Stunting, or impaired linear growth, affects millions of children in Sub-Saharan Africa and has been linked to negative effects throughout childhood and beyond, including delayed cognitive development, decreased educational attainment, and increased morbidity and mortality. While stunting has long been linked to poor nutrition outcomes, there is growing literature that implicates poor water, sanitation, and hygiene (WASH) and environmental enteropathy in stunting.

Emory University and the Freeman Research Group entered a partnership with Catholic Relief Services (CRS) to support their efforts to reduce stunting in Homa Bay and Migori counties, Kenya and Mbeya Region, Tanzania. 26% and 37% of children under the age of 5 are stunted in Kenya and Tanzania, respectively.

In Kenya, CRS is implementing THRIVE II, a two-year integrated early childhood development (ECD), positive parenting, WASH, and infant and young child feeding (IYCF) designed to help children reach all of their educational milestones. See the official THRIVE website here. Emory supports THRIVE II through professional consulting on educational materials, evaluation services, and development of a theory-driven behavioral intervention based on thorough formative research and trials of improved practice (TIPs). The intervention aims to improve maternal and child health through improved dietary diversity, food hygiene practices, and handwashing behaviors. The intervention uses a mealtime focus in order to give order and context for the behaviors.

In Tanzania, CRS is implementing a four-year project called the Accelerating Stunting Reduction Program (ASRP) designed to reduce stunting in the Mbeya region through improved dietary diversity and complementary child feeding. Emory supports ASRP through the testing of the feasibility and acceptability of a nutrition toolkit and the development of an intervention.


  1. Development and Application of Novel Caregiver Hygiene Behavior Measures Relating to Food Preparation, Handwashing, and Play Environments in Rural Kenya (2018)

Briefs, reports, case studies:



Study Locations

Homa Bay and Migori counties, Kenya


Mbeya Region, Tanzania


Target Population

Pregnant women and mothers with children under the age of two



Matthew Freeman (Principal)



CRS, Kenya: Mercy Orphans Support Group, Homa Hills Community Development Organization, Tanzania: The Centre for Counseling, Nutrition, and Health Care (COUSENUTH)



CRS, Kenya: Conrad N. Hilton Foundation, Tanzania: UNICEF


Project Staff

Anna Ellis, Emilie McClintic, Emily Ogutu



Emory University: Amy Webb Girard, Kimberly Jacob Arriola, Bethany Caruso. Uzima University: Dr. Richard Muga, Dr. Lydia Atetwe, Lily Lukhorito. Catholic University of Health and Allied Sciences: Sosprato Ngallaba, Esther Pastory, Martha Mushi



Sonia Aima, Nicanor Muga, Samwel Ochieng, Rosemary Okoth, Fred Okumu, Jeffrey Otieno, Debrah Owino, Modester Adhiambo, Lilian Modote, Eunica Auma, Vivienne Oyugi, Jackeline Okumu, Rosebel Ouda, Nancy Oyugi, Malere Siegfried, Helena Nkuba, Raymond Mhaluka, Vera Jeremiah, Titus Ndibohoye, Gerald Rumanyika, Rehema John, Theresia Maduka, Teddy Ngallaba, Sekela Kitalima, Rosemary Mchembi, Rebecca Shomi, Rebecca Mwampashe, Michael Makonyo, Katherine Mfisile, Happy Mnkunwa, Flora Kuzenza, Esther Daud, Bernadetha Lenga