Virtual Conference
Nutrition 2022

Ester Elisaria

Ifakara Health Institute, Tanzania

Title: Effectiveness of integrated nutrition interventions on childhood stunting: A Quasi-Experimental Evaluation Design

Abstract

Stunting is recognized as chronic undernutrition with multi-causal factors, nonetheless there has been limited integrated nutrition interventions to reduce its burden in children under-fives and those prevailing are not well evaluated. This study assessed the effectiveness of the provision of health and nutrition education and the promotion of home gardening in stunting reduction in Tanzania. A controlled quasi-experimental evaluation design was employed. Two rounds of household surveys were done to assess changes in behaviors (uptake of Antenatal Care services and child feeding practices) and stunting among children under-fives years. A two-stage stratified sample of 896 and 1736 households was selected 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-5 years residing in selected households were eligible. Ethical clearance was obtained from relevant authorities before data collection.  A total of 3467 and 4145 children under 5 years were recruited at baseline and end-line respectively. The difference in difference (DID) analysis was used to estimate the impact of the interventions. The proportion of stunted children decreased from 35.9 to 34.2% in the 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 was 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), breastfeeding within 1 h after birth (DID: 7.8%, (95%CI: 2.2–13.4), p?=?0.006) and exclusive breastfeeding in children under 6 months (DID:20.3%, (95% CI: 10.5–30.1), p?=?0.001). This three years program did not result in significant evidence of stunting reduction, but the observed effect on health and nutrition behavioural indicators are at 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 a significant reduction in the prevalence of stunting.

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