Menu ENN Search

Feeding the unborn babies

By Severin Kabakama

Dr Severin Kabakama (MD Dar) is Assistant Project Officer (Early Child Development) in the Western Tanzania Refugee Program, UNICEF Kasulu Field Office. He has worked for twelve years as medical officer in Tanzania (of which 5 year have been spent with the Rwandese, Congolese and Burundian refugee programs in Western Tanzania)

In 1998, UNICEF initiated a supplementary feeding program for pregnant women in the Kigoma/Kagera refugee program of Western Tanzania. The programme which is still ongoing was implemented in order to reduce the prevalence of low birth weight and improve pregnancy outcome. Prevalence of low birth weight in the camps at the start of the intervention was 30% (Low Birth Weight is defined as weighing less than 2500g at birth). The main causes of LBW are malaria, HIV infection, worm infestation and lack of adequate nutrient intake during pregnancy. Women enrolled in the programme are given a dry takehome ration from the second trimester (from 16 weeks gestation age) to delivery. Approximately 30,000 pregnant women in eleven refugee camps are involved in the intervention.

The World Food Program (WFP) provides the supplementary ration while UNICEF through operational partnership with implementing agencies, closely monitors the implementation of the programmes and its outcome.

Ration size and quality

The daily ration comprises 200g of CSB (Corn Soya Blend), 20g of vegetable oil and 20g of sugar per pregnant woman providing a total of 1018 Kcal (38g of protein). This is distributed every two weeks at the nutrition supplementation Unit. In total it is assumed that a pregnant woman receives about 3180 Kcal per person per day if the general ration is included (2100 Kcal1 per person per day from general distribution).

The weighing, mixing and distribution of the supplement is normally carried out by the pregnant women themselves, who have been recruited onto the programme through their attendance at antenatal clinics where verification of gestation age is necessary.

The distribution process

Names are called out by a nutrition attendant with each beneficiary receiving a "premix" for 14 days - about 3.36Kg. As large numbers are always involved (approximately 400 for a camp of 38,000 refugees), a roster for each block/village in the camp is used to avoid congestion and time wasting. Nutritional education (emphasising the nutritional value of the supplementary ration) and cooking demonstrations are frequently conducted at the distribution site.

Main findings and lessons learnt

The programme has contributed to a reduction in low birth weight in the camps. Prevalence of LBW has decreased from 30% to 8.5 - 10% in different camps. These results are similar to a study in Gambia in 1997 where a 50% reduction in LBW was observed after supplementation with groundnut-based high energy biscuits (providing 1000 kcal per person per day).

The success of the program is mainly due to close cooperation between the pregnant women themselves, the service providers at the antenatal clinic and the personnel at the supplementary feeding units.

Added impacts and benefits of the programme

Programme Constraints

Show footnotes

1Comprising of 360g maize meal/grain (410g), 120g pulses, 40g CSB and 20g vegetable oil per person per day (pppd). An additional 50 g of maize is provided to offset the milling costs and wastage totalling 410g pppd.

More like this

Resource: Targeting & Supplementary feeding for pregnant & lactating women

Case studies from: INFANT AND YOUNG CHILD FEEDING IN EMERGENCIES GIFA/ENN PROJECT (2003) Researchers: Mary Corbett (Evaluation of Module 1) and Marie McGrath (Collation of...

FEX: Needs of host population versus refugees in Tanzania

Summary of published presentation1 Tanzania, arrival of refugees from Rwanda, Kegenyi camp, Ngara region A paper, presented at the Berlin symposium on Nutrition in the...

FEX: Food for thought: Supplementary feeding programme or ‘antenatal feeding programme’ for pregnant women

By Michael H Golden Michael Golden is Emeritus Professor at the University of Aberdeen, Scotland. An independent physician and researcher, he has over 40 years of experience...

FEX: Ensuring pregnancy weight gain: An integrated community-based approach to tackle maternal nutrition in India

View this article as a pdf By Sreeparna Ghosh Mukherjee, Pia Sen and Dr Nagma Nigar Shah Sreeparna Ghosh Mukherjee is Senior Programme Manager in the Health and Nutrition...

NEX: Tackling high defaulting rates in refugee camp settings – lessons from Chad

Seife Kifleyohannes Temere Seife Kifleyohannes Temere is a Nurse Nutritionist. He has been working for International Medical Corps since 2010. In eastern Chad there are 12...

en-net: Nutrition Survey Co-ordinator Tanzania


FEX: Scurvy outbreak among South Sudanese adolescents and young men – Kakuma refugee camp, Kenya, 2017-2018

View this article as a pdf Read the postscript to this article here. Summary of research1 Location: Kenya What we know: Refugee populations dependent on food assistance are...

FEX: Advocacy from Eritrea: working with WFP

By Hassan Taifour Hassan Taifour is the Emergency Response Nutritionist for SC(UK). He graduated from the Faculty of Agriculture, University of Khartoum in 1985 and completed...

FEX: Anthropometric indicators to identify a pregnant woman as acutely malnourished and predict adverse birth outcomes

Summary of published research1 Location: Global What we know: There is no consensus on how to identify pregnant women as acutely malnourished and when to enrol them in...

FEX: Breastfeeding support in the refugee camps of North Western Tanzania

By Lucas Kulwa Machibya Lucas Machibya has been working for UNHCR since June 1994 in the north-western Tanzania refugee operation as National Public Health Nutrition Officer....

FEX: Supplementation Programmes for Pregnant and Lactating Women.

In emergencies, a marginal or deficient diet for a pregnant or lactating woman has repercussions not only for her own health, but also for the health of the unborn, and the...

en-net: Blanket Supplementary Feeding Program(BSFP) Does it need anthropometric measurements?

Dear Team,
we are in an emergency sitruation where GAM rate is 30%, Food Insecurity status(IPC 4), and crisis. As a response to that, one of our emergency response is...

Combining a mid-day meal, health service package and peer support in Karnataka State, India

Combining a mid-day meal, health service package and peer support in Karnataka State, India View this article as a pdf Uma Mahadevan is Principal Secretary in the...

FEX: Continuum of care for children with wasting in India: Opportunities for an integrated approach

View this article as a pdf By Arjan de Wagt, Eleanor Rogers, Praveen Kumar, Abner Daniel, Harriet Torlesse and Saul Guerrero Arjan de Wagt is Chief of the Nutrition section,...

FEX: Supplementary Feeding Programme - Current Guidelines

Circumstances leading to the setting up of SFPs (from WFP guidelines) Blanket SFP Targeted SFP A generalised SFP for prevention purposes maybe implemented in the absence of a...

en-net: Adequate maternal weight gain

Hi there, Can anyone share information on using maternal weight gain as an admission/discharge criterion into maternal supplementary feeding programmes? I remember seeing a...

Delivering care to address a double burden of maternal malnutrition in Sri Lanka

View this article as a pdf Dr Irosha Nilaweera is a Consultant Community Physician for the National Programme for Maternal Care, Family Health Bureau, Ministry of Health, Sri...

FEX: Effects of nutrition interventions during pregnancy on low birth weight

Summary of research1 Location: Global What we know: Low birth weight (LBW) is a major underlying cause of infant mortality and childhood morbidity; LBW is greatly affected by...

FEX: Blanket BP5 distribution to under fives in North Darfur

By Hanna Mattinen, ACF Since 2005, Hanna Mattinen has been Food Aid Advisor at the Action contre la Faim (ACF) headquarters, focusing on policy and operational issues around...

FEX: Reaction to the article on the double burden of obesity and malnutrition in Western Sahara refugees

Dear editors One of the key challenges that the nutrition community faces in this century is the double burden of nutrition. In many countries, it is found that acute...


Reference this page

Severin Kabakama (2001). Feeding the unborn babies. Field Exchange 12, April 2001. p25.



Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.