Suchergebnisse

OBJECTIVES: A 5-arm cluster randomized controlled trial to examine the effectiveness of specialized nutritious foods (SNF), unconditional cash transfers (UCTs) delivered to the regular BISP beneficiaries and social and behavioral change communication (SBCC) to prevent stunting among children 6–23 months. METHODS: The 5 study arms were (1) control group, which received routine government health services; (2) Unconditioned Cash Transfer (UCTs); (3) UCTs and Specialized Behaviour Change Communication (SBCC); (4) UCTs and SNF; and (5) UCTs, SNF and SBCC. BISP beneficiary households with children 6–23 months were eligible to participate in the study. Children at 6 months of age were enrolled and followed on a monthly basis up to 24 months of age. A total of 2179 children were randomized into the 4 interventions and control arms to detect a 20% reduction in the prevalence of stunting at 24 months of age. RESULTS: At 24 months of age, children who received UCTs with SNF (stunting RR = 0.80, 95% CI: 0.67–0.94, P = 0.007) and UCTs with SBCC and SNF (stunting RR = 0.77, 95% CI: 0.66–0.90, P = 0.001) had a significant reduction in the risk of being stunted as compared to the control arm. Furthermore, when compared with the control arm at 24 months of age (49.3%, 95% CI: 44.77–54.28), a 15% reduction in the prevalence of stunting was found in both the UCTs with SNF arm (41.73%, 95% CI: 37.22–46.74, P = 0.007) and the UCTs with SBCC and SNF arm (41.83%, 95% CI: 37.21–46.93, P = 0.001). CONCLUSIONS: The study found a significant reduction in the prevalence of stunting, wasting, and underweight in children who received UCTs, SBCC and SNF between 6–23 months of age. FUNDING SOURCES: World Food Programme and the German Government's Economic Cooperation and Development Section.

OBJECTIVES: We evaluated the effectiveness of a locally produced lipid-based nutrient supplement - medium-quantity (LNS-MQ) known as Wawamum to prevent stunting in children 6–23 months of age in Thatta and Sujawal districts of Sindh province, Pakistan. METHODS: A cluster randomized controlled trial was conducted and a total of 870 children between 6–18 months old were enrolled. Children in the intervention group received 50 grams/day of Wawamum for 6 months, while children in the control group received standard government health services, not including Wawamum. The primary outcome was stunting risk reduction among children 6–23 months of age. RESULTS: Children who received Wawamum were found to have a significantly reduced risk of stunting (RR = 0.91, 95% CI; 0.88–0.94, P < 0.001) and wasting (RR = 0.78, 95% CI; 0.67–0.92, p-0.004) as compared to children who received the standard government health services. A non-significant impact was observed on underweight (RR = 0.94, 95% CI; 0.85–1.04, p-0.241) in the intervention group compared to the control group. Statistically significant reduction in anaemia in the intervention group was also found as compared to the control group (RR = 0.97, 95% CI; 0.94–0.99, p-0.008). The reduction in risk of severe anaemia was even more evident (RR = 0.45, 95% CI; 0.28–0.99, p-0.002) in the intervention group than in the control group. The mean compliance of Wawamum was 60.3% among children. CONCLUSIONS: The study confirmed the plausibility of achieving nutrition gains in the short-term with a locally produced LNS-MQ, known as Wawamum, through the primary health care system. The risk of stunting and wasting was reduced by 9% and 22%, respectively. The statistically significant reduction in risk of stunting, wasting and anaemia among children 6–23 months of age showed that an immediate improvement in these nutrition indicators is indeed possible. This approach can be scaled up in similar settings to achieve positive outcomes for nutrition and health. FUNDING SOURCES: World Health ...