Abstract
{ "background": "Child undernutrition remains a critical public health challenge in sub-Saharan Africa. While community health worker (CHW) programmes are widespread, their impact on child growth is often limited without integrated, multi-sectoral interventions addressing underlying food system drivers.", "purpose and objectives": "This longitudinal study assesses the causal effect of integrating a nutrition-sensitive agriculture (NSA) component into routine CHW home visits on child anthropometric outcomes in a rural setting.", "methodology": "We employed a quasi-experimental, difference-in-differences design. Households with children under five were assigned to either an intervention group (CHW visits with NSA modules on dietary diversity and homestead food production) or a control group (standard CHW visits). Child height-for-age (HAZ) and weight-for-height (WHZ) z-scores were measured quarterly over a multi-year period. The primary analysis used a linear mixed-effects model: $Y{it} = \\beta0 + \\beta1 (Groupi \\times Timet) + \\beta2 X{it} + \\mui + \\epsilon{it}$, where $Y{it}$ is the anthropometric z-score for child $i$ at time $t$, with robust standard errors clustered at the village level.", "findings": "Children in the intervention group exhibited a statistically significant improvement in mean HAZ score (0.31, 95% CI: 0.12, 0.50) compared to controls by the study's end. The prevalence of stunting was reduced by 7.2 percentage points in the intervention arm, a relative decrease of 18%.", "conclusion": "The integration of NSA into existing CHW programmes significantly improved linear growth and reduced stunting among children in this rural context.", "recommendations": "National health and agriculture policies should mandate the integration of practical NSA education into CHW training and service delivery protocols. Programme funders should support the co-design of such integrated curricula and monitoring systems.",