Adubra L. auteur aut IRD Le Port A. auteur aut IRD Kameli Yves auteur aut IRD Fortin Sonia auteur aut IRD Mahamadou T. auteur aut IRD Ruel M. T. auteur aut IRD Martin-Prével Yves auteur aut IRD Savy Mathilde auteur aut IRD text journalArticle eng text/pdf born digital access Background: In 2014, the World Food Programme added to an ongoing health and nutrition program named "Sante Nutritionnelle a Assise Communautaire dans la region de Kayes" (SNACK), the distribution of cash to mothers and/or lipid-based nutrient supplement (LNS) to children aged 6-23 mo, conditional upon attendance at community health centers (CHCs) during the first 1000 d of life. Objective: We evaluated the additional impact of the distribution of cash and/or LNS on mean height-for-age z scores (HAZ; primary outcome), stunting (HAZ < -2), and on intermediate outcomes along the program impact pathways. Methods: In a cluster-randomized controlled trial using a 2 x 2 factorial design, 76 CHCs were randomly assigned to deliver either SNACK, SNACK + Cash, SNACK + LNS, or SNACK + Cash + LNS. Cross-sectional surveys among 12- to 42-mo-old children and their mothers were conducted at baseline (2013, n = 5046) and at endline (2016, n = 5098). Results: Factorial analysis showed no interaction between cash and LNS treatments for HAZ, but found an antagonistic interaction for stunting (OR: 1.55; 95% CI: 1.05, 2.31; P = 0.03). There were no impacts of the cash, LNS, or cash + LNS treatments, compared with the SNACK alone, on either HAZ or stunting (treatment x time interaction). There were significant impacts of the LNS and cash + LNS treatments on attendance at =1 growth monitoring (GM) session (OR: 3.95; 95% CI: 1.69, 9.24; OR: 3.90; 95% CI: 1.73, 8.81, respectively) and half the expected sessions (OR: 4.72; 95% CI: 1.47, 15.17; OR: 5.25; 95% CI: 1.82, 15.11, respectively), mothers' knowledge on importance of GM (OR: 1.98; 95% CI: 1.16, 3.39; OR: 3.12; 95% CI: 1.60, 6.09, respectively), and, only for the LNS group, appropriate timing for complementary feeding (OR: 1.62; 95% CI: 1.09, 2.41). Conclusions: Implementation constraints and suboptimal participation in program activities may explain the lack of impact on child linear growth in this rural region of Mali. specialized conditional cash transfer lipid-based nutrient supplement community health center linear growth children Mali MALI 054 056 110 6 1476-1490 2019 0002-9165 https://www.documentation.ird.fr/hor/fdi:010077742 10.1093/ajcn/nqz238 0002-9165 [F B010077742] https://www.documentation.ird.fr/hor/fdi:010077742 https://www.documentation.ird.fr/intranet/publi/2020/01/010077742.pdf Accès réservé (Intranet de l'IRD) IRD - Base Horizon / Pleins textes 2020-02-05 2025-02-24 fdi:010077742 fre