Stunting reduction in Peru

Maternal and reproductive care

Overall impact:  

  Medium

Impact: 

  Positive

Strength: 

  Medium

Care for pregnant women before and during birth and for mothers after birth have both a direct biological linkage to stunting reduction and are associated with improved ability for a mother to care for herself and her child.

Literature Review

Impact: 

  Positive

Strength: 

  Limited


Complete antenatal care, particularly during the first trimester of pregnancy, has been identified as having a protective effect against stunting, while lack of antenatal care has been associated with higher stunting rates.   However, data on quality of nutrition-specific interventions targeting pregnant women are limited.

Quantitative Analysis

Impact: 

  Positive

Strength: 

  Strong


Based on the linear mixed effects regression, skilled birth attendance significantly influenced stunting prevalence in the expected direction. This correlation was significant at the 1 percent level but the effect size was small, at 0.07 Cohen’s F2 (compared with PAN, which had an effect size of 1.64).

Antenatal care, however, was not found to be a significant influencer of stunting prevalence.

Driven primarily by the contribution of skilled birth attendance, maternal care under the decomposition analysis is the largest driver of predicted HAZ-score over the 2000-2016 period and was also significant over the 2008-2016 period.

Qualitative Analysis

Impact: 

  Positive

Strength: 

  Medium


Not mentioned specifically. However, maternal care was an important part of several key programs brought up and discussed in interviews (e.g., Juntos, PSMN).

Conclusion

A mother’s own care during pregnancy and delivery is unequivocally essential. The SBA and ANC4+ markers identified in this study extend beyond care for the mother-child pair during pregnancy and delivery (where she, for instance, receives the required knowledge, vaccines, supplements and appropriate hygienic care during these critical periods). SBA and ANC4+ are also markers of a mother’s broader health care knowledge and care-seeking behavior. As such, these prominent indicators could reflect healthier choices and disease prevention and treatment behaviors of the mother.