Abstract
OBJECTIVES: The objectives of impact evaluation were to assess the prevalence and impact of nutrition-based supplementation on stunting in children under-five year of age. METHODS: Baseline and endline surveys on a sub-set of population in 2014 and 2017 were conducted in two districts of Sindh, Pakistan. Children 6–23 months received a daily ration of 50 g/day of lipid based nutrient supplement-medium quality (LNS-MQ). Children aged 24–59 months received a micronutrient powder sachet containing the RDA for 15 micronutrients every alternate day for at least 6 months. RESULTS: 2195 children at baseline and 2923 at endline were included in analysis. A significant reduction of 10% (45% at baseline; 40% at endline; P = 0.003) was observed in the stunting prevalence among children 6–59 months in intervention areas, but only a 2% reduction (52% at baseline; 51% at endline; P = 0.46) was noted in control areas. There was a significant reduction of 8% in the prevalence of underweight in intervention areas (35% at baseline; 32% at endline; P = 0.05) and a 2% reduction in control areas (45% at baseline; 43% at endline; P = 0.44). Reductions in the anemia prevalence in children 6–59 months was significant in intervention and control areas (P < 0.001). There was a significant decrease of 13% in anemia prevalence (88% at baseline; 75% at endline; P < 0.001) in intervention areas. An 11% reduction in the anemia prevalence was observed in children 6–59 months (87% at baseline; 77% at endline; P < 0.001) in control areas. CONCLUSIONS: The significant 10% reduction in the stunting prevalence shows the ability of nutrition-based supplementation in achieving nutrition gains in the short term in children 6–59 months through the primary healthcare system. This is an effective method to protect children from stunting caused by food insecurity and limited access to age-appropriate nutritious foods in Pakistan and similar settings. FUNDING SOURCES: World Food Programme, Pakistan.