Improving Nutritional Status Among Moderately Underweight Infants in Mumbai; Results of a Randomised Controlled Trial to Evaluate Swasth Kadam, an mhealth Intervention

This paper reports the results of a randomised controlled trial (CTRI/2023/01/048939) conducted to evaluate the outcomes of a telephonic counselling service for mothers of moderately underweight infants aged 6-24 months as defined by the WHO standards and residing in low-income settlements of the Mumbai metropolitan region (N=713). The primary outcome was accelerated weight gain and reduction in the decline to more severe levels of malnutrition. These were measured in terms of the change in the percentile category between baseline and endline using the standard WHO tables. Results indicate that the proportion of infants who showed no change or deterioration in the percentile category of weight was higher in the control group. Moreover, analysis of disaggregated data indicate that the gains of the intervention were more significant for more vulnerable infants such as those in the lowest percentile of weight at baseline (Chi square = 6.786; p = 0.034), born with low birth weight (Chi square = 8.402; p = 0.015), girls (Chi square = 6.590; p = 0.037), and infants whose fathers were in unskilled occupations (Chi square = 6.033; p = 0.049). Despite the limitations of sample size and being a single site study, these results point to the potential of an mhealth intervention to address the widespread problem of malnutrition among infants aged 0-2 years, particularly among vulnerable groups, which are unable to access actionable information and advice from other sources.