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USAID's
Office of Food for Peace
Occasional Paper No. 4
The
Impact of Title II Maternal and Child Health and Nutrition Programs on the Nutritional
Status of Children
Over the past seven years, Title II Maternal and Child Health and Nutrition (MCHN) activities have evolved from predominantly facility-based food distribution programs targeted at undernourished children and their mothers, combined with some growth monitoring, to integrated community-based development programs with long-term health and sustainability objectives. The result of this shift has been a significant improvement in the nutritional status of children benefiting from these programs. This paper presents the results of a recent review of the impact of Title II MCHN programs on the prevalence of stunting and underweight in their target populations.
Information on the impact of the Title II MCHN program on child nutritional status was available for 29 programs. The review focused on Title II MCHN programs that ended in 2000 and 2001, for which final evaluation or annual results reports with data on anthropometry were available. Of the 35 Title II MCHN programs with end dates prior to 2002, evaluations with information on program impacts on child nutritional status were available for 25 (71 percent). In addition, final evaluation reports were available for four programs with end dates in 2002 (all in Ethiopia) and for a joint evaluation of all the Ethiopia programs. Approximately 6.6 million children benefited from the Title II MCHN programs that were reviewed.
The review of evaluations clearly shows that the Title II MCHN programs have been successful in improving the nutritional status (as measured by stunting and/or underweight) of children in their target populations. A large majority of the evaluations that reported on stunting (16 of 18) documented a reduction in the prevalence of stunting between the baseline and final evaluation – on average stunting was reduced by 2.4 percentage points per year, from an average prevalence of stunting at baseline of 53 percent. The median length of time between the baseline and final evaluation was four years. The 95 percent confidence interval is -3.6 to -1.3; this clearly supports the conclusion that the programs were associated with a reduction in stunting among the target population. However, the averages do mask considerable variability in the results. The standard deviation for all evaluations is 2.3.
The Title II MCHN programs were also associated with a reduction in the prevalence of underweight in the target population. On average, underweight was reduced by 1.9 percentage points per year, from an average prevalence of underweight at baseline of 42 percent. Again, the 95 percent confidence interval (from -2.8 to -0.9) clearly supports the conclusion of successful reductions in underweight.
