Impact of a Community-based Intervention Program on Nutritional Status of Children Aged Under 5 Years With Undernutrition in Western Rural Nepal

Objective

To identify the impact of community-based nutritional intervention among children with undernutrition in Nepal.

Design

Quasi-experimental time series.

Setting

Three villages in the rural Terai region with a majority marginalized ethnic population.

Participants

Seventy-five children with undernutrition between 6 and 59 months.

Interventions

Community-based package included super flour, milk, growth monitoring, nutrition education, and counseling conducted from September, 2016 to March, 2017.

Main Outcome

Change in nutritional status.

Analysis

We compared differences in pretest and posttest measurements using paired t test and repeated-measures analysis of various identified changes in z-scores. We applied random-effects panel data regression to evaluate the effect of intervention and exposure time.

Results

The mean z-scores of weight-for-age (underweight) and weight-for-height (wasting) continued to increase until 6 months of intervention, except for the height-for-age (stunting). On average, every month of the nutritional intervention led to an improvement in weight-for-age z-scores by 0.49 units (coefficient, 0.49 [95% coefficient intervals (CI), 0.47–0.50]), weight-for-height z-scores by 0.41 units (coefficient, 0.41 [95% CI, 0.38–0.44]) and height-for-age z-scores by 0.31 units (coefficient, 0.31 [95% CI, 0.29–0.33]) after adjusting the sociodemographic and health-related variables.

Conclusions and Implications

Community-based nutrition interventions that use local resources effectively reduce undernutrition. Similar interventions can be promoted in low-resource settings.