Evaluation of Zambia’s First 1,000 Most Critical Days Program: Final Report

Andrew Brudevold-Newman
Paula Dias
Terry Roopnaraine
Gelson Tembo
The First 1,000 Most Critical Days Program bundled a series of health interventions that have been proven to reduce stunting, including vitamin supplements, breastfeeding support, sanitation, education, and more.

In Zambia, the rate of stunting—a common measure of malnutrition—is 40%. The First 1,000 Most Critical Days Program was designed to offer mothers and babies in Zambia a suite of interventions to improve their health and development. AIR was hired to evaluate the efficacy of this program and whether it was ready to scale up to additional communities.

AIR’s evaluation revealed the challenges inherent in delivering a bundled nutrition program. Rolling out and delivering these services concurrently presented significant logistical hurdles. Because the interventions are so disparate—ranging from deworming, to family planning, to growth monitoring—the providers of these services spanned numerous government ministries and funding organizations, many of which operate on different calendars. Not only did these numerous stakeholders struggle at times to communicate and coordinate, but the program also suffered from problems relating to funding flows and complicated financial management procedures.

AIR did find small, encouraging reductions in malnutrition and stunting in young children, but the results were not statistically significant. To learn more about the outcomes of this study and its implications for future research, check out our Q&A with Senior Researcher Hannah Ring.