Effectiveness of Integrated Nutrition Interventions on Childhood Stunting: A Quasi-Experimental Evaluation Design

Résumé

Abstract Background: Although malnutrition particularly stunting is recognized as multi-causal, there has been limited integrated nutrition interventions to reduce its burden in children under-fives and those existing are not well evaluated. This study tested the effectiveness of provision of health and nutrition education and promotion of home gardening in child stunting.Methods: A quasi-experimental evaluation design with repeated cross-sectional surveys was used to assess changes in behaviors (uptake of Antenatal Care services and child feeding practices) and stunting among children under-five years. Household surveys were done at the baseline, and end-line in both controls (Tabora, Lindi and coast regions) and interventions (Simiyu and Ruvuma regions) sites. The sample size was calculated to detect a 10% percent absolute baseline-to-end-line change in stunting as a key indicator. A two-stage stratified sampling process was employed to select study participants. A total of 840 and 1,680 households was need at each round of data collection in the intervention and control districts respectively. Mothers delivered in the past 24 months preceding the survey and all children under-five years residing in selected households were eligible. The difference in difference (DID) analysis was used to estimate effect of the interventions. All ethical clearances were obtained from relevant authorities prior to data collection.Results: A total of 3,467 and 4,145 children under five years were recruited at baseline and endline respectively. The proportional of stunted children decreases from 35.9% to 34.2% in intervention and from 29.3% to 26.8 % in the control sites. Overall, no statistically significant stunting reduction was observed between intervention and control sites. However, a significant effect were observed in intermediate outcomes; Uptake of iron folic acid (DID: 5.2%, (95% CI: 1.7-8.7), p=0.003), health facility delivery (DID: 6.5%, (95% CI: 1.8-11.2), p=0.006), pre-lacteal feeding (DID: -5.9%, (95%CI: -9.2, -2.5), p=0.001), breast feeding within one hour after birth (DID: 7.8 %, (95%CI: 2.2-13.4), p=0.006) and exclusive breast feeding in children under six months (DID:20.3%, (95% CI: 10.5-30.1), p=0.001).Conclusion: The three years program did not result in significant evidence of stunting reduction, but the observed effect on health and nutrition behavioural indicators were substantial. These are intermediate indicators that are in the causal pathways to improved child nutritional outcomes in the long run. Implementation of these integrated packages over a longer duration is needed to witness significant reduction the prevalence of stunting.

Citer ce document

Accès au document

Ce document est hébergé sur son dépôt institutionnel d'origine.

Auteur(s)

Statistiques

Consultations : 1

Téléchargements : 0