Topical Area: Community and Public Health Nutrition
(P04-135-20) Effectiveness of Social Protection Program to Prevent Stunting Among Children 6-24 Months in Rural Pakistan; A Cluster Randomized Controlled Trial
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
Sajid B. Soofi
Associate Professor Aga Khan University Karachi, Sindh, Pakistan