Childhood malnutrition is still a publichealth concern in Malawi. Since 2013 the government ofMalawi (GoM) has been implementing a large-scalemultisectoral nutrition program, which expanded to alldistricts of the country with the World Bank Group and otherdonor funding. At the start of this program a nationalbaseline survey was conducted, and in early 2018, an endlinesurvey was conducted. The endline survey followed amixed-methods approach similar to the 2013 baseline survey,using both quantitative and qualitative data collectionmeasurements. An Oaxaca-Blinder decomposition analysis wasused to determine the pathways that contributed most to theprogram’s success. In addition, a panel dataset wasconstructed to compare the nutritional outcomes of childrenwithin the same household who were born before and after theprogram intervention. The findings of the endline surveyconfirm the positive trends observed in childhoodmalnutrition in Malawi. Between 2013 and 2018, nutritionindicators improved and the percentage of children under agefive who were stunted fell from forty-two percent in 2013 tothirty-seven percent in 2018. Improvements were observed insome underlying factors: the percentage of deliveriesattended by a skilled birth attendant and handwashing bothimproved significantly between 2013 and 2018. The findingsfrom the decomposition analysis and cross-sectional andpanel data suggest that improvements in water, sanitation,and hygiene (WASH), in particular, handwashing and antenatalcare (ANC) practices, were largely responsible for theobserved improvements in child nutrition. The findings ofthe Community-Based Nutrition (CBN) Survey further suggestthat the country should consider investing in morecoordination and capacity at the district and communitylevels and should address inequalities in programperformance across districts, delivering morecontext-specific investments and program designs whilemoving forward
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