Impact Evaluation of Benazir Nashonuma Program (BNP) on Stunting Among Under-five Children

NCT06025786 | Recruiting

• 1 other identifier: BNP Quasi Experimental Study
• Study Type: interventional
• Target: 13,200
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the study is to evaluate the impact of Benazir Nashonuma Program (BNP) on prevalence of stunting among under-five children in low income setting of Pakistan. The research question that the study aims to answer is: Is there any change in the prevalence of stunting among under-five children in districts where Benazir Nashonuma Program (BNP) is established compared to districts where BNP is not established? Districts where BNP is functional, and women and children are receiving the intervention will be compared at baseline and end line with control districts where conventional reproductive care services are given. Prevalence of stunting among under-five children will be compared along with other nutritional and growth status indicators over a period of 4 years.

Conditions

Stunting; Wasting; Anemia; Nutrient Deficiency

Keywords

Quasi experimental study; Maternal and child nutrition; Stunting; Wasting; Under-five malnutrition; Specialized Nutritious Food (SNF)

Outcome Measures

Primary Outcomes (1)

• Baseline to end-line change in the prevalence of stunting among children 0-59 months of age

  Height-for-age ≤-2 SD of the WHO Child growth standards median

  3 years (on study completion)

Secondary Outcomes (10)

• Baseline to end-line change in the prevalence of underweight women of reproductive age (15-49 years)

  3 years (on study completion)

• Baseline to end-line change in the prevalence of wasting among children 0-59 months of age

  3 years (on study completion)

• Baseline to end-line change in the prevalence of food insecurity status at household level

  3 years (on study completion)

• Baseline to end-line change in the number of antenatal care (ANC) visits during pregnancy

  3 years (on study completion)

• Baseline to end-line change in the prevalence of institutional deliveries

  3 years (on study completion)

Study Arms (2)

Districts with established and operational BNP implementation

EXPERIMENTAL

The intervention arm consists of nine districts from four provinces and two regions of Pakistan where the Benazir Nashonuma Program (BNP) is operational, providing reproductive and healthcare services to pregnant women and their children under the age of two.

Combination Product: Benazir Nashonuma Program (BNP)

Districts without BNP implementation and functionality

NO INTERVENTION

The control arm comprises of nine districts where Benazir Nashonuma Program (BNP) has not been implemented. These districts are comparable to their respective intervention districts in terms of average maternal BMI and prevalence of stunting.

Interventions

Benazir Nashonuma Program (BNP) COMBINATION_PRODUCT

Benazir Nashonuma Program (BNP) Dietary supplement for pregnant women and lactating mothers during the first six months of lactation: Maamta is a 75-gram sachet made from peanut butter with 400 kcal of energy Dietary supplement for children aged 6-23 months: Wawamum is a lipid-based nutrient supplement consisting of skimmed milk powder, micronutrients, vegetable oil, roasted chickpeas and antioxidants. Wawamum covers the recommended daily dose of most micronutrients and 255 kcal of energy. Conditional Cash Transfer (CCT): This includes stipends of PKR 2000 during pregnancy contingent on three antenatal care visits, consuming SNF, attending awareness sessions on health and nutrition, getting two doses of tetanus toxoid and institutional delivery. After delivery PKR 2000/- for boys and 2500/- for girls are paid as incentives conditioned on getting child's birth registered, routine immunization and consumption of SNF by the child from 6-23 months

Districts with established and operational BNP implementation

Eligibility Criteria

• Age: 1 Day - 59 Months
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may not qualify if:

• Mother of the child who is not a woman of reproductive age, i.e., less than 15 years or greater than 49 years

Sponsors & Collaborators

• Aga Khan University: lead
• International Food Policy Research Institute: collaborator
• Bill and Melinda Gates Foundation: collaborator

Study Sites (1)

Aga Khan University

Karachi, Sindh, 75290, Pakistan

RECRUITING

Related Publications (1)

• Muhammad S, Malik AA, Soofi S, Habib A, Umer M, Rizvi A, Ahmed I, Leroy J, Cousens S, Bhutta ZA. Impact assessment of Benazir Nashonuma Programme (BNP) on maternal, child health and nutritional status in Pakistan: a quasi-experimental study protocol. BMJ Open. 2025 Jun 27;15(6):e094565. doi: 10.1136/bmjopen-2024-094565.

  PMID: 40578861 DERIVED

MeSH Terms

Conditions

Growth Disorders; Cachexia; Anemia

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Weight Loss; Body Weight Changes; Body Weight; Signs and Symptoms; Thinness; Hematologic Diseases; Hemic and Lymphatic Diseases

Study Officials

• Zulfiqar A Bhutta, PhD, FRC

  Aga Khan University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Sajid Bashir Soofi, MD, CPSP

CONTACT

+923002769398; sajid.soofi@aku.edu

Shah Muhammad, MD

CONTACT

+923325590559; shah.muhammad@aku.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Distinguished University Professor and Founding Director of the Institute for Global Health and Development and the Centre of Excellence in Women and Child Health

Study Record Dates

• First Submitted: August 16, 2023
• First Posted: September 6, 2023
• Study Start: December 1, 2021
• Primary Completion: December 20, 2025
• Study Completion (Estimated): June 30, 2026
• Last Updated: September 11, 2023

Record last verified: 2023-07

Locations

PA (1)