Suaahara in Nepal: An at-scale, multi-sectoral nutrition program influences knowledge and practices while enhancing...

Area of Science:

• Public Health
• Nutrition Science
• Health Equity

Background:

• South Asia faces a significant burden of undernutrition, necessitating interventions addressing both health and non-health determinants.
• Integrated nutrition programs aim to reduce undernutrition in women and children during the critical 1,000-day period while tackling health inequities.

Purpose of the Study:

• To evaluate the impact of Nepal's Suaahara integrated nutrition program on exposure to inputs, knowledge, and practices related to maternal and child health, nutrition, and WASH.
• To assess the program's effect on reducing disparities between disadvantaged (DAG) and non-disadvantaged households in these indicators.

Main Methods:

• Household-level process evaluation data from 480 participants were analyzed.
• Regression models were adjusted for child-, maternal-, and household-level confounders and clustering.
• Exposure, knowledge, and practice indicators for health, nutrition, and WASH were assessed.

Main Results:

• Suaahara program areas showed higher prevalence of exposure, knowledge, and some practice indicators compared to non-program areas.
• Disadvantaged households in Suaahara areas demonstrated better exposure, knowledge, and practices than disadvantaged households in non-Suaahara areas and sometimes non-disadvantaged households.
• The program significantly reduced disparities between disadvantaged and non-disadvantaged households in several key indicators.

Conclusions:

• Large-scale integrated nutrition interventions can effectively enhance nutrition-related knowledge and practices.
• These programs have the potential to simultaneously reduce inequities in health and nutrition outcomes among vulnerable populations.