This article assesses the effectiveness of IMC's PDH project by measuring changes in weight-for-age z-score (WAZ) among participating children both during and t 12 months post-implementation. WAZ was the anthropometric indicator of choice, as recommended by PDH guidance (Nutrition Working Group CORE, 2002). This article evaluates changes in nutritional status and seeks to understand caregiver perceptions around implementing promoted practices. Overall, 1,138 children were included in the study (621 Duguna Fango, 517 Damot Woyde), with an average age of 13.5 months (+- 4.8) at enrolment. Within three months of the intervention, 556 (49%) children met the WAZ =-2 criteria. Of the 1,035 children with 12 months of measurements, 472 (46%) achieved normal weight (WAZ =-2) by 12 months of follow-up. The prevalence of severely and moderately underweight children decreased from 36% and 64% (day 1) to 12% and 42% (month 12), respectively. Overall, these findings indicate that weight gain and improvement in WAZ were sustained throughout the 12-month period. Average overall weight gain across the 12 months was 2.55 +- 0.28 kg, with an average change in WAZ of 0.75 +- 0.36 standard deviation. At three months post-intervention, 99% of children met the 0.9 kg weight gain requirement as outlined in PDH protocols. Children who were more severely underweight at enrolment remained underweight by month 12 and had a lag in catch-up growth, compared to those who began the intervention moderately underweight. Although the severely underweight group experienced slightly higher gains over the 12-month period, these gains were often insufficient to reach a normal weight status. This suggests that severely underweight children may require specific, targeted interventions to address their needs.