{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:51:51Z","timestamp":1792054311432,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004448","name":"Aga Khan Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004448","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      The Central Asia Stunting Initiative (CASI) is a program designed to address malnutrition among women of reproductive age and children under five in Badakhshan Province, Afghanistan, a region facing significant nutritional challenges. This study used a pre\u2010post design to assess the impact of CASI interventions, with cross\u2010sectional surveys conducted at baseline and midline among non\u2010pregnant women of reproductive age (15\u201349 years) and children under five using a two\u2010stage stratified random sampling approach; data collection included anthropometric measurements and hemoglobin assessments. Between the baseline and midline surveys, access to safe drinking water improved from 80.9% to 90.7%, and sanitation improved from 37.4% to 88.3%, while the severe food insecurity rate dropped from 94.7% to 30.5% (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Exclusive breastfeeding among children aged 0\u20135 months increased from 64.0% to 80.9%, and dietary diversity among children 6\u201324 months rose from 7.5% to 20.7% (both\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Child under nutrition declined significantly, with underweight decreasing from 35.0% to 15.5% (Cohen's h = 0.46) and stunting from 52.3% to 37.3% (Cohen's h = 0.30). The prevalence of moderate anemia among children fell from 59.7% to 41.1%, while normal hemoglobin levels rose from 39.2% to 58.1% (both\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Among women, underweight prevalence declined from 20.0% to 9.4% (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), while overweight prevalence rose from 5.4% to 10.7% (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003). Adjusted models confirmed lower odds of stunting, underweight, and anemia at midline compared with baseline. These findings suggest that CASI was associated with substantial improvements in maternal and child nutrition indicators in Badakhshan, and policymakers should focus on scaling up effective interventions and ensuring continuous monitoring. However, given the single\u2010group pre\u2010post design without a comparison group, these findings should be interpreted as temporal associations rather than causal effects.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/mcn.70241","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:41:57Z","timestamp":1792053717000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Central Asia Stunting Initiative on Stunting and Anemia Among Children and Women of Afghanistan"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-3113","authenticated-orcid":false,"given":"Imran A.","family":"Chauhadry","sequence":"first","affiliation":[{"name":"Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminah","family":"Jahangir","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Umer","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khakerah","family":"Rashidi","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habibullah","family":"Haziq","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafi","family":"Sadeed","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humayun","family":"Helal","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Atif","family":"Habib","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0079-3330","authenticated-orcid":false,"given":"Imtiaz","family":"Hussain","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9627-2662","authenticated-orcid":false,"given":"Shabina","family":"Ariff","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatyana","family":"Elkour","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-8406","authenticated-orcid":false,"given":"Sajid B.","family":"Soofi","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Hudspeth","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-599X","authenticated-orcid":false,"given":"Zulfiqar A.","family":"Bhuuta","sequence":"additional","affiliation":[{"name":"Institute for Global Health and Development Aga Khan University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60996-4"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60937-X"},{"key":"e_1_2_10_4_1","volume-title":"Study Design for Evaluating Population Health and Health Service Interventions: A Guide","author":"Centre for Epidemiology and Evidence","year":"2023"},{"key":"e_1_2_10_5_1","volume-title":"Sampling Techniques","author":"Cochran W. G.","year":"1963"},{"issue":"1","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.1080\/16549716.2017.1340396","article-title":"First 1000 Days' Health Interventions in Low\u2010and Middle\u2010Income Countries: Alignment of South African Policies With High\u2010Quality Evidence","volume":"10","author":"English R.","year":"2017","journal-title":"Global Health Action"},{"key":"e_1_2_10_7_1","unstructured":"Food and Agriculture Organization (FAO).2020. \u201cThe State of Food Security and Nutrition in Afghanistan.\u201d [Internet]. [cited 2025 January 28].https:\/\/www.fao.org."},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.nut.2021.111565","article-title":"Determinants of Malnutrition Among Children: A Systematic Review","volume":"96","author":"Katoch O. 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V.","year":"2015","journal-title":"Paediatrics and Child Health"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1186\/1471-2458-14-1077","article-title":"Effectiveness of a Nutrition Education Package in Improving Feeding Practices, Dietary Adequacy and Growth of Infants and Young Children in Rural Tanzania: Rationale, Design and Methods of a Cluster Randomised Trial","volume":"14","author":"Kulwa K. B.","year":"2014","journal-title":"BMC Public Health"},{"issue":"1","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.orcp.2014.03.001","article-title":"Shifting of Undernutrition to Overnutrition and Its Determinants Among Women of Reproductive Ages in the 36 Low to Medium Income Countries","volume":"9","author":"Mamun A. 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[cited January 28 2025].https:\/\/www.unicef.org."},{"key":"e_1_2_10_22_1","unstructured":"UNICEF. 2023. \u201cPakistan's Nutrition Strategy and Progress Report.\u201d [Internet]. [cited January 28 2025].https:\/\/www.unicef.org."},{"key":"e_1_2_10_23_1","volume-title":"Afghanistan Multiple Indicator Cluster Survey 2022\u201323, Survey Findings Report","author":"United Nations Children's Fund (UNICEF)","year":"2023"},{"key":"e_1_2_10_24_1","volume-title":"Undernourished and Overlooked: A Global Nutrition Crisis in Adolescent Girls and Women. 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World Health Organization.\u201d [cited 2025 January 28].https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/malnutrition."}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70241","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.70241","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.70241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:42:02Z","timestamp":1792053722000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.70241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":29,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/mcn.70241"],"URL":"https:\/\/doi.org\/10.1111\/mcn.70241","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2025-10-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70241"}}