The social determinants of child malnutrition in the study sites were identified through literature reviews, semi-structured interviews (SSIs) and focus group discussions (FGDs) wth local stakeholders. Anthropometric survey and household survey conducted at baseline and post-intervention follow-up in the Kenya study and comparator sites of Mombasa. Anthropometric survey and household survey conducted at baseline in the Chile study and comparator sites of Valparaiso. Baseline household and anthropometric surveys were then conducted in intervention and control areas of each study site to determine the nutritional status of 2-5 year old children and to understand better the determinants of their nutritional status. The researchers then established an intersectoral urban nutrition working group in the study area and facilitated the group through 6-monthly cycles of action and reflection to plan, implement and evaluate small-scale actions to improve child nutrition in the intervention areas. Follow up anthropometric and HH surveys were then conducted in Mombasa to evaluate the impact of the intervention. (It was not possible to collect these data in the Valparaiso study site.) Baseline household survey Mombasa: 742 households Baseline child anthropometric survey Mombasa: 810 children aged between 24 and 60 months (776 children between 24 and 47 months) Follow up household survey Mombasa: 797 households Follow up child anthropometric survey Mombasa: 1028 children aged between 24 and 60 months (956 children between 24 and 47 months) Baseline household survey containing Valparaiso: 499 households Baseline child anthropometric survey Valparaiso: 660 children aged between 24 and 48 MONTHS This study aimed to help two project countries, Chile and Kenya, reduce malnutrition in young children through intervening to change the social determinants of health in informal, urban settlements and slums. The central research question was: Can child malnutrition amongst families living in poverty in informal settlements and slums in Mombasa and Valparaíso be reduced through broadening community and stakeholder participation and strengthening local political accountability for nutrition? This question was explored using participatory action research (PAR) with one multidisciplinary urban nutrition working group in each study site. Each group worked collaboratively to design and trial small scale co-ordinated actions to reduce child malnutrition. The impact of these actions was assessed quantitatively using an experimental design with data from baseline and follow-up anthropometric and household surveys. (It was not possible to collect the follow up data in the Child study site.) Qualitative data were collected to identify the social determinants of child malnutrition and illuminate the process through which any change in nutritional status had been achieved.

The social determinants of child malnutrition in the study sites were identified through literature reviews, semi-structured interviews (SSIs) and focus group discussions (FGDs) wth local stakeholders. Baseline household and anthropometric surveys were then conducted in intervention and control areas of each study site to determine the nutritional status of 2-5 year old children and to understand better the determinants of their nutritional status. The researchers then established an intersectoral urban nutrition working group in the study area and facilitated the group through 6-monthly cycles of action and reflection to plan, implement and evaluate small-scale actions to improve child nutrition in the intervention areas. Follow up anthropometric and HH surveys were then conducted in Mombasa to evaluate the impact of the intervention. (It was not possible to collect these data in the Valparaiso study site.) In Mombasa, Kenya: Child anthropometric survey and linked household survey conducted at baseline and post-intervention follow-up. FGDs with mothers of children aged 2-5 years. SSIs with stakeholders (health officials, administrators, local authority representative). In Valparaiso, Chile: Baseline anthropometric survey and household survey. FGDs with parents and guardians of nursery school children aged 2-5 years. SSIs with professionals (including local health workers and nutritionists working with nursery schools)