Academic journal article Bulletin of the World Health Organization

Deterioration in the Nutritional Status of Young Children and Their Mothers in Brazzaville, Congo, Following the 1994 Devaluation of the CFA Franc

Academic journal article Bulletin of the World Health Organization

Deterioration in the Nutritional Status of Young Children and Their Mothers in Brazzaville, Congo, Following the 1994 Devaluation of the CFA Franc

Article excerpt

Voir page 116 le resume en francais. En la pagina 117 figura un resumen en espanol.


The African Financial Community (CFA) franc was devalued by 50% on 12 January 1994 in 14 sub-Saharan African countries. Such monetary action, not uncommon in developing countries, is aimed at reestablishing a macroeconomic balance and stimulating domestic production. Generally, considerations focus on the reasons for and pertinence of the devaluation, and its effects are assessed in terms of the economic performance of the countries involved (e.g. reference (1)). The potential impact on the health of the population is rarely considered and often remains undocumented.

Questions about the consequences of the 1994 devaluation of the CFA franc for the most vulnerable populations, particularly in terms of health and education, were raised immediately (2, 3) for the following reasons: the magnitude of the devaluation; the number of countries involved; and the fact that the populations concerned were rendered particularly vulnerable because of several years of economic crisis. Furthermore, the welfare of these populations, notably those in urban areas, primarily depended on their access to imported staple products.

A study conducted in Brazzaville, Congo, and Dakar-Pikine, Senegal, in December 1994 (i.e. a few months after devaluation) found a marked diminution in the quality of the first solid foods given to infants as a complement to breastfeeding (4) -- poor quality complementary feeding is an important risk factor for malnutrition among young children, and negatively affects their health and development (5). Several questions then arose. Was the decreased quality in complementary feeding temporary, to be considered as related to the devaluation shock, or was it to be long-lasting? Would the changes observed be associated with a deterioration in the nutritional status of the children? Was the nutritional situation of the adults (the mothers of these children) also affected?

The present epidemiological survey was conducted in 1996 to address these questions. Its primary objective was to evaluate the changes in the feeding practices for infants, the quality of complementary foods, and the nutritional status of the children and their mothers following a survey undertaken in 1993, prior to devaluation. It involved a representative sample of young children and their mothers in the same two districts of Brazzaville as the earlier survey.

Subjects and methods

Context, study zone, sampling

For the nutritional, questionnaire-based, cross-sectional survey carried out between March and May 1993 in the Poto-Poto and Bacongo districts of Brazzaville, the sample consisted of 2623 households, including 2807 children (aged 4-23 months) and their mothers (n = 2746). The primary aim of this survey, which included anthropometric measurements, was to provide preliminary data for the evaluation of a programme intended to improve complementary feeding (6). The study zone had been defined to be consistent with the objectives of this programme and fitted the "sociohealth areas" determined by the National Plan for Health Development. The study zone therefore contained a homogeneous population of roughly the same size in each district (ca. 60 000 inhabitants).

Since the beginning of the 1990s, the Congo has been the scene of social and political instability, which degenerated into civil war in 1997 (7). However, Brazzaville was the scene of much more limited civil unrest from November 1993 to February 1994, which prevented programme development. It was in the middle of this period that the CFA franc was devalued (January 1994). The second survey was conducted 3 years after the first, i.e. in April-June 1996, in the same zone and the same age group. The children included had all been born after the civil unrest and the devaluation (Fig. 1). The survey was carried out at the same time of year, to avoid any seasonal bias, and using the same methodology as the first, but involved a slightly smaller sample (1584 households with 1695 children aged 4-23 months and 1670 mothers). …

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