Effectiveness of unconditional cash transfers combined with lipid-based nutrient supplement and/or behavior change communication to prevent stunting among children in Pakistan: a cluster randomized controlled trial
| Autor: | Yasir Ihtesham, Sajid Bashir Soofi, Masawar Hussain, Atif Habib, Gul Nawaz Khan, Cecilia Garzon, Shabina Ariff, Saskia de Pee, Arjumand Rizvi, Muhammad Sajid, Zulfiqar A Bhutta, Naveed Akbar, Sumra Kureishy |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Adult
Male Behavior change communication Medicine (miscellaneous) Rate ratio Disease cluster Lower risk law.invention Randomized controlled trial Behavior Therapy law Prevalence Cluster Analysis Humans Medicine Pakistan Trial registration Growth Disorders Nutrition and Dietetics business.industry Significant difference Infant Feeding Behavior Lipids Dietary Supplements Female Marginalized populations Food Assistance business Demography |
| Zdroj: | The American Journal of Clinical Nutrition. 115:492-502 |
| ISSN: | 0002-9165 |
| DOI: | 10.1093/ajcn/nqab341 |
| Popis: | Background In Pakistan, the prevalence of stunting among children under-five years has remained above WHO critical thresholds (≥30%) over the last two decades. Objective We hypothesized that an unconditional cash transfer (UCT) combined with lipid-based nutrient supplement (LNS) and/or social and behavior change communication (SBCC) will prevent stunting among children 6-23 months of age. Design This was a four-arm, community-based cluster randomized controlled trial conducted in the district of Rahim Yar Khan, Pakistan. A total of 1729 children (UCT n = 434); (UCT+SBCC n = 433); (UCT+LNS n = 430) and (UCT+LNS+SBCC n = 432) were enrolled at 6 months of age and measured monthly for 18 months until the age of 24 months. Results At 24 months of age, children who received UCT+LNS (rate ratio [RR], 0.85 [95% CI 0.74, 0.97]; P = 0.015); and UCT+LNS+SBCC (RR, 0.86 [95% CI 0.77, 0.96]; P = 0.007) had significantly lower risk of being stunted as compared to the UCT arm. No significant difference was noted among children who received UCT+SBCC (RR, 1.03 [95% CI 0.91, 1.16]; P = 0.675) in the risk of being stunted as compared to the UCT arm. The pooled prevalence of stunting among children 6-23 months was 41.7%, 44.8%, 38.5% and 39.3% in UCT, UCT+SBCC, UCT+LNS and UCT+LNS+SBCC, respectively. In pairwise comparisons, a significant impact on stunting among children in UCT+LNS (P = 0.029) and UCT+LNS+SBCC (P = Conclusions UCT combined with LNS and UCT+LNS+SBCC were effective in reducing the prevalence of stunting among children aged 6-23 months in marginalized populations. UCT+SBCC was not effective in reducing the child stunting prevalence.Clinical trial registration number: ClinicalTrials.gov NCT03299218. |
| Databáze: | OpenAIRE |
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