(P02-061-25) Accelerating Childhood Undernutrition Reduction in a Lower-Middle-Income Country: Evidence From a ‘Best-in-Class’ Public-Private Partnership, Madhya Pradesh, India

Objectives: Undernutrition remains a critical issue in India, with 1 in 3 children under 5 stunted and underweight (NFHS-5, 2019-20). The COVID-19 pandemic worsened this crisis, especially in vulnerable communities. Integrated approaches addressing child health factors are crucial for rapid, sustainable improvement. This public-private partnership program aimed to reduce undernutrition among children under 5 in a high-priority region of Madhya Pradesh, India.

Methods: The program was implemented over 18 months in collaboration with the Government, targeting approximately 10,000 children aged 0–6 years. It combined nutritional supplementation with caregiver and community interventions to address child growth and development. Key differentiators included: a) introduction of, for the first time ever, age-appropriate, nutritious hot cooked meals for children 6 months–3 years; b) home-based communication with caregivers on IYCF practices; and c) comprehensive community engagement to sustain child feeding practices and drive action. Frontline workers were trained to enhance nutrition counselling and growth monitoring for effective service delivery. Focused home visits supported caregivers of moderately malnourished children, with follow-ups for SAM children post-discharge from nutrition rehabilitation centres. Community initiatives included setting up women self-help group-managed community kitchens and recipe demonstrations to promote favourable feeding practices. A robust real-time monitoring mechanism was developed, with the rich data used to create an AI tool to predict undernutrition. External evaluations were conducted at baseline and endline.

Results: Difference-in-Difference analysis showed a 10% decline (signifying a 21.1% reduction) in prevalence of stunting and an 8.4 % decline (signifying a 27.2% reduction) in underweight prevalence, among children under 5 years (p < 0.01). The findings also indicated enhanced caregiver knowledge and systemic-level improvements in the intervention area.

Conclusions: Innovative approaches providing supplementary nutrition at an early age, engaging caregivers to influence feeding practices, and fostering community involvement demonstrate potential to accelerate reduction in childhood undernutrition in lower-middle-income country (LMICs).

Funding Sources: American India Foundation