Comprehensive Intervention Improves Linear Growth and Weight Status in Children Under Five Years of Age in Surat City: Results from a Cluster Randomized Trial
OBJECTIVES: The objective of the present study was to evaluate the impact of a public private multi-stake holders comprehensive intervention on the linear growth, and weight status among children 0–59 mo. METHODS: A cluster randomized efficacy trial of a public private multi-stake holders comprehensive intervention package designed for Anganwadi centers (n = 20, 10 experimental (E) and 10 control (C) centers, including 679 children aged 0–5 y) of the Government run ICDS program was conducted in Western India in Surat city, Gujarat, (October, 2016 -January, 2018). The intervention package included additional 100 ml milk supplementation, health education, infrastructure development and upgradation of anganwadis including pediatrician's visits as compared to only routine government activities in the control anganwadis for a period of 1 year. Data on anthropometry, demographics, household characteristics, child morbidity, feeding practices and community facilities were collected and analyzed using WHO Anthro software and SPSS version 20. RESULTS: Of the 368 only 86.9% E and 311 (74.0%, C) participants completed the study after 1 year. Children in intervention arm had lower maternal education, and poorer anthropometry status at baseline but were similar in age and household incomes. In models adjusted for maternal education, conditional on random effects, the intervention improved HAZ by 0.85 (95% CI: 0.62, 1.08), WHZ by 0.53 (95% CI: 0.33, 0.74), and MUACZ by 0.30 (95% CI: 0.19, 0.42) at 14 mo. CONCLUSIONS: Comprehensive intervention packages for Anganwadis can potentially improve growth outcomes in Indian children 0–59 mo on successful implementation. FUNDING SOURCES: Rotary Club, District 3060 and Surat Municipal Corporation.