Researchers, in partnership with the Zambian Ministry of Health and IPA, evaluated the impact of growth charts and Small Quantity Lipid-Based Nutrient Supplements (SQ-LNS) on child growth. SQ-LNS significantly improved growth and development, while growth charts offered some benefits but were less effective. Combining both resulted in a reduction in anemia and being underweight, but it did not have the same impact as using SQ-LNS alone.

Stunting, or being too short for one’s age, is a warning signal that a child is at risk of failing to reach their full physical and developmental potential. In Zambia, stunting impacts 35 percent of children under five, which is higher than Africa’s 31 percent average.¹ Growth charts may help visualize the link between stunting and children’s well-being and enable caregivers to improve health outcomes at home. SQ-LNS—ready-to-eat food supplements—can address nutritional gaps in children’s diets that contribute to stunted growth, with evidence from other low- and middle-income countries showing transformative impacts on children’s growth and development.² 

Researchers partnered with IPA and the Zambian Health Ministry to evaluate the impacts of growth chart posters and SQ-LNS on child growth, nutrition, and development outcomes. A total of 2,291 caregivers and their infant children across Choma, Mansa, and Lusaka districts were randomly divided into the following groups: 

1. Growth charts for home use
2. Monthly supply of SQ-LNS
3. Growth charts and the monthly supply of SQ-LNS
4. Comparison group.

The distribution of SQ-LNS led to notable improvements in the growth, health and development of children under five years old. SQ-LNS reduced stunting by 37 percent and anemia by 26 percent, and enhanced cognitive, motor, language, and social-emotional skills as indicated by a 0.28 standard deviation increase in the Global Scales for Early Development (GSED) scores. While growth charts showed some health improvements, they were not as effective as SQ-LNS in promoting growth and development. The combined use of growth charts and SQ-LNS decreased anemia and underweight but did not match the benefits of SQ-LNS alone on child growth and development outcomes.

Sources

^1. United Nations Children’s Fund (UNICEF), World Health Organization (WHO), International Bank for Reconstruction and Development/The World Bank. Levels and trends in child malnutrition: UNICEF / WHO / World Bank Group Joint Child Malnutrition Estimates: Key findings of the 2023 edition. New York: UNICEF and WHO; 2023. CC BY-NC-SA 3.0 IGO.

^2. Dewey, Kathryn G., K. Ryan Wessells, Charles D. Arnold, Elizabeth L. Prado, Souheila Abbeddou, Seth Adu-Afarwuah, Hasmot Ali et al. "Characteristics that modify the effect of small-quantity lipid-based nutrient supplementation on child growth: an individual participant data meta-analysis of randomized controlled trials." The American journal of clinical nutrition 114 (2021): 15S-42S.

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