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Randomized Controlled Trial
. 2022 Feb 9;115(2):492-502.
doi: 10.1093/ajcn/nqab341.

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

Sajid Bashir Soofi  1   2 , Shabina Ariff  1 , Gul Nawaz Khan  1 , Atif Habib  1 , Sumra Kureishy  3 , Yasir Ihtesham  3 , Masawar Hussain  2 , Arjumand Rizvi  2 , Muhammad Sajid  2 , Naveed Akbar  4 , Cecilia Garzon  3 , Saskia de Pee  5 , Zulfiqar A Bhutta  2
Affiliations
Randomized Controlled Trial

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

Sajid Bashir Soofi et al. Am J Clin Nutr. .

Abstract

Background: In Pakistan, the prevalence of stunting among children younger than 5 y has remained above WHO critical thresholds (≥30%) over the past 2 decades.

Objectives: 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 mo of age.

Methods: This was a 4-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 mo of age and measured monthly for 18 mo until the age of 24 mo.

Results: At 24 mo 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 a significantly lower risk of being stunted compared with 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 compared with the UCT arm. The pooled prevalence of stunting among children aged 6-23 mo 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 compared with the UCT arm.

Conclusions: UCT combined with LNS and UCT + LNS + SBCC were effective in reducing the prevalence of stunting among children aged 6-23 mo in marginalized populations. UCT + SBCC was not effective in reducing the child stunting prevalence. This trial was registered at clinicaltrials.gov as NCT03299218.

Keywords: children; lipid-based nutrient supplement; social and behavior change communication; stunting; unconditional cash transfer.

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Figures

FIGURE 1
FIGURE 1
Trial profile. LNS, lipid-based nutrient supplement; SBCC, social and behavior change communication; UCT, unconditional cash transfer.
See this image and copyright information in PMC

References

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