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Health practitioner measuring child's foot
Photo Credit: Allan Gichigi, MCSP

For over a decade, evaluators and nutrition program implementers have used stunting (low height-for-age) to measure program achievements. The prevalence of stunting is an important population-level measure that provides insights into a population's overall living conditions and welfare, and can help track progress of a population over time. While stunting is a useful indicator for some nutrition activities, practitioners should carefully consider alternative indicators for comprehensively and meaningfully measuring the results of nutrition programs.

Building on recent literature, USAID Advancing Nutrition published a review paper, Stunting: Considerations for Use as an Indicator in Nutrition Projects, summarizing findings on the strengths and limitations of the prevalence of stunting as an indicator of programmatic impact. Stunting is complex and requires high levels of coverage and exposure, as well as long implementation periods. It is not an appropriate indicator for single-intervention activities or short-term programming.

USAID Advancing Nutrition also released a companion document, Beyond Stunting: Complementary Indicators for Monitoring and Evaluating USAID Nutrition Activities, which suggests approaches and indicators for comprehensively and meaningfully measuring the results of nutrition programs using indicators beyond stunting. By developing a logic model to help identify indicators that are more directly associated with interventions as described in the companion document, program implementers can ensure that they’re not misinterpreting the impact of program activities. The recommendations derived from this activity will help future USAID nutrition projects improve their monitoring and evaluation planning.

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From 2021-2023, USAID Advancing Nutrition supported the Government of Uganda in advancing the country’s food fortification program.