Effectiveness of a Community-Based Nursing Intervention for Reducing Stunting in Under-Five Children in Rural Katsina State: A Cluster Randomised Controlled Trial

Background: Child stunting affects over one-third of Nigerian children under five, with North West Nigeria among the highest burden regions. Community nursing interventions integrating nutritional counselling, growth monitoring, and caregiver education represent a promising but inadequately evaluated strategy. Aim: This study evaluated the effectiveness of a community-based nursing intervention for reducing stunting in under-five children in rural Katsina State. Methods: A cluster randomised controlled trial assigned 20 communities to intervention and control arms. In intervention communities, trained community health nurses delivered monthly home visits, growth monitoring, and group nutritional education over 18 months. Primary outcomes were height-for-age z-scores. Secondary outcomes included dietary diversity and caregiver knowledge. Data were analysed using mixed-effects regression. Results: Children in intervention communities had significantly higher height-for-age z-scores at 18 months (mean difference = 0.38, p < 0.001). Stunting prevalence was 29.1% in the intervention arm compared with 38.7% in controls. Significant improvements in caregiver nutritional knowledge and dietary diversity were recorded. Conclusion: Community nursing interventions are effective in reducing stunting in North West Nigeria. The findings provide evidence for scaling up nurse-delivered nutrition programmes through Nigeria's primary health care system. Keywords: child stunting, community nursing, cluster RCT, Katsina State, child nutrition.