High rates of malnutrition persist in Nepal: 37% of children (<5yrs) are stunted and 20% of mothers of children (<2yrs) are underweight. This study aims to assess the effect of a large-scale USAID funded integrated nutrition program (Suaahara) on health and nutrition knowledge and practices among Suaahara beneficiaries.
A cross-sectional survey of pregnant women and mothers of children <2yrs (n=478) in 4 intervention and 4 matched-comparison districts. Statistical analysis was done to examine differences between intervention and comparison areas.
IYCF knowledge was higher in Suaahara than comparison areas for: 1) early initiation of breastfeeding (91% vs. 73%; p<0.05); 2) extra meal during child illness (50% vs. 10%; p<0.01); and 3) exclusive breastfeeding (68% vs. 16%; p<0.001). Several IYCF practices were more prevalent in Suaahara areas: feeding colostrum (94% vs. 75%; p<0.01), exclusive breastfeeding (77% vs. 51%; p<0.05), minimum dietary diversity (78% vs. 52%; p<0.01), and giving more liquid during diarrhea (40% vs. 18%; p<0.01). Women in Suaahara areas were also more knowledgeable about: consuming 180 IFA tablets during pregnancy (89% vs 64%; p<0.05), 45 IFA tablets post-partum (85% vs. 50%; p<0.001) and eating more during pregnancy (96% vs 79%; p<0.001). They were also more likely to report eating more during pregnancy (76% vs. 32%; p<0.01) and consuming dairy (69% vs. 39%; p<0.01).
Differences observed between intervention and comparison populations were significant. These findings suggest that integrated programming can improve maternal and child health and nutrition-related practices and even for challenging practices, such as feeding during child illness.