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BRIEF April 29, 2021

Pakistan: An RCT to assess effectiveness of the in-home Growth Monitoring Tool (GroMoTo) in addressing chronic childhood undernutrition in Pakistan

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In Pakistan, almost half of children under the age of five are stunted from chronic malnutrition.  Stunting can have a negative impact on children¡¯s cognitive development, health, and the years they spend in school, which together can reduce their chances for productive and healthy lives as adults. Nutrition counselling for parents through community health workers is a typical but not very effective way of addressing this. Using data collected by community health workers during their counselling visits, this evaluation will test different approaches for making counselling more effective, including growth charts that families can use to plot their child¡¯s growth against healthy norms and small cash transfers that families are told ¨C but not required ¨C to use for purchasing healthy food for children.

Study title:An RCT to assess effectiveness of the in-home Growth Monitoring Tool (GroMoTo) in addressing chronic childhood undernutrition in Pakistan.
Research question:Do in-home growth monitoring and cash payments decrease stunting? 
Policy problem:High levels of stunting among young children. 
Evaluation design:

Treatment 1 At each monthly visit, community health workers will prompt caregivers in these households to measure their child¡¯s height and plot it on a growth chart. The visiting community health worker will then discuss the results with reference to the healthy norm, in addition to providing information about best practices on infant and young child feeding and measuring children¡¯s height and weight.  

Treatment 2 In addition to the activities in Treatment 1, this group of households will also receive a fixed amount of cash, with suggestion on using it to buy nutritious food for their child. 

Control Community health workers will conduct monthly home visits to provide information to  caregivers about best practices on infant and young child feeding and measure the height and weight of their children. 

Data sources:Household survey as well as anthropometric data from community health workers¡¯ visits to households. 
Researchers:, ,