Impact of Fortified Blended Foods on Recovery from Moderate Acute Malnutrition in Children Under Five in Borno State

Moderate acute malnutrition affects millions of children in North East Nigeria, and the selection of appropriate food products for outpatient therapeutic programmes is a critical programmatic decision with significant humanitarian implications. This study evaluates the impact of locally produced fortified blended foods compared to standard imported Super Cereal Plus on recovery rates from moderate acute malnutrition among children aged 6 to 59 months in the Jere and Konduga local government areas of Borno State. A randomised comparative effectiveness trial enrolled 240 children with moderate acute malnutrition, defined as weight-for-height z-score between negative three and negative two with no bilateral pitting oedema. Children were randomised to receive locally fortified blended food or Super Cereal Plus as daily rations for eight weeks. Primary outcomes included recovery rate, defined as achieving weight-for-height z-score above negative two, average weekly weight gain, and mid-upper arm circumference change at endpoint. Secondary outcomes included default rate, caregiver acceptability of the product, and estimated cost per recovery. Monthly weight, height, and mid-upper arm circumference measurements were taken by trained community nutrition workers. Intention-to-treat analysis was used as the primary analytical approach. Findings will generate comparative effectiveness data on locally produced therapeutic food options that are potentially more culturally acceptable, accessible, and cost-efficient for moderate acute malnutrition treatment in the North East humanitarian context. Keywords: moderate acute malnutrition, fortified blended food, recovery, Borno State, outpatient therapeutic programme.