Tracking Weight-for-Age of Infants Using Home Based Newborn Care Plus by ASHA Workers
Harish Kumar1, Rajat Khanna2, Varun Alwadhi3
1VRIDDHI, IPE Global Ltd., New Delhi, India.
Insights
Home visits by community health workers significantly improved infant nutritional status. Malnutrition reduced from over 50% at 3 months to 11.1% by 12 months, showing catch-up growth is possible.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Malnutrition is a critical global health issue, disproportionately affecting children.
- Home visits during infancy offer an underexplored strategy to enhance nutritional status.
Purpose of the Study:
- To evaluate the nutritional status (weight-for-age) of infants aged 3-12 months.
- To assess the impact of home visits on infant malnutrition.
Main Methods:
- A cohort of infants across 13 districts in India were monitored.
- Weight-for-age data was collected by Accredited Social Health Activist (ASHA) workers.
- Nutritional status was categorized using WHO weight-for-age z-scores.
Main Results:
- At 3 months, 51.97% of infants were underweight (z-score ≤-2 SD), decreasing to 11.1% by 12 months.
- A statistically significant improvement in weight-for-age z-scores was observed (P<0.001).
- Severe and moderate malnutrition proportions declined by 15% and 26%, respectively.
Conclusions:
- Catch-up growth in weight-for-age is achievable for malnourished infants within their first year.
- Regular engagement with healthcare providers may drive these nutritional improvements.
Background:
Malnutrition in all its forms remains a serious global concern, particularly affecting children, a highly vulnerable population group. Home visits during the first year of life using the community worker platform is an unexplored opportunity for making improvements in nutritional status.
Objective:
To analyze the nutritional status (weight for age) of a cohort of infants between 3 and 12 months of age.
Design:
Tracking weight for age of infants by ASHA workers.
Settings:
13 districts in the states of Bihar, Madhya Pradesh, Odisha and Rajasthan.
Intervention:
Home visits under a home-based newborn care program, home-based newborn care plus (HBNC+).
Methods:
Norway India Partnership Initiative (NIPI) project supported implementation of HBNC+, in 13 districts across four states in India. A descriptive analysis of infants based on retrospective record based program data was done. The nutritional status (weight-for-age) of the cohort was analyzed. Categories were defined based on the z-scores of weight for age (≤-3 SD; ≤-2 SD and > -3 SD; and > -2 SD). Trend of malnutrition and proportions of children in each category at 3, 6, 9 and 12 months were assessed.
Results:
At 3 months of age, out of 3,50,986 infants provided home visits, 1,82,049 (51.97%) were underweight as per WHO definition with weight for age z-score ≤- 2 SD; this reduced to 11.1% at 12 months of age. Difference of means at 3 months and 12 months significantly different for weight for age z-score (P<0.001). There was a decline in the proportion of children in severe and moderate malnutrition categories by 15% and 26%, respectively.
Conclusions:
Catch-up growth in terms of weight-for-age among malnourished children is possible within one year of age. Frequent contacts with the health care functionaries may result in this improvement, though it is difficult to conclude in the absence of an appropriate control.
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