Background: Malnutrition is one of the major causes of childhood morbidity and mortality in Zambia. Positive deviant hearth (PH/hearth) has been recommended as one way of overcoming the high morbidity and mortality rates among under-five children. The current study aimed at assessing the effect the positive deviance hearth approach (PD/Hearth) had on underweight among children in Chinkozya community of Kazungula district in Southern Province Zambia.

Method: An intervention study was 44 children aged 6 – 24 months were admitted to the hearth for a period of 3 months. The intervention was conducted through experimental learning. Mothers/caregivers and community volunteers met at a local point where knowledge on practices from mothers with wellnourished children were shared with mothers with acute malnourished children. Questionnaires were administered to the head of the households of the 44 children who were admitted into the hearts and socio-demographic information was obtained. We conducted anthropometric measurements at baseline (day 1)and at the end of the three months intervention. Data analysis was conducted using STATA version 16 and WHO Anthro software version 3.2.2.

Results: The baseline prevalence of stunting was 40.9%, underweight 25% and wasting 4.5%. At the end of the intervention underweight among children was 6.8%. PD/heath reduced underweight by 18.2% (from 25% - 6.8) in Chinkozya community. Based on the paired t-test, the mean WAZ difference reduced by 0.27 (95%CI:-0.67, 0.13) between baseline and endline. However, this effect was not significant. (P-value = 0.1806).

Conclusion: PD/hearth reduced the prevalence of underweight in Chinkozya community, Kazungula district.