Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition
Location: Hall D
Poster Board Number: 330
Background: Chronic childhood malnutrition or stunting remains a persistent barrier to optimal child growth and social development. More than 48% of the children under-five years are stunted in Sindh province, Pakistan. We aimed to get in-depth evidence on the effectiveness of nutrient-based interventions to prevent stunting among children under-two years in community settings by the government primary health care system in Thatta and Sujawal districts in Pakistan.
Methods: A cluster randomized controlled trial was conducted and a total of 870 children between 6-18 months were enrolled. Children in 6 intervention clusters received a daily dose of 50 gram of lipid-based nutrient supplement (LNS), while children in 6 control clusters received routine health services. Primary outcome was risk reduction in stunting.
Results:After baseline adjustment a significant risk reduction in stunting (RR=0.91, 95% CI; 0.87-0.96, p-value=0.001) and wasting (RR=0.80, 95% CI; 0.65-0.99, p-value=0.047) was noted in intervention compared with control group. Initiation of breastfeeding within one hour (RR=0.91, 95% CI; 0.86-0.96, p-value=0.001), minimum meal frequency (RR=0.0.91, 95% CI; 0.86-0.96, p-value=0.001), diarrhoea (RR=0.0.91, 95% CI; 0.86-0.96, p-value=0.001), acute respiratory infection (RR=0.0.91, 95% CI; 0.86-0.97, p-value=0.002), availability of soap and water in households (RR=0.88, 95% CI; 0.83-0.94, p-value=<0.000 and improved toilet facility (RR=0.95, 95% CI; 0.90-0.99, p-value=0.045) were significantly associated with stunting. A significant impact on anaemia in intervention group was also noted as compared to the control group (RR=0.97, 95% CI; 0.94-0.99, p-value=0.006).
Conclusion: The study has confirmed the plausibility of achieving nutrition gains in the short term with a combination of LNS coupled with nutrition, health and hygiene messages delivered through the primary health care system of the government. The statistically significant risk reduction in stunting, wasting and anemia among children aged 6-23 months shows that an immediate improvement in nutrition indicators is indeed possible and can be scale up in similar settings.
Keywords: Lipid-based nutrient supplement, Stunting, Malnutrition, Wasting, Nutrition, Sindh, Pakistan
Gul Nawaz Khan
Aga Khan University, Karachi, Pakistan
Karachi, Sindh, Pakistan