Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs
Childhood malnutrition is still a public health concern in Malawi. Since 2013 the government of Malawi (GoM) has been implementing a large-scale multisectoral nutrition program, which expanded to all districts of the country with the World Bank Gro...
| Main Authors: | , , , , , , , , , |
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| Format: | Working Paper |
| Language: | English |
| Published: |
World Bank, Washington, DC
2019
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/297601565964816621/Determinants-of-Reductions-in-Childhood-Stunting-n-Malawis-Community-based-Nutrition-Programs http://hdl.handle.net/10986/32302 |
| Summary: | Childhood malnutrition is still a public
health concern in Malawi. Since 2013 the government of
Malawi (GoM) has been implementing a large-scale
multisectoral nutrition program, which expanded to all
districts of the country with the World Bank Group and other
donor funding. At the start of this program a national
baseline survey was conducted, and in early 2018, an endline
survey was conducted. The endline survey followed a
mixed-methods approach similar to the 2013 baseline survey,
using both quantitative and qualitative data collection
measurements. An Oaxaca-Blinder decomposition analysis was
used to determine the pathways that contributed most to the
program’s success. In addition, a panel dataset was
constructed to compare the nutritional outcomes of children
within the same household who were born before and after the
program intervention. The findings of the endline survey
confirm the positive trends observed in childhood
malnutrition in Malawi. Between 2013 and 2018, nutrition
indicators improved and the percentage of children under age
five who were stunted fell from forty-two percent in 2013 to
thirty-seven percent in 2018. Improvements were observed in
some underlying factors: the percentage of deliveries
attended by a skilled birth attendant and handwashing both
improved significantly between 2013 and 2018. The findings
from the decomposition analysis and cross-sectional and
panel data suggest that improvements in water, sanitation,
and hygiene (WASH), in particular, handwashing and antenatal
care (ANC) practices, were largely responsible for the
observed improvements in child nutrition. The findings of
the Community-Based Nutrition (CBN) Survey further suggest
that the country should consider investing in more
coordination and capacity at the district and community
levels and should address inequalities in program
performance across districts, delivering more
context-specific investments and program designs while
moving forward |
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