The impact of nutritional and psychosocial interventions  on the development of children with severe acute malnutrition (SAM): a cluster randomized controlled trial.

Introduction: Toddlers with Severe Acute Malnutrition (SAM) are at high risk of impaired growth and development. Nutritional intake and lack of adequate stimulation can be the cause. The purpose of this study was to evaluate the effectiveness of the Bregas Nutriroll Ready to Use Therapeutic Food intervention, with and without combination of psychosocial stimulation among SAM toddlers. Methods: This research was a cluster random controlled experiment, involved 55 children ages 12 to 59 months with SAM which split up into three groups. The control group was given F100, group 1 received an intervention consisting of Bregas Nutriroll, whereas group 2 received both Bregas Nutriroll and psychosocial stimulation. This research conducted on August 2023 to February 2024 in Panite and Kualin villages, South Central Timor Regency, East Nusa Tenggara Province, Indonesia. Data collected included toddler and family characteristics, as well as toddler development, anthropometric data including weight, height, and upper arm circumference. Results: Kruskal Wallis test showed data antropometric between group were homogen, except for the median age data (p=0.034). One-way ANOVA test showed Weight-for-Age. Z-score (WAZ) (p=0.048) and Weight-for-Height Z-score (WHZ) (p<0.001), were significanly different after intervention. The development mean score in toddlers increased in control group (8.4±2.2 to 8.8±1.5), and group 2 (8.4±2.1 to 9.5±1.0), respectively. Friedman test analysis showed there were significant differences in development score between control group and group 2 (p<0.05). Conclusion: Study showed that a comprehensive approach combining nutritional interventions and psychosocial stimulation could be an effective strategy to improve nutritional status and developmental in SAM toddlers.