Grant: Project Grant

Undernutrition accounts for at least half of all childhood deaths worldwide. Those who survive are at an increased risk for repeated infections, chronic diseases, poor physical and mental development, and poor economic prosperity later in life. Infants and children between 0-23 months of age are particularly vulnerable to the detrimental effects of undernutrition. This formative period therefore offers a window of opportunity for promoting healthy growth and improving child survival. Child undernutrition remains a devastating problem in Pakistan, with one in three children reported to be underweight, four in 10 too short for one's age, and almost one in five dangerously thin for one's height. Current research suggests that although low household wealth is an important constraint, infections, cultural norms, beliefs, and maternal knowledge are important factors contributing to undernutrition. This study will take place in the Rahim Yar Khan District of Punjab, Pakistan. Aligned with the current literature, the goals are to rehabilitate moderately malnourished children 7-9 months of age and enable mothers to sustain rehabilitation in their home by improving household feeding and childcare practices. The study team will engage the community to identify uncommon but successful behaviors practiced by local mothers of well-nourished children from economically disadvantaged homes, and transfer these to mothers with undernourished children who are equally disadvantaged in the wider study community. We will collect pre-intervention data to learn about the uncommon practices and design the intervention. Mothers and interested family will come together in a home-like setting to rehabilitate their malnourished child and learn new behaviors to sustain growth in their home. Home visits, print information and community events will reinforce key messages. Data will be collected during and post-intervention, and findings will be shared with the local and global community.