Arrival at the Health Center
Mariam arrived at the health center with Hassan, her nineteen-month-old son, holding his vaccination booklet tightly. “My husband stayed in the village; I went to the hospital alone with my child,” she says calmly. At first, vaccinations were regular. Then, over time, appointments became less frequent, and the vaccination booklet fell behind schedule.
When he was six months old, Hassan’s health began to deteriorate. “For forty days, he refused to breastfeed and became very ill,” Mariam recalls. They first consulted a traditional healer in their village, but his condition did not improve. It was finally at the health center that Hassan received appropriate care. The team updated his vaccinations and offered to enroll him in the OptiMAx program.
Introducing SQ-LNS
At the intervention center, the project’s approach is explained: after reviewing the vaccination card and conducting a nutritional assessment, sachets of SQ-LNS (Small Quantity Lipid-Based Nutrient Supplement) are distributed.
“When he was 6 months old, we were admitted into the OptiMAx program, and he was given nutritional supplements,” Mariam recalls. It was not easy at the beginning. Hassan initially refused this new addition to his diet, surprised by the taste.
Mariam persisted despite his resistance. “It wasn’t easy; he didn’t always accept it,” she explains. Gradually, his appetite returned. He was calmer during the night, his energy improved, and visits to the health center became regular again. What began as a constraint gradually turned into a trusted routine.
Visible Change
Today, Mariam sees the difference: “My child’s health has improved thanks to the vaccines and the supplements.” She recommends the program to other mothers: “I encourage other mothers to bring their children for vaccination and to benefit from the nutritional supplements. It really helps.” For Mariam and her son, the combination of vaccination and supplementation made all the difference.
What OptiMAx Measures
The OptiMAx study aims to measure three concrete outcomes: increased vaccination coverage, reduced malnutrition prevalence, and improved family retention in health services. The project is based on a simple idea: pairing an immediate benefit (SQ-LNS sachet) with a preventive act (vaccination) to create positive momentum around pediatric monitoring.
Conducted as a cluster randomized controlled trial, OptiMAx is being implemented in 12 health centers in Chad: six pilot centers where nutritional interventions are integrated into vaccination sessions, and six control centers where vaccination continues according to usual practices without nutritional supplementation.
To date, 1,839 children between 6 and 12 months old have benefited from the OptiMAx program.
Mariam and Hassan’s story shows that integrating nutrition and vaccination can produce tangible results: updated vaccination booklets, restored appetite, and renewed trust. In Ngouri, for Mariam, it has above all given her the confidence to return to the health center, knowing her child will comprehensive care, tailored to his needs.
This study is made possible through the financial support of the Gates Foundation and Edesia Nutrition and runs over a 24-month period. They are also funding a similar, simultaneous trial in Mirriah, Niger.
