Impact Evaluation of a Comprehensive Nutrition Program for Reducing Stunting in Children Aged 6-23 Months in Rural Malawi.
J Nutr
; 150(11): 3024-3032, 2020 11 19.
Article
in En
| MEDLINE
| ID: mdl-32840613
ABSTRACT
BACKGROUND:
The prevalence of stunting in central rural Malawi is â¼50%, which prompted a multipronged nutrition program in 1 district from 2014 to 2016. The program distributed a daily, fortified, small-quantity lipid-based nutritional supplement, providing 110 kcal and 2.6 g of protein to children aged 6-23 mo, and behavior change messages around optimal infant and young child feeding (IYCF) and water, sanitation, and hygiene.OBJECTIVES:
Our objective was to perform an impact evaluation of the program using a neighboring district as comparison.METHODS:
Using a quasi-experimental study design, with cross-sectional baseline (January-March, 2014; n = 2404) and endline (January-March, 2017; n = 2453) surveys, we evaluated the program's impact using a neighboring district as comparison. Impact on stunting was estimated using propensity score weighted difference-in-differences regression analyses to account for baseline differences between districts.RESULTS:
No differences in mean length-for-age z-score or prevalence of stunting were found at endline. However, mean weight, weight-for-length z-score, and mid-upper arm circumference were higher at endline by 150 g, 0.22, and 0.19 cm, respectively, in the program compared with the comparison district (all P < 0.05). Weekly reports of high fever and malaria were also lower by 6.4 and 4.7 percentage points, respectively, in the program compared with the comparison district (both P < 0.05). There was no impact on anemia. Children's dietary diversity score improved by 0.17, and caregivers' infant and young child feeding and hand-washing practices improved by 8-11% in the program compared with the comparison district (all P < 0.05).CONCLUSIONS:
An impact evaluation of a comprehensive nutrition program in rural Malawi demonstrated benefit for child ponderal growth and health, improved maternal IYCF and hand-washing practices, but a reduction in stunting prevalence was not observed.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Rural Population
/
Infant Nutrition Disorders
/
Food Assistance
/
Government Programs
/
Growth Disorders
Type of study:
Evaluation_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
Africa
Language:
En
Journal:
J Nutr
Year:
2020
Type:
Article
Affiliation country:
United States