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Equity in the effect of small-quantity lipid-based nutrient supplements on child growth, development and anemia

Ante-Testard, P. A.; Arnold, C. D.; Wessells, K. R.; Adu-Afarwuah, S.; Ashorn, P.; Becquey, E.; Brown, K. H.; Christian, P.; Colford, J. M.; Fernald, L. C. H.; Galasso, E.; Hess, S. Y.; Humphrey, J. H.; Huybregts, L.; Iannotti, L. L.; Luby, S. P.; Maleta, K.; Null, C.; Prendergast, A. J.; Weber, A. M.; Ali, H.; Ali, S.; Ashorn, U.; Bendabenda, J.; Chasekwa, B.; Diop, L.; Dulience, S. J.-L.; Jannat, K.; Kumwenda, C.; Lartey, A.; Le Port, A.; Leroy, J. L.; Mangani, C.; Matias, S.; Mridha, M. K.; Ntozini, R.; Okronipa, H.; Ouedraogo, J.-B.; Phuka, J.; Rahman, M.; Ratsifandrihamanana, L.; Shaikh,

2025-06-06 nutrition
10.1101/2025.06.05.25329064 medRxiv
Show abstract

Undernutrition in early childhood causes stunted growth, cognitive delays, and anemia, with effects often magnified among children from the poorest households. Small-quantity lipid-based nutrient supplements (SQ-LNS) are effective in addressing undernutrition and improving child development. As momentum builds to scale up SQ-LNS for children aged 6-24 months in the Global South, a key concern is achieving equity in its distribution and outcomes. We performed equity analysis of individual participant data from 14 randomized controlled trials in nine countries (N=37,707 children) to assess SQ-LNS effects on child growth, development, and anemia across levels of an international wealth index. Benefits of SQ-LNS were consistent across the wealth spectrum, leading to similar improvements in child growth, development, and anemia regardless of wealth. However, such equal benefits of SQ-LNS did not erase large inequities in child growth and development between the poorest and wealthier households.

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