{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T21:17:18Z","timestamp":1794431838217,"version":"4.9.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T00:00:00Z","timestamp":1701475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005185","name":"Millennium Challenge Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005185","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We evaluate the impacts of a $120 million project\u00a0in Indonesia conducted between 2014 and 2018 that sought to reduce stunting through a combination of (1) community\u2010driven development grants targeted at health and education outcomes, (2) training for health providers on infant and young child feeding and growth monitoring and (3) training for sanitarians on a local variation of community\u2010led total sanitation. This cluster randomized controlled trial involved 95 treatment and 95 control subdistricts across South Sumatra, West Kalimantan, and Central Kalimantan provinces. Overall, we find no significant impacts on stunting, the study's primary outcome measure (0.5\u2009pp; 95% confidence interval [CI]: \u22123.0 to 4.1 percentage points [pp]), or other longer\u2010term undernutrition outcomes about 1 year after the end of the project. The project had a modest impact on some secondary, more proximal outcomes related to maternal and child nutrition, including the percentage of mothers consuming the recommended number of iron\u2010folic acid pills during pregnancy (8.7\u2009pp; 95% CI: 4.1\u201313.3\u2009pp), 0\u20135\u2010month\u2010olds being exclusively breastfed (8.7\u2009pp; 95% CI: 1.8\u201315.6\u2009pp) and 6\u201323\u2010month\u2010olds receiving the number of recommended meals per day (8.5\u2009pp; 95% CI: 3.8\u201313.2\u2009pp). However, there were no significant impacts on other proximal outcomes like the number of pre\u2010natal and post\u2010natal checkups, child dietary diversity, child vitamin A receipt or the incidence of child diarrhoea. Our findings highlight that successfully implementing an integrated package of interventions to reduce child stunting may be challenging in practice. Project design needs to consider implementation reality along with best practice\u2014for example, by piloting the synchronous implementation of multifaceted interventions or phasing them in more gradually over a longer timeframe.<\/jats:p>","DOI":"10.1111\/mcn.13593","type":"journal-article","created":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T19:24:13Z","timestamp":1701545053000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A cluster randomized controlled trial of a community\u2010based initiative to reduce stunting in rural Indonesia"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3776-8737","authenticated-orcid":false,"given":"Amanda","family":"Beatty","sequence":"first","affiliation":[{"name":"Youth Impact  Garorone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Borkum","sequence":"additional","affiliation":[{"name":"Mathematica Inc Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Leith","sequence":"additional","affiliation":[{"name":"Mathematica Inc Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clair","family":"Null","sequence":"additional","affiliation":[{"name":"Mathematica Inc Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayan","family":"Suriastini","sequence":"additional","affiliation":[{"name":"SurveyMETER Yogyakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctvcm4j72"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/134.10.2579"},{"key":"e_1_2_10_4_1","unstructured":"Badan Pusat Statistik. (2013).Population size by province in Indonesia.https:\/\/jatim.bps.go.id\/indicator\/12\/114\/2\/jumlah-penduduk-menurut-provinsi-di-indonesia.html"},{"key":"e_1_2_10_5_1","volume-title":"MCC Indonesia nutrition project impact evaluation final report. Final report to the Millennium Challenge Corporation","author":"Beatty A.","year":"2020"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqaa153"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60996-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12282"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265040251S105"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyr102"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13524-019-00760-y"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-311050"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1201\/9781315152950"},{"key":"e_1_2_10_14_1","unstructured":"Kementerian Kesehatan. (2018).Laporan Nasional Riskesdas.https:\/\/dinkes.babelprov.go.id\/sites\/default\/files\/dokumen\/bank_data\/20181228%20-%20Laporan%20Riskesdas%202018%20Nasional-1.pdf"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/156482651103200105"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30005-6"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1257\/app.6.4.1"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30268-2"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1179\/2046905514Y.0000000158"},{"key":"e_1_2_10_20_1","volume-title":"National strategy to accelerate stunting reduction 2018\u20102024","author":"Republic of Indonesia","year":"2018"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073784"},{"key":"e_1_2_10_22_1","volume-title":"Improving child nutrition: The achievable imperative for global progress","author":"United Nations Children's Fund (UNICEF)","year":"2013"},{"key":"e_1_2_10_23_1","volume-title":"Levels and trends in child malnutrition: Key findings of the 2021 edition of the joint child malnutrition estimates","author":"United Nations Children's Fund (UNICEF)","year":"2021"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1519"},{"key":"e_1_2_10_25_1","volume-title":"Econometric analysis of cross section and panel data","author":"Wooldridge J. 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