Nutrition Intervention Integrated With Food Voucher to Improve Child Growth and Feeding Practices

Primary Investigator

  • Gulshan Ara

Study Period

January 2018 - April 2019

Study Description


The period from birth to two years of age is the "critical window" for the promotion of optimal growth, health, and development. Insufficient quantities and inadequate quality of complementary foods, poor child-feeding practices and high rates of infections have a detrimental impact on growth. Approximately one-third of children less than 5 years of age in developing countries are stunted, and large proportions are also deficient in one or more micronutrients. An estimated 6% or 6 hundred thousand under-5 deaths can be prevented by ensuring optimal complementary feeding (CF) only.

Knowledge gap:

Even though the importance of CF is established, children < 2y are being fed complementary foods with poor nutrient quality, particularly in resource poor countries like Bangladesh.


Approximately 36% under 5 children are stunted in Bangladesh. Only 23% of children age 6-23 months is fed appropriately based on recommended infant and young child feeding (IYCF) practices. The routine diet of the population including children is mainly plant based and lacks adequate protein and other essential nutrients. Hygiene is also an issue as only 21% of rural households use soap and water during handwashing. An intervention package including CF counselling, WASH and micronutrient powder (MNP) could be potential option for optimizing complementary feeding practice in rural Bangladesh.

Hypothesis: An integrated intervention package will improve child growth in terms of length and complementary feeding practice in the selected intervention area from rural Bangladesh compared to control area.


  1. To improve nutritional status (length for age Z-score or LAZ) of the children (6-12 mo) through food voucher to promote improved recipe and intervention package with 12 months of intervention period.
  2. To improve young child feeding practices following counselling

Study Arms

  • Experimental: Intervention group will receive child feeding counselling, food voucher for recipe, WASH and home fortification
  • No Intervention: Control will receive usual health messages from government and NGO

Primary Outcomes

  • Length for age Z-score (LAZ) [ Time Frame: 12 months ] difference of 0.4 SD in LAZ between intervention and control group

Study Interventions

  • Water, sanitation, hygiene (WASH)
  • Cash transfer
  • Behavior change communication (BCC)
  • Micronutrient powders (MNP)

Research Gaps

  • Composition

    Which ingredients offer the best prevention or treatment for undernutrition?

  • Effectiveness

    How well do different food compositions and interventions prevent or treat undernutrition, when implemented "on the ground"?

  • Innovation

    What novel food-based products and programming methods effectively prevent and treat undernutrition?

Study Population