Action - Lady Health Worker (LHW) - Growth monitoring and promotion - Infants and young children|Preschool-age children (Pre-SAC)

Programme: Lady Health Worker (LHW)

Programme description

The Lady Health Worker (LHW) programme started in 1994, expanding to 100 000 LHWs by 2002/3, at about 1:1000 people, or about 1:150 households; the aim was 1:200 households. An evaluation found that they worked approximately 30 hours/week, with about 25 household visits per week. LHW supervisors were at a ratio of about 1:20–25.

Programme type

Large scale programmes


1 LHW:1000 people, or about 1:150 householdsFinancial costs: Estimated about US$ 500 per LHW/year, of which US$ 240 is stipend/salaries, about US$ 2.50/household per year


WHO (2013) Essential Nutrition Actions – Improving maternal, newborn, infant and young child health and nutrition, which provides a compact of WHO guidance on nutrition interventions targeting the first 1000 days of life. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions require to implement them. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the essential nutrition actions described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities. This summary of LHW is retrieved from the ENA Part II where LHW is one of 32 large-scale community-based programs that has been reviewed in detail and evaluated.


Start date:

Target group: 
Infants and young children
Preschool-age children (Pre-SAC)
Age group: 
Children below 5 years
Coverage level (%): 
Coverage to approximately 70 % of households
Outcome indicator(s): 


M&E system: 

<p>Evaluations showed good impact on some process indicators – e.g. immunization and&nbsp;growth monitoring – although none on EBF. Child nutritional status was not measured;&nbsp;the only outcome seems to have been infant/child mortality rates. No impact was found, but&nbsp;it could be due to lack of statistical power in the evaluation designs.</p>


Most estimates up to 2001 indicate an underweight reduction of 0.6 ppt/year improvement at national level. No recent estimates exist


Revision log

Thu, 03/22/2018 - 13:32engesveenkCopy of the revision from Wed, 11/26/2014 - 16:02.published