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.