Community development and livestock promotion in rural Nepal: effects on child growth and health.

摘要

Background. More than 50% of children in Nepal are malnourished. Economic growth and poverty reduction are not always sufficient to improve the health and nutritional status of children. Heifer Nepal uses livestock training as a tool for community development and poverty alleviation but does not directly address child health and nutrition. Objective. To systematically assess the effects of Heifer activities on child health and nutrition. Methods. The study was a 2-year, longitudinal, randomized, controlled trial in six communities in Nepal (both Terai and hills), pair-matched for specific characteristics, randomly assigned to receive Heifer community development activities at baseline (intervention) or 1 year (control). At 6-month intervals over a period of 2 years, child anthropometric and comprehensive household surveys were performed. Results. Four hundred fifteen households were enrolled containing 607 children 6 months to 5 years of age. The intervention and control communities were equivalent for baseline socioeconomic status, household size, ownership of land and animals, and child nutrition and health. At 12 months (prior to animal donations), the Terai intervention group had improved child weight ( p=.04), improved child height ( p=.05), and reduced sick days ( p=.03), as well as increased household income ( p=.004), increased ownership of animals ( p=.04) and land ( p=.04), and improved sanitation practices ( p<.01). In all districts, longer participation in Heifer activities corresponded to more improvement in child height-for-age z-scores. Conclusions. Heifer interventions resulted in improved socioeconomic status and household income per family member. Children under 60 months of age in the intervention group had greater incremental improvement in height-for-age and weight-for-age z-scores than children in the control group, and longer participation in Heifer activities was associated with better growth. Poverty alleviation programs, such as Heifer, may indirectly benefit child growth.