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

Authors

Sajid Bashir Soofi, Aga Khan UniversityFollow
Shabina Ariff, Aga Khan UniversityFollow
Gul Nawaz Khan, Aga Khan UniversityFollow
Atif Habib, Aga Khan UniversityFollow
Sumra Kureishy, World Food Programme, Islamabad, Pakistan
Yasir Ihtesham, World Food Programme, Islamabad, Pakistan
Masawar Hussain, Aga Khan UniversityFollow
Arjumand Rizvi, Aga Khan UniversityFollow
Muhammad Sajid, Aga Khan UniversityFollow
Zulfiqar Ahmed Bhutta, Aga Khan UniversityFollow

Document Type

Article

Department

Paediatrics and Child Health; Centre of Excellence in Women and Child Health

Abstract

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 = <0.001) was noted as compared to UCT arm.
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.

Comments

Volume, issue, and pagination are not provided by the author/publisher

Publication (Name of Journal)

The American Journal of Clinical Nutrition

Recommended Citation

Soofi, S., Ariff, S., Khan, G. N., Habib, A., Kureishy, S., Ihtesham, Y., Hussain, M., Rizvi, A., Sajid, M., Bhutta, Z. A. (2021). 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. The American Journal of Clinical Nutrition.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/1092

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.