Suaahara Impact Evaluation: End-line Survey
Condition: Nutritional Stunting; Feeding Behavior
MeSH terms: Growth Disorders
Study type: Interventional
Phase: Phase 3

Summary: 
      Suaahara's primary aim is to reduce the prevalence of stunting, wasting, and underweight
      among children under 5 years of age and to reduce the prevalence of anemia among women of
      reproductive age and children 6-59 months of age. For this, the program uses a multi-sectoral
      approach to achieve four key intermediate results: 1) improved household nutrition,
      sanitation, and health behaviors; 2) increased use of quality nutrition and health services
      by women and children; 3) improved access to diverse and nutrient-rich foods by women and
      children; and 4) accelerated roll-out of the Multi-Sectoral Nutrition Plan (MSNP) through
      strengthened local governance
    

Detailed description: 
      The Government of Nepal and development partners have prioritized multi-sectoral (integrated)
      nutrition as a key development agenda. The Suaahara program funded by the United States
      Agency for International Development is one of the programs that support the Government of
      Nepal's multi-sectoral nutrition plan. It aims to reduce maternal and child under-nutrition
      over a period of ten years, spanning two phases: Suaahara I (2011-2016) and Suaahara II
      (2016-2021). Initially launched in 20 of 75 districts, the program has scaled-up to 42 of 77
      districts that span across Nepal's three agroecological zones of mountains, hills, and terai.

      Suaahara I was led by Save the Children International in partnership with Helen Keller
      International, Johns Hopkins University Center for Communications Programs, Jhpiego, Nepal
      Water for Health (NEWAH), the National Promotion and Consultancy Service, and the Nepali
      Technical Assistance Group (NTAG). Suaahara II was led by Helen Keller International in
      partnership with Cooperative for Assistance and Relief Everywhere, Inc., Family Health
      International 360), he Nepali Technical Assistance Group, Digital Broadcast Initiative Equal
      Access, Environmental and Public Health Organization, and Vijaya Development Resource Center.

      Suaahara's primary aim is to reduce the prevalence of stunting, wasting, and underweight
      among children under 5 years of age and to reduce the prevalence of anemia among women of
      reproductive age and children 6-59 months of age. For this, the program uses a multi-sectoral
      approach to achieve four key intermediate results (IRs): 1) improved household nutrition,
      sanitation, and health behaviors; 2) increased use of quality nutrition and health services
      by women and children; 3) improved access to diverse and nutrient-rich foods by women and
      children; and 4) accelerated roll-out of the MSNP through strengthened local governance.
      Suaahara interventions span health and family planning (FP), nutrition, agriculture/homestead
      food production (HFP), and water, sanitation and hygiene (WASH). Diverse social and behavior
      change communication interventions are used, primarily to generate demand for access to
      improved services and to motivate households to adopt optimal health, nutrition, and WASH
      practices. All Suaahara interventions are supported by a crosscutting theme of gender
      equality and social inclusion (GESI), in part by targeting women and disadvantaged groups and
      conducting activities that address GESI-related barriers to optimal health, nutrition, and
      WASH behaviors. Suaahara's conceptual framework illustrates the paths by which the program
      activities linked to desired outcomes achieve Suaahara II objectives.
    

Intervention name(s): Health and family planning; Nutrition; Agriculture and homestead food production; Water, sanitation, and hygiene
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): Promotion of health and family planning behaviors; Promotion of maternal, infant, and young child feeding behaviors and nutrition; Promotion of knowledge and practices about homestead food production; Promotion of behaviors to improve water, sanitation, and hygiene
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: Two-arm quasi-experimental design with baseline and end-line. The baseline and end-line were collected on different households but in the same clusters.
Masking: None (Open Label)
Primary purpose: Prevention