MNCH outcomes
SECONDARY
We also examined impacts on a set of secondary, more proximal outcomes through which the project was expected to affect stunting, including both MNCH‐ and sanitation‐related outcomes. Any impacts on these outcomes did not ultimately translate into impacts on stunting. Nevertheless, identifying specific targeted behaviours that the project was more and less successful in changing is useful to assess where the project logic might have broken down because many of these behaviours have broader value for family and community health beyond their impact on stunting.The project had a significant positive impact on mothers' self‐reported consumption of the recommended 90 IFA pills during pregnancy (8.7 pp; 95% CI: 4.1−13.3 pp) among mothers of 0–11‐month‐olds at endline, who would have been exposed to the improved formulation IFA tablets distributed through the project (Table Impacts on MNCH and sanitation‐related outcomes.
Abbreviations: EBF, exclusive breastfeeding; EIBF, early initiation of breastfeeding; IFA, iron and folic acid.Adjusted for district, whether the respondent completed junior secondary school, wealth quintile, mother's age when the sampled child was born, birth order of the sampled child, the sampled child's gender and the baseline outcome at the district level. The design effect of cluster random assignment was accounted for using Stata's cluster option.Measured using maternal and child health books when available or through self‐reports otherwise.There was no significant impact on the percentage of mothers of 0–23‐month‐olds who initiated breastfeeding within 1 hour of birth (3.6 pp; 95% CI: −2.0 to 9.2 pp). However, the project had a positive impact on exclusive breastfeeding; about 45% of 0–5‐month‐olds in the treatment group were exclusively breastfed at endline using the WHO and UNICEF definition (based on feeding in the previous day, World Health Organization WHO, The UNICEF and WHO minimum acceptable diet indicator for children 6−23 months combines standards of dietary diversity and feeding frequency. They recommend a diet that includes at least four of the seven food groups a day to ensure adequate growth (Arimond & Ruel, In terms of growth monitoring, the impact on the percentage of 0–5‐month‐olds who were weighed monthly was positive but only marginally significant (5.3 pp; 95% CI: −0.4 to 11.1 pp). There was no significant impact on the percentage of 0–11‐month‐olds who had their length measured at least once in the previous year (−3.2 pp; 95% CI: −8.9 to 2.5), but a large positive and significant impact on this outcome for 12–35‐month‐olds (10.8 pp; 95% CI: 5.5−16.1).