Specialized nutritious foods and behavior change communication interventions during the first 1000 d of life to prevent stunting: a quasi-experimental study in Afghanistan.

Autor:	Soofi SB; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan. Electronic address: sajid.soofi@aku.edu., Khan GN; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan., Sajid M; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan., Hussainyar MA; Aga Khan University Academic Projects, Kabul, Afghanistan., Shams S; World Food Programme, Kabul, Afghanistan., Shaikh M; World Food Programme, Kabul, Afghanistan., Ouma C; World Food Programme, Kabul, Afghanistan., Azami S; Aga Khan Health Services, Kabul, Afghanistan., Naeemi M; Aga Khan Foundation, Kabul, Afghanistan., Hussain A; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan., Umer M; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan., Hussain I; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan., Ahmed I; Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan., Ariff S; Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
Jazyk:	angličtina
Zdroj:	The American journal of clinical nutrition [Am J Clin Nutr] 2024 Sep; Vol. 120 (3), pp. 560-569. Date of Electronic Publication: 2024 Jul 14.
DOI:	10.1016/j.ajcnut.2024.07.007
Abstrakt:	Background: Considerable evidence supports the effectiveness of nutritional supplementation with or without nutrition education in preventing stunting in developing countries, but evidence from Afghanistan is scarce. Objectives: This project aimed to assess the effectiveness of specialized nutritious food (SNF), social and behavior change communication (SBCC) intervention to prevent stunting among children under 2 y during the first 1000 d of life in Badakhshan, Afghanistan. Methods: We used a community-based quasi-experimental pre-post study design with a control group. Pregnant and lactating women received a monthly ration of 7.5 kg of super cereal (250 g/d) during pregnancy and the first 6 mo of breastfeeding. Children aged 6-23 mo received 30 sachets of medium-quantity lipid-based nutrient supplement (50 g/sachet/d) monthly. We compared pre- and postintervention assessments of the intervention and control groups to isolate the effect of the intervention on key study outcomes at the endline by difference-in-differences (DID) estimates. Results: A total of 2928 and 3205 households were surveyed at baseline and endline. DID estimates adjusted for child, maternal, and household characteristics indicated a significant reduction in stunting (DID: -5% (95% confidence interval [CI]: -9.9, -0.2) and underweight (DID: -4.6% (95% CI: -8.6, -0.5) among children <2 y of age. However, DID estimates for wasting among children in the intervention and control groups were not significantly different (DID: -1.7 (95% CI: -5.1, 1.6). Furthermore, exposure to the SBCC messages was associated with improvements in the early initiation of breastfeeding (DID: 19.6% (95% CI: 15.6, 23.6), exclusive breastfeeding under 6 mo (DID: 11.0% (95% CI: 2.3, 19.7), minimum meal frequency (DID: 23% (95% CI: 17.7, 28.2), and minimum acceptable diet (DID: 13% (95% CI: 9.8, 16.3). Conclusions: The provision of SNF in combination with SBCC during the first 1000 d of life was associated with reduction in stunting and underweight and improvements in infant and young child feeding practices among children under 2 y of age. This trial was registered at clinicaltrials.gov as NCT04581993. (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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