Effectiveness of Nutrition/Health Behavior Change Communication Training; Micronutrient Supplementation and Lipid-Nutrient Supplements to Improve Child Health in Western Kenya

Despite robust economic growth in the recent decades; 48% of Kenya’s children under five years are chronically malnourished; i.e. stunted (see KDHS; 2014; UNICEF). Levels of anemia are increasing with 70 percent of children fewer than five years being affected and Kenya has one of the highest under-5 mortality rates in Sub-Saharan Africa. Nearly half of these deaths (43%) account to mild and moderate malnutrition; another 11% are related to severe forms of malnutrition. Stunting in linear growth occurs mainly during the first 1000 days; from conception through 24 months of age. In recognition of this critical period; there have been few evaluations of the growth impact of interventions that cover most of this window. The objective of this study was to evaluate home fortification approaches for preventing maternal and child under nutrition within a community-based health program through Ministry of Health and One Acre Fund Partnership. The research hypothesizes that folic acid and small-quantity lipid-based nutrient supplements (LNS) provided to women during pregnancy and the first 6 months postpartum; LNS provided to their offspring from 6 to24 months of age; or both would result in greater child length-for-age z score (LAZ) at 24 months than iron and folic acid (IFA) provided to women during pregnancy and postpartum plus micronutrient powder (MNP) or no supplementation for their offspring from 6 to 24 months. We conducted a cluster-randomized effectiveness trial with 2 arms: 1) women and children both received LNS (LNS-IFAs group); 2) women received IFAs (IFA group).