Stunting prevention in children 6-59 months of age Nutritional, Metabolic, Endocrine Stunting prevention
Conditions
Interventions
The allocation of participants into the four groups in the intervention and control clusters is non-randomized. Clusters (each ~150 households) with a Lady Health Worker (community health workers) are
Sponsors
Khyber Medical University
Eligibility
Sex/Gender
All
Age
6 Months to 49 Years
Inclusion criteria
Inclusion criteria: Group 1: 1. Pregnant women between the ages of 15-49 years will be recruited in the first group. 2. Pregnant women will be invited in their first trimester (preferably 1st two months of pregnancy). Group 2: 1. Lactating women will be recruited in this group. 2. Lactating women will be invited within the early days following delivery (preferably within 2 months of delivery). Group 3 & 4: 1. Children age 6-23 months and 24-59 months will form group 3 and 4 respectively 2. In group 3 children with ages between 6-18 months will be invited for the trial 3. Similarly for group 4 children with ages between 24-48 months will be invited 4. Preferably these children will be recruited from the households from which pregnant and lactating women were invited
Exclusion criteria
Exclusion criteria: Current exclusion criteria as of 30/12/2021: 1. Children with Severe Acute Malnutrition (SAM) or Moderate Acute Malnutrition (MAM) will be excluded and referred for treatment 2. Similar nutrition specific interventions currently being implemented in the selected cluster 3. Participants planning to move from the study area during the study timelines 4. Children with congenital malformations identified at the baseline or severe developmental impairment such as cerebral palsy and children for whom LNS is contraindicated (malabsorption/metabolic disorder) or who are unable to take LNS (e.g. cleft palate) will be excluded _____ Previous exclusion criteria: 1. Children with Severe Acute Malnutrition (SAM) or Moderate Acute Malnutrition (MAM) will be excluded and referred for treatment 2. Similar nutrition specific interventions currently being implemented in the selected cluster 3. Participants planning to move from the study area during the study timelines
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current primary outcome measures as of 30/12/2021: 1. Change in Length-for-Age Z scores (LAZ) is measured using the height boards (SECA) at each month in the intervention vs control arms, compared to the baseline LAZ score against WHO 2006 growth standards. (Timeframe: Baseline, thereafter monthly till the end of the study (3 years)) 2. Change in Weight-for-Age Z scores (WAZ) is measured using the digital weighing scales (SECA) at each month in intervention vs control arms, compared to the baseline WAZ score against WHO 2006 growth standards. (Timeframe: Baseline, thereafter monthly till the end of the study (3 years)) 3. Change in Weight-for-Height Z scores (WHZ) is measured using the digital weighing scales (SECA) and height boards (SECA) at each month in intervention vs control arms, compared to the baseline WHZ score against WHO 2006 growth standards. (Timeframe: Baseline, thereafter monthly till the end of the study (3 years) 4. Change in Early Childhood Development scores is measured using the Caregiver-Reported Early Development Instrument (CREDI) in the intervention vs control arms. (Timeframe: 12 months and 24 months after delivery) _____ Previous primary outcome measures: 1. Change in Length-for-Age Z scores (LAZ) is measured using the height boards (SECA) at each month in the intervention vs control arms, compared to the baseline LAZ score against WHO 2006 growth standards. (Timeframe: Baseline, thereafter monthly till the end of the study (3 years)) 2. Change in Weight-for-Age Z scores (WAZ) is measured using the digital weighing scales (SECA) at each month in intervention vs control arms, compared to the baseline WAZ score against WHO 2006 growth standards. (Timeframe: Baseline, thereafter monthly till the end of the study (3 years)) 3. Change in Weight-for-Height Z scores (WHZ) is measured using the digital weighing scales (SECA) and height boards (SECA) at each month in intervention vs control arms, compared to the baseline WHZ score against WHO 20 | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Infant and Young Child Feeding (IYCF) indicators is measured using a questionnaire (WHO guideline based) at baseline and at the end of the study in the intervention vs control arm. (Timeframe: Baseline and at the end of the study) 2. Birth weight of live newborns is measured using digital weighing scales (SECA) at 24 hours of birth in the intervention vs control arm. (Timeframe: Within 24 hours of delivery) 3. Nutritional intake (energy and protein) measured using 24-hour dietary recall method (FAO guideline based) at baseline and at the end of the study. (Timeframe: Baseline and at the end of the study) 4. Maternal weight gain during pregnancy is measured using digital weighing scales (SECA) at baseline, thereafter monthly till delivery in the intervention vs control arm. (Timeframe: Baseline, thereafter monthly till delivery) 5. Hemoglobin, albumin and micro nutrients like iron, zinc, iodine and vitamins are measured using blood samples at baseline, thereafter yearly till the end of the study (3rd year end) in a subsample in the intervention vs control arm. (Timeframe: Baseline, thereafter yearly till the end of the study (3rd year end)) | — |
Countries
Pakistan
Outcome results
None listed