The Preventing Malnutrition in Children under 2 Approach (PM2A) is a food-assisted approach that targets health and nutrition interventions to all pregnant women, mothers of children 0–23 months, and children under 2 years—during the critical 1,000-day window of opportunity—in areas that are food-insecure. To study the impact and cost-effectiveness of PM2A for preventing chronic malnutrition, FANTA partner IFPRI conducted two cluster-randomized trials, one in Guatemala and one in Burundi, each in the context of an ongoing USAID Office of Food for Peace Title II development food assistance project. These studies sought to answer questions such as: Do food rations have an effect on a child`s nutritional status? What types and quantities are most effective? and How long should they be provided for? A brief, Building the Evidence around PM2A in Burundi and Guatemala, summarizes the findings.

Collaborating Organizations: CRS, Mercy Corps

Burundi Trial

The study in Burundi evaluated the implementation of PM2A in the Tubaramure project. FANTA conducted and published baseline survey results in 2010, and a process evaluation of the implementation of the project in 2013. A second survey, which was conducted 2 years into the project, found that PM2A, had a positive effect on household access to food, child feeding practices, and child morbidity. A third survey found that PM2A continued to have a positive post-program impact on children 24-41 months and their mothers. 

Strengthening and Evaluating the Preventing Malnutrition in Children Under 2 Years of Age Approach in Burundi. Summary Report (2018)

Optimizing Food-Assistance Programs: Food Assistance Improves Child Growth in Burundi (IFPRI Research Brief, 2018)

Optimizing Food-Assistance Programs: Food Nutrition-Sensitive Food Assistance Lowers Anemia Prevalence in Burundi (IFPRI Research Brief, 2018)

Strengthening and Evaluating the Preventing Malnutrition in Children under 2 Years of Age Approach, Burundi Follow-Up Report: Children 24–41 Months (2017)

Strengthening and Evaluating the Preventing Malnutrition in Children under 2 Years of Age Approach—Burundi Follow-Up Report: Children 0–23 Months (2014) 

A Process Evaluation of the Tubaramure Program for Preventing Malnutrition in Children under 2 Approach (PM2A) in Burundi (2013)

Strengthening and Evaluating the Preventing Malnutrition in Children under 2 Approach (PM2A) in Burundi: Baseline Report (2012)

Renforcement et évaluation de l’approche Prévention de la Malnutrition chez les enfants de moins de 2 ans (PM2A) au Burundi : Rapport initial (2012)

Journal of Nutrition: Tubaramure, a Food-Assisted Integrated Health and Nutrition Program, Reduces Child Stunting in Burundi: A Cluster-Randomized Controlled Intervention Trial (2018)

Journal of Nutrition: Tubaramure, a Food-Assisted Integrated Health and Nutrition Program in Burundi, Increases Maternal and Child Hemoglobin Concentrations and Reduces Anemia (2016)

Guatemala Trial

The study in Guatemala evaluated the implementation of PM2A in the PROCOMIDA project. FANTA conducted and published formative research to inform the health-strengthening activities and social and behavior change strategy of the project, a process evaluation of the project, and an enrollment survey. Findings from the longitudinal study were also published, highlighting the reduction in stunting as a result of the PROCOMIDA project, with some variations based on the types and amounts of food rations provided.

Strengthening and Evaluation the Preventing Malnutrition in Children under 2 Years of Age Approach. Guatemala Follow-Up Report (2018)

Strengthening and Evaluating the PM2A in Guatemala: Report of the Enrollment Survey (2013)

A Process Evaluation of the PROCOMIDA “Preventing Malnutrition in Children under 2 Approach” in Guatemala (2013)

Report of Formative Research Conducted in Alta Verapaz, Guatemala, to Help Inform the Health-Strengthening Activities and the Social and Behavior Change Communication Strategy That Will Be Implemented through the Mercy Corps PM2A Program – PROCOMIDA (2012)

Strengthening and Evaluating the Preventing Malnutrition in Children Under Two Years of Age Approach (PM2A) in Guatemala: Cross-Sectional Baseline Report (2011)

Cost and Cost-Effectiveness Study for Both Countries

Cost Study of the Preventing Malnutrition in Children under 2 Years of Age Approach in Burundi and Guatemala (2018)