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Grow Smart

Micronutrient deficiencies & limited learning opportunities contribute to the loss of developmental potential among more than 200 million children in low and middle income countries. Early developmental loss contributes to low academic performance, limited economic capabilities, and lifelong disparities. Both nutrition and early child-development interventions have been effective in promoting child development and integrated interventions that include both nutrition and early child development have been recommended as efficient and optimal strategies to promote the developmental potential of children.

The 1-year trial had an infant phase (enrollment age: 6–12 months) and a preschool phase (enrollment age: 36–48 months) and was implemented in rural areas of the Nalgonda District of Andhra Pradesh. Infants were individually randomized into one of four groups: placebo, placebo plus early learning, MNP alone, and MNP plus early learning (integrated intervention), conducted through home visits. The preschool phase was a cluster-randomized trial conducted in Anganwadi centers (AWCs). AWCs were randomized into MNP or placebo, with the MNP or placebo mixed into the children’s food. The evaluation examines whether the effects of the MNP intervention vary by the quality of the early learning opportunities and communication within the AWCs. Project Grow Smart evaluates the effects of an integrated micronutrient powder (MNP) and early learning intervention on micronutrient status and development of infants & preschoolers.

Preliminary analyses suggest that PROJECT GROW SMART was effective at reducing anemia in infants by 17% (from 67 to 50 percent) and in preschoolers by 37% (from 47 to 10 percent). Beneficial effects on language in response to both the MNP and early learning intervention were also evident in both groups; and clearest when both the MNP and early learning intervention were considered together. Findings from this home (infant) and preschool (AWC) based integrated trial will be used to guide larger-scale policy and programs designed to promote the developmental, education, and economic potential of young children in rural India.

Faculty & Staff

Maureen Black, Ph.D.
Univeristy of Maryland, School of Medicine 

Nicholas Tilton
University of Maryland, School of Medicine 

Krishnapillai Madhavan Nair, Ph.D.
National Institute of Nutrition, Hyderabad, India 

Sylvia Fernandez-Rao, Ph.D.
National Institute of Nutrition, Hyderabad, India 

Nagalla Balakrishna, M.D.
National Institute of Nutrition, Hyderabad, India 

Kristen M. Hurley, Ph.D.
Johns Hopkins Bloomberg School of Public Health, Baltimore 

Kimberly B. Harding, M.S.
Micronutrient Initiative, Ottawa, Canada 

Greg A. Reinhart, Ph.D.
The Mathile Institute for the Advancement of Human Nutrition, Dayton, OH