Background: Despite the continued high prevalence of faltering growth, height monitoring remains limited in many low- and middle-income countries.
Objective: The objective of this study was to test whether providing parents with information on their child’s height can improve children’s height and developmental outcomes.
Design: Villages in Chipata District, Zambia (n = 127), were randomly assigned with equal probability to 1 of 3 groups: home- based growth monitoring (HBGM), community-based growth monitoring including nutritional supplementation for children with stunted growth (CBGM+NS), and control. Primary study outcomes were individual height-for-age z score (HAZ) and overall child development assessed with the International Fetal and Newborn Growth Consortium for the 21st Century Neurodevelopment Assessment tool. Secondary outcomes were weight-for-age z score (WAZ), protein consumption, breastfeeding, and general dietary diversity.
Results: We enrolled a total of 547 children with a median age of 13 mo at baseline. Estimated mean difference (b) in HAZ was 0.127 (95% CI: 20.107, 0.361) for HBGM and 20.152 (95% CI: 20.341, 0.036) for CBGM+NS. HBGM had no impact on child development [b: 20.017 (95% CI: 20.133, 0.098)]; CBGM+NS reduced overall child development scores by 20.118 SD (95% CI: 20.230, 20.006 SD). Both interventions had larger positive ef- fects among children with stunted growth at baseline, with esti- mated interaction effects of 0.503 (95% CI: 0.160, 0.846) and 0.582 (95% CI: 0.134, 1.030) for CBGM+NS and HBGM, respec- tively. HBGM increased mean WAZ [b = 0.183 (95% CI: 0.037, 0.328)]. Both interventions improved parental reports of children’s protein intake.
Conclusions: The results from this trial suggest that growth monitoring has a limited effect on children’s height and development, despite improvements in self-reported feeding practices. HBGM had modest positive effects on children with stunted growth. Given its relatively low cost, this intervention may be a cost-effective tool for increasing parental efforts toward reducing children’s physical growth deficits.
IPA Zambia is pleased to share its second quarter bulletin of 2017. This bulletin features updates on our research projects on improving public services by improving staff allocation; trust, spontaneous clusters, and the growth of urban small- and medium-sized enterprises; and interpersonal communication to encourage use of the Maximum Diva Woman's Condom. This bulletin also highlights IPA Zambia's presentation of preliminary results from the Girls Negotiation study in early May.
IPA Zambia is pleased to share its first quarter bulletin of 2017. This bulletin highlights our research projects on the impact of teaching girls negotiation skills and the challenges of water provision, including policy dissemination events co-hosted with the International Growth Centre on results from these two studies. This bulletin also features our project on maternal mortality risk and the gender gap in desired fertility.
IPA Zambia is pleased to share with you its final bulletin of the year: "2016 in Review." This bulletin highlights ten of IPA Zambia's research projects, including updates from projects included in the previous bulletin as well as new contributions. We hope you enjoy this look at the high-quality evidence we've generated this past year, and we look forward to continuing this work with you in the year ahead.
Women who received private access to vouchers for contraceptives were more likely to take up and use contraception, compared to women whose husbands were involved in the voucher program. In contexts in which women have less bargaining power in family planning decisions, providing private access to contraceptives may be an important and effective means of enabling women to achieve their fertility goals.
State capacity to provide public services depends on the motivation of the agents recruited to deliver them. We design an experiment to quantify the effect of agent selection on service effectiveness. The experiment, embedded in a nationwide recruitment drive for a new government health position in Zambia, shows that agents attracted to a civil service career have more skills and ambition than those attracted to “doing good”. Data from a mobile platform, administrative records, and household surveys show that they deliver more services, change health practices, and produce better health outcomes in the communities they serve.