Stéphane Doyon, MSF nutrition team leader.

First ever intervention on such a large scale

Earlier MSF studies had indicated the benefits of the early intervention model over traditional treatment programmes, but the 2007 intervention was the first time that energy-dense food supplements were distributed on such a large scale.

“In previous years, thousands of severely malnourished children had to be admitted to our therapeutic feeding centres in this area. But during the 2007 blanket distribution, this was not the case. The protective effect is staggering, so why should we wait for a child to be on the brink of death to act?” said Doyon.

These results obtained in the MSF Niger programme challenge current food aid and nutrition programming.

“Today, most food aid for children is fortified blended flours like the USAID-provided Corn Soy Blend (CSB), which we know lacks the critical nutrients that growing children need and does little to prevent malnutrition,” said Dr. Tido von Schoen-Angerer, Director of MSF’s Access to Essential Medicines Campaign. "Our operational experience shows once more that providing a nutritionally appropriate alternative to CSB works

Since 2007, main actors on the nutrition scene have agreed on the need to change the quality of food aid distributed to children. Organisations like UNICEF in Somalia and the World Food Programme (WFP) in Burkina Faso have followed suit and given children appropriate food supplements in the rations provided to families.