Adolescent Girls' Nutritional Status and Knowledge, Beliefs, Practices, and Access to Services: An Assessment to Guide Intervention Design in Nepal.

Background: Despite growing recognition of the importance of the adolescent period for health and nutritional well-being, scant evidence exists to inform interventions. Beyond limited understanding of adolescents' knowledge and practices, gaps in adolescent research also include limited understanding of how best to reach them with programs and policies and how the contexts in which they live present barriers and opportunities. Given that most studies on adolescent health and nutrition have used data from surveys of women of reproductive age, this study also sought to understand variation among younger and older adolescents and those who were already mothers.

Objectives: The primary aim was to support the design of an evidence-based adolescent program (Suaahara) in Nepal by describing adolescent girls' nutritional status; their exposure to information and services, knowledge, and practices in nutrition, health, family planning, and water, sanitation, and hygiene (WASH); and contextual factors; and to quantify variation by stage of adolescence.

Methods: Using the first round (2017) from a panel of Nepalese adolescent girls, we categorized adolescent girls as: younger (10-14.9 y; = 512), older (15-19.9 y; = 325), and mothers (15-19.9 y; = 256). Descriptive analyses generated proportions and means ± SDs, with statistical significance testing of differences.

Results: The prevalence of underweight was highest in younger adolescents, whereas the prevalence of overweight/obesity in mothers was double that of the other 2 groups. More younger adolescents were in school, but fewer owned a mobile phone or had radio access. Exposure, knowledge, and behaviors across thematic areas also differed by stage of adolescence.

Conclusions: These findings have implications for Suaahara and other programs and policies aiming to support the health and nutritional well-being of adolescent girls. Heterogeneity among adolescent girls should be considered when identifying which interventions are needed and have the most potential for each subpopulation.