RESUMO
Background The report of the 2013 Nigeria Demographic and Health Survey (NDHS 2013) showed Ondo State had one of the worst indices for stunting and underweight in the southwestern geopolitical zone of the country, a development that was considered "unacceptable" by the state government. In the bid to reverse the ugly trend, the State Primary Health Care Development Agency put in place a comprehensive nutrition program in 2015 tagged "Nutrition Rebirth," aimed at reversing the high prevalence of malnutrition among under-five children in the State. Aims This study seeks to evaluate the Ondo State comprehensive nutrition program by comparing the children's nutritional status pre- and post-period under review in the implementation of the program. This provides a measure of assessment of the performance of the program as implemented in the period under review. Materials and methods This study covered the period between 2015 and 2017 in the implementation of the nutrition rebirth program. Data for the study were obtained from the NDHS (2013) and NDHS (2018) nutrition of children and women data. Analysis of the NDHS (2013) and NDHS (2018) data commenced simultaneously with field work and lasted for about six and eight months, respectively. Analysis of the data obtained from the NDHS for this study spanned through a period of about three weeks. An ecologic time-trend analysis was used to compare the trends in nutritional status indicators among under-five children in all 18 Local Government Areas (LGAs) in Ondo State. Results Malnutrition among children less than five years dropped in most of the LGAs in 2018. Malnutrition was not associated with children's gender and maternal age in 2013 and 2018. Prevalence of stunting growth and underweight was associated with maternal education, wealth index, residence type, place of delivery, and LGA in 2013 (p < 0.05) but was not in 2018 (p > 0.05). Conclusions The spatial analysis of the Ondo State comprehensive nutrition program showed that the program has a positive impact, reducing malnutrition among children under five years; but critical appraisal of implementation challenges in LGAs with no significant reduction in malnutrition among their children under five years is recommended. The comprehensive and wholistic approach of the program is also recommended for other states and settings with a high prevalence of under-five malnutrition to understudy the possible adaptation, as appropriate.
