Effectiveness of SNF and SBCC to Prevent Stunting Among Children in Afghanistan: a Quasi-experimental Study
Condition: Stunting; Malnutrition, Child
MeSH terms: Malnutrition; Child Nutrition Disorders; Growth Disorders
Study type: Interventional

Summary: 
      Over the years, there has been some progress made in reducing stunting in Afghanistan, the
      prevalence remains high with half of the provinces experiencing rates above the WHO alert
      threshold. As part of the Country Strategic Plan (CSP), the World Food Programme (WFP) plans
      to implement a stunting prevention programme in collaboration with Ministry of Public Health
      (MoPH) through its Public Nutrition Department (PND) in selected locations with stunting
      rates above 45%. The programme will emphasis on appropriate nutrition support in the '1000
      days' window of opportunity with special focus on proven effective nutrition interventions
      such appropriate breast feeding, complementary feeding, micronutrient supplementation,
      malnutrition treatment and prevention, WASH.
    

Detailed description: 
      Over the years, there has been some progress made in reducing stunting in Afghanistan, the
      prevalence remains high with half of the provinces experiencing rates above the WHO alert
      threshold. As part of the Country Strategic Plan (CSP), the World Food Programme (WFP) plans
      to implement a stunting prevention programme in collaboration with Ministry of Public Health
      (MoPH) through its Public Nutrition Department (PND) in selected locations with stunting
      rates above 45%. The programme will emphasis on appropriate nutrition support in the '1000
      days' window of opportunity with special focus on proven effective nutrition interventions
      such appropriate breast feeding, complementary feeding, micronutrient supplementation,
      malnutrition treatment and prevention, WASH. This will therefore take the form of an
      integrated approach ensuring the targeted beneficiaries are supported to access nutrition
      assistance as well as other complimentary interventions provided in-kind by study partners or
      promoted through social and behaviour change communication (SBCC). WFP will target pregnant
      and lactating women (PLW) and children aged 6-23 months but will also engage men and players
      that influence maternal infant and young child nutrition practices. Through this programme,
      children aged 6-23 months will receive lipid-based nutrient supplement - medium quantity
      (LNS-MQ) to complement their diets while PLW will receive Super Cereal - wheat soya blend
      with sugar.

      An operational research study was embedded in the stunting prevention programme by credible
      third-party to determine the extent to which the new actions will influence nutrition
      outcomes and practices. Introducing the provision of SNF, SBCC as well as formulation and
      adoption of local culturally acceptable recipes for complementary feeding from locally
      available nutritious food would be new additions to the current Community Based Nutrition
      Program (CBNP) package in the implementation phase. During the project implementation,
      emphasis will be placed will be placed on the adoption of the locally formulated
      complementary foods as well as application of knowledge and practices promoted through the
      SBCC activities as part of the exit strategy and ensuring a lasting impact of the project.

      Therefore, the Centre of Excellence in Women and Child Health, Aga Khan University, Pakistan
      proposes an operational research study with mix-methods including formative research,
      quasi-experimental design to evaluate the stunting prevention programme and process
      evaluations for stronger evidence base on the effectiveness of proposed interventions on
      prevention of stunting and developing viable programmes on nutrition under "real" operational
      conditions.
    

Intervention name(s): Super Cereal - wheat soya blend with sugar; Lipid-based nutrient supplement-medium quantity (LNS-MQ); Social and behavior change communication (SBCC)
Intervention type(s): Dietary Supplement; Dietary Supplement; Behavioral
Intervention description(s): Pregnant and lactating women will received Super Cereal during pregnancy and first six months of lactation.; Children will receive LNS during 6-23 months of age.; SBCC will be provided to improve care-givers knowledge, attitudes and practices related to infant and young child feeding.
Allocation: Non-Randomized
Intervention model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Stunting; Children; Specialized Nutritious Foods; Social and Behavior Change Communication; Afghanistan