Optimizing Community-Health-Worker Resources to Scale Promising Child Nutrition Programs in Rural Pakistan

There is evidence that growth posters installed inside the household can improve nutritional outcomes of children by increasing salience, changing the parents’ reference for healthy norms, and helping them better understand the returns to improved nutritional inputs. We intend to test the efficacy of home-based growth-monitoring (HBGM) whereby a growth-poster installed inside the home enables caregivers/parents – with front-loaded Lady Health Worker’s support – to measure their children’s height/weight and track their linear growth over time at home (as well as compare this development to the healthy norm as per the WHO 2007 growth standards). An intervention based on home-based growth monitoring has the advantage of being cost-effective and is therefore, scalable.

Our intervention design also attempts to address concerns around intra-household reallocation (for instance, from daughters to sons) in two ways. The poster will have visuals highlighting the benefits of good nutrition to both boys and girls. The counseling will emphasize that there is no difference in nutritional needs between the two genders. Moreover, a key objective of the counseling is to help the caregivers understand the returns to food of better quality (e.g., eggs vs packaged foods/snacks that may cost the same), which should benefit all children in the household irrespective of gender.