Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial

Publication date: January 2019Source: The Lancet Global Health, Volume 7, Issue 1Author(s): Jean H Humphrey, Mduduzi N N Mbuya, Robert Ntozini, Lawrence H Moulton, Rebecca J Stoltzfus, Naume V Tavengwa, Kuda Mutasa, Florence Majo, Batsirai Mutasa, Goldberg Mangwadu, Cynthia M Chasokela, Ancikaria Chigumira, Bernard Chasekwa, Laura E Smith, James M Tielsch, Andrew D Jones, Amee R Manges, John A Maluccio, Andrew J Prendergast, Jean H HumphreySummaryBackgroundChild stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe.MethodsWe did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Ministry of Health and Child Care. Women were eligible for inclusion if they permanently lived in clusters and were confirmed pregnant. Clusters were randomly assigned (1:1:1:1) to standard of care (52 clusters), IYCF (20 g of a small-quantity lipid-based nutrient supplement per day from age 6 to 18 months plus complementary feeding counselling; 53 clusters), WASH (construction of a ventilated improved pit latrine, provision of two handwashing stations, liquid soap, chlorine, and play space plus hygiene counselling; 53 clusters), or IYCF plus WASH (53...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research