Mal J Nutr 28(2): 295-303, 2022 __________________________ *Corresponding author: Dr. Ekong E. Udoh Paediatric Department, University of Uyo, Uyo, Nigeria Tel: + 234 (0) 80 3835 5559; Email: rejoicerejoice2001@yahoo.com doi: https://doi.org/10.31246/mjn-2021-0040 Effect of adherence to follow-up on recovery from moderate acute malnutrition among under-fves in a supplementary feeding programme Ekong Emmanuel Udoh 1* , Rosemary Augustine Umoh 1 , Kevin Bassey Edem 1 , Frances Samuel Okpokowuruk 1 , Ekemini Nsikan Udo 1 , Blessing Njideka Nwazuluoke 2 & Olugbemi Oluseyi Motilewa 3 1 Department of Paediatrics, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria; 2 Dietetic Unit, Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria; 3 Department of Community Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria ABSTRACT Introduction: Supplementary feeding programme is a strategy for managing under- fves with moderate acute malnutrition (MAM). This study aimed to determine the effect of adherence to follow-up on recovery from MAM among under-fves. Methods: A clinical trial to evaluate the effectiveness of daily supplementary rations of a standardised milk-based formulation (SMBF), standardised non-milk-based formulation (SNMBF), and hospital-based formulation (HBF) on recovery from MAM over a four months period was conducted among eligible children aged 6 – 59 months. Recovery from MAM among participants was determined based on their status of adherence to follow-up at week 16. It was deemed statistically signifcant if p-value was <0.05. Results: Of the 157 children evaluated, 41/54 (75.9%) who received the SMBF, 32/57 (56.1%) who received the SNMBF, and 22/46 (47.8%) who received the HBF had good adherence. Adherence to follow-up was signifcantly higher with SMBF than SNMBF and HBF (χ²=8.923; p=0.012). In all, 95/157 (60.5%) had good adherence to follow-up with 73/95 (76.8%) recovery from MAM against 42/62 (67.7%) recovery in those with poor adherence (p=0.208). Conclusion: The status of adherence to scheduled follow-up was not signifcantly associated with recovery from MAM among under-fves enrolled in the supplementary feeding programme. Nevertheless, efforts at promoting adherence to scheduled follow-up visits should be sustained. Key words: adherence, clinical, follow-up, malnutrition, nutrition, trial INTRODUCTION Malnutrition is presently a leading cause of childhood morbidity and mortality globally. Micha et al. (2020) gave an estimate of about 144 million stunted and 47 million wasted under-fves globally. Of the 47 million under-fves with wasting, 14.3 million have severe acute malnutrition, while 32.7 million have moderate acute malnutrition (MAM). Most malnourished children reside in Asia and sub-Saharan Africa (Micha et al., 2020). Supplementary feeding programme is one of the strategies recommended by the World Health Organization (WHO)