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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Multisector intervention to accelerate reductions in child stunting: An observational study from 9 sub-Saharan African countries
American Journal of Clinical Nutrition, Volume 94, No. 6, Year 2011
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Description
Background: In sub-Saharan Africa, ̃40% of children <5 y old are stunted, with levels that have remained largely unchanged over the past 2 decades. Although the complex determinants of undernutrition are well recognized, few studies have evaluated strategies that combine nutrition-specific, health-based approaches with food system- and livelihood-based interventions. Objective: We examined changes in childhood stunting and its determinants after 3 y of exposure to an integrated, multisector intervention and compared these changes with national trends. Design: A prospective observational trial was conducted across rural sites in 9 sub-Saharan African countries with baseline levels of childhood stunting >20%. A stratified random sample of households and resident children <2 y old from villages exposed to the program were enrolled in the study. Main outcome measures included principal determinants of undernutrition and childhood stunting, which was defined as a height-for-age z score less than -2. National trends in stunting were generated from demographic and health surveys. Results: Three years after the start of the program in 2005-2006, consistent improvements were observed in household food security and diet diversity, whereas coverage with child care and diseasecontrol interventions improved for most outcomes. The prevalence of stunting in children <2 y old at year 3 of the program (2008-2009) was 43% lower (adjusted OR: 0.57; 95% CI: 0.38, 0.83) than at baseline. The average national stunting prevalence for the countries included in the study had remained largely unchanged over the past 2 decades. Conclusion: These findings provide encouraging evidence that a package of multisector interventions has the potential to produce reductions in childhood stunting. © 2011 American Society for Nutrition.
Authors & Co-Authors
Remans, Roseline
United States, New York
Columbia University
Pronyk, Paul Michael
United States, New York
Columbia University
Fanzo, Jessica C.
Italy, Rome
Bioversity International
Chen, Jiehua
United States, New York
Columbia University
Palm, Cheryl A.
United States, New York
Columbia University
Nemser, Bennett
United States, New York
Columbia University
Muniz, Maria
United States, New York
Columbia University
Radunsky, Alex
United States, New York
Columbia University
Abay, Alem Hadera
Ethiopia, Addis Ababa
Center for National Health Development
Coulibaly, Mouctar
Mali, Bamako
Millennium Development Goal Mdg Centre for West and Central Africa
Mensah-Homiah, Joseph
Unknown Affiliation
Wagah, Margaret
Kenya, Nairobi
Mdg Centre for East and Southern Africa
An, Xiaoyi
United States, New York
Columbia University
Mwaura, Christine
United States, New York
Columbia University
Quintana, Eva
United States, New York
Columbia University
Somers, Marie Andrée
United States, New York
Columbia University
Sánchez, Pedro Antônio
United States, New York
Columbia University
Sachs, Sonia Ehrlich
United States, New York
Columbia University
McArthur, John W.
United States, New York
Columbia University
United States, New York
Millennium Promise Alliance, Inc.
Sachs, Jeffrey David
United States, New York
Columbia University
Statistics
Citations: 90
Authors: 20
Affiliations: 6
Identifiers
Doi:
10.3945/ajcn.111.020099
ISSN:
00029165
e-ISSN:
19383207
Research Areas
Food Security
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study