Learning Together Experimental Evidence On The Impact Of Group Based Nutrition Interventions In Rural Bihar
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Learning together: Experimental evidence on the impact of group-based nutrition interventions in rural Bihar by Raghunathan, Kalyani,Kumar, Neha,Gupta, Shivani,Chauhan, Tarana,Kathuria, Ashi Kohli,Menon, Purnima Pdf
Despite improvements over the last decade or more, India still accounts for a large proportion of the global prevalence of maternal and child undernutrition. We use a cluster-randomized controlled design and two waves of panel data on more than 2000 households from Bihar to analyse the impact on diet quality and anthropometry of a health and nutrition intervention delivered through an at-scale women’s self-help group (SHGs) platform. We find that the intervention had small but significant impacts on women and children’s dietary diversity, with the main impacts coming from an increase in the consumption of fruits and vegetables and dairy, however, it had no impact on women’s body mass index. We identify several potential pathways to impact. To the extent that SHGs can effect broad-based social change, their current reach to millions of women makes them a powerful platform for accelerating improvements in maternal and child health and nutrition outcomes.
The Operational Evidence Base for Delivering Direct Nutrition Interventions in India by Rasmi Avula,Suneetha Kadiyala,Kavita Singh,Purnima Menon Pdf
The persistence of undernutrition in the face of Indias impressive economic growth is of enormous concern. Less than 55 percent of mothers and children receive any essential health and nutrition inputs that are critical for improving maternal and child nutrition. We conducted a desk review (1) to document the extent to which national and civil society/NGO programs in India reflect current technical recommendations for nutrition and (2) assess the operational evidence base for implementing essential interventions for nutrition in the Indian context. We reviewed the design of the two major national programs, Integrated Child Development Services (ICDS) and the National Rural Health Mission (NRHM). Subsequently, we used Google Scholar to search the published literature from 2000 to 2012 for evidence of interventions addressing the inputs to improve child nutrition. Finally, we contacted 70 program stakeholders to identify the unpublished evidence on inputs in program models implemented by civil society/nongovernment organizations. We find that, by design, the two national programs (ICDS and NRHM) together appear to incorporate all the essential inputs and use evidence-based interventions. There is an expectation by design that the frontline workers of ICDS and NRHM coordinate and collaborate to deliver the interventions. A review of 22 program models shows that a majority focused on improving breastfeeding and timely initiation of complementary feeding. However, only a few addressed the full spectrum of complementary feeding, vitamin A deficiency, pediatric anemia, and severe acute malnutrition. None addressed how to reduce intestinal parasitic burdens or prevent malaria. There is limited published literature on the effectiveness of the recommended interventions to deliver the essential inputs. There are few efficacy studies and even fewer effectiveness studies or program evaluations on delivering essential nutrition interventions in the Indian context. The most commonly used delivery strategies across multiple essential inputs were home visits that involved individual or group counseling by community health workers or by self-help groups. Mass media and community events such as marriages and fairs were used as avenues to generate support for the interventions. Some programs used community mobilization to promote the interventions. Several of these programs worked to improve coordination and convergence between ICDS and NRHM and to strengthen these existing systems through training, improved monitoring, and supervision. Overall, a large gap persists in both the published and gray literature on how to promote interventions to address the essential inputs. Much more operational evidence is needed to ensure high-quality delivery of the evidence-based interventions that are already being implemented nationwide. Given the potential for the national programs to effectively deliver interventions to achieve maximum coverage and impact, and the government of Indias current interest in ICDS system strengthening, this is an opportune time to test some of the innovations using the ICDS and NRHM platforms.
"The prevalence of child undernutrition in India is among the highest in the world, nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth. Drawing on qualitative studies and quantitative evidence from large household surveys, this book explores the dimensions of child undernutrition in India and examines the effectiveness of the Integrated Child Development Services (ICDS)program, India's main early child development intervention, in addressing it. Although levels of undernutrition in India declined modestly during the 1990s, the reductions lagged behind those achieved by other countries with similar economic growth. Nutritional inequalities across different states and socioeconomic and demographic groups remain large. Although the ICDS program appears to be well-designed and well-placed to address the multi-dimensional causes of malnutrition in India, several problems exist that prevent it from reaching its potential. The book concludes with a discussion of a number of concrete actions that can be taken to bridge the gap between the policy intentions of ICDS and its actual implementation."
Combating Micronutrient Deficiencies by Brian Thompson,Leslie Amoroso Pdf
This book, inclusive of 19 chapters, provides discussions on the benefits and limitations of food-based approaches for the prevention and control of micronutrient malnutrition. Different chapters focus on specific relevant topics, including current developments in food-based approaches and their program applications, relevance of agricultural interventions to nutrition, impact of multi-sectoral programmes with food-based approaches components in alleviating undernutrition and micronutrient malnutrition, animal-source foods as a food-based approach to address nutrient deficiencies, aquaculture's role in improving food and nutrition security, benefits of vegetables and fruits in preventing and combating micronutrient malnutrition, benefits of food-based approaches for overcoming single specific micronutrient deficiencies, and food fortification. This book will be of great use to professionals interested in public health, human nutrition, micronutrient deficiency interventions, food and nutrition security policy interventions, and agricultural research.
The State of Food and Agriculture 2013 by Food and Agriculture Organization of the United Nations Pdf
Malnutrition -- in the form of undernutrition, micronutrient deficiencies, and overweight and obesity -- imposes unacceptably high economic and social costs on countries at all income levels. The causes of malnutrition are complex, yet all forms of malnutrition share one common feature: nutritionally inappropriate diets. The State of Food and Agriculture 2013 makes the case that healthy diets and good nutrition begin with food and agriculture.
Using outcome trajectory evaluation to assess HarvestPlus’ contribution to the development of national biofortification breeding programs by Douthwaite, Boru,Johnson, Nancy L.,Wyatt, Amanda Pdf
While the key role that policy plays in sustainable development has long been recognized, rigorously documenting the influence of research on policy outcomes faces conceptual, empirical and even political challenges. Addressing these challenges is increasingly urgent since improving policies—broadly defined—is at the heart of the structural transformation agenda. This paper describes the use of a new evaluation method—outcomes trajectory evaluation (OTE), based on both evaluation and policy process theory—to explore the influence of HarvestPlus, a large and complex research for development program focused on improving nutrition, on a specific policy outcome, namely the establishment of crop biofortification breeding programs in national agricultural research institutes in Bangladesh, India and Rwanda. The findings support claims of significant HarvestPlus contributions to the establishment of the programs while also raising issues that need to be monitored moving forward to ensure sust
Do grassroots interventions relax behavioral constraints to the adoption of nutrition-sensitive food production systems? by Alvi, Muzna,Ward, Patrick S.,Makhija, Simrin,Spielman, David J. Pdf
In many developing countries, agricultural policies and programs are often designed in a way to promote productivity growth with modern inputs and technologies, and with limited reference to the nutrition gains that can be made through production diversification. We test whether grassroots programs can relax behavioral constraints inhibiting the adoption of diversified nutrition-sensitive production systems. We use a series of lab-in-field experiments and survey instruments in Odisha, India to elicit male and female farmers’ preferences for risk, aversion to loss, empowerment and aspirations for one’s self and children. We find that respondents in villages where grassroots interventions were promoted showed significantly lower levels of risk aversion, higher levels of loss aversion and higher aspirations for themselves and their children, along with improvements in production and consumption diversity. Insights into the prevalence of behavioral constraints and interventions that relax such constraints fills an important knowledge gap in how to design programs that promote more nutrition-sensitive food production systems.
Nutrition-sensitive agriculture by Ruel, Marie T.,Quisumbing, Agnes R.,Balagamwala, Mysbah Pdf
A growing number of governments, donor agencies, and development organizations are committed to supporting nutrition-sensitive agriculture (NSA) to achieve their development goals. Although consensus exists on pathways through which agriculture may influence nutrition-related outcomes, empirical evidence on agriculture’s contribution to nutrition and how it can be enhanced is still weak. This paper reviews recent empirical evidence (since 2014), including findings from impact evaluations of a variety of NSA programs using experimental designs as well as observational studies that document linkages between agriculture, women’s empowerment, and nutrition. It summarizes existing knowledge regarding not only impacts but also pathways, mechanisms, and contextual factors that affect where and how agriculture may improve nutrition outcomes. The paper concludes with reflections on implications for agricultural programs, policies, and investments, and highlights future research priorities.
Government transfers, COVID-19 shock, and food insecurity: Evidence from rural households in India by Kumar, Anjani,Saroj, Sunil,Mishra, Ashok K.,Rashid, Shahidur Pdf
The COVID-19 pandemic has decimated the lives and livelihoods of people around the world. The impact of COVID-19 has been especially devastating for low-income families in rural areas of India. Food insecurity became pervasive in rural areas soon after the nationwide lockdown was announced, as many families relied on daily wage work to fund basic necessities. By providing cash transfers and the additional foodgrains, Indian policymakers acted swiftly to reduce the financial impact on family income and consumption. This paper investigates the factors affecting the participation of rural families in the cash transfer program and the effect of government cash transfers on food insecurity. Results indicate that the government cash transfer program in India decreased moderate food insecurity by 2.4% and severe food insecurity by about 0.92%.
Author : World Health Organization Publisher : World Health Organization Page : 211 pages File Size : 46,7 Mb Release : 2015-08-05 Category : Medical ISBN : 9789241564861
Investing to Overcome the Global Impact of Neglected Tropical Diseases by World Health Organization Pdf
"The presence, or absence, of neglected tropical diseases (NTDs) can be seen as a proxy for poverty and for the success of interventions aimed at reducing poverty. Today, coverage of the public-health interventions recommended by the World Health Organization (WHO) against NTDs may be interpreted as a proxy for universal health coverage and shared prosperity - in short, a proxy for coverage against neglect. As the world's focus shifts from development to sustainable development, from poverty eradication to shared prosperity, and from disease-specific goals to universal health coverage, control of NTDs will assume an important role towards the target of achieving universal health coverage, including individual financial risk protection. Success in overcoming NTDs is a "litmus test" for universal health coverage against NTDs in endemic countries. The first WHO report on NTDs (2010) set the scene by presenting the evidence for how these interventions had produced results. The second report (2013) assessed the progress made in deploying them and detailed the obstacles to their implementation. This third report analyses for the first time the investments needed to achieve the scale up of implementation required to achieve the targets of the WHO Roadmap on NTDs and universal coverage against NTDs. INVESTING TO OVERCOME THE GLOBAL IMPACT OF NEGLECTED TROPICAL DISEASES presents an investment strategy for NTDs and analyses the specific investment case for prevention, control, elimination and eradication of 12 of the 17 NTDs. Such an analysis is justified following the adoption by the Sixty-sixth World Health Assembly in 2013 of resolution WHA6612 on neglected tropical diseases, which called for sufficient and predictable funding to achieve the Roadmap's targets and sustain control efforts. The report cautions, however, that it is wise investment and not investment alone that will yield success. The report registers progress and challenges and signals those that lie ahead. Climate change is expected to increase the spread of several vector-borne NTDs, notably dengue, transmission of which is directly influenced by temperature, rainfall, relative humidity and climate variability primarily through their effects on the vector. Investments in vector-borne diseases will avoid the potentially catastrophic expenditures associated with their control. The presence of NTDs will thereby signal an early warning system for climate-sensitive diseases. The ultimate goal is to deliver enhanced and equitable interventions to the most marginalized populations in the context of a changing public-health and investment landscape to ensure that all peoples affected by NTDs have an opportunity to lead healthier and wealthier lives."--Publisher's description.
The Capability Approach by S. Ibrahim,M. Tiwari Pdf
How can human capabilities be articulated and promoted in practice? How can the challenges encountered in its application be addressed? This volume answers these research questions through nine country case studies from the Global North and the Global South.
Transforming Food Systems for a Rising India by Prabhu Pingali,Anaka Aiyar,Mathew Abraham,Andaleeb Rahman Pdf
This open access book examines the interactions between India’s economic development, agricultural production, and nutrition through the lens of a “Food Systems Approach (FSA).” The Indian growth story is a paradoxical one. Despite economic progress over the past two decades, regional inequality, food insecurity and malnutrition problems persist. Simultaneously, recent trends in obesity along with micro-nutrient deficiency portend to a future public health crisis. This book explores various challenges and opportunities to achieve a nutrition-secure future through diversified production systems, improved health and hygiene environment and greater individual capability to access a balanced diet contributing to an increase in overall productivity. The authors bring together the latest data and scientific evidence from the country to map out the current state of food systems and nutrition outcomes. They place India within the context of other developing country experiences and highlight India’s status as an outlier in terms of the persistence of high levels of stunting while following global trends in obesity. This book discusses the policy and institutional interventions needed for promoting a nutrition-sensitive food system and the multi-sectoral strategies needed for simultaneously addressing the triple burden of malnutrition in India.
Dean T. Jamison,Joel G. Breman,Anthony R. Measham,George Alleyne,Mariam Claeson,David B. Evans,Prabhat Jha,Anne Mills,Philip Musgrove
Author : Dean T. Jamison,Joel G. Breman,Anthony R. Measham,George Alleyne,Mariam Claeson,David B. Evans,Prabhat Jha,Anne Mills,Philip Musgrove Publisher : World Bank Publications Page : 1449 pages File Size : 47,5 Mb Release : 2006-04-02 Category : Medical ISBN : 9780821361801
Disease Control Priorities in Developing Countries by Dean T. Jamison,Joel G. Breman,Anthony R. Measham,George Alleyne,Mariam Claeson,David B. Evans,Prabhat Jha,Anne Mills,Philip Musgrove Pdf
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
Nourishing millions: Stories of change in nutrition: Synopsis by Yosef, Sivan,Pandya-Lorch, Rajul Pdf
In recent years, the world has seen unprecedented attention and political commitment to addressing malnutrition. Milestones such as the Scaling Up Nutrition (SUN) Movement, the Lancet Maternal and Child Nutrition Series, and the Second International Conference on Nutrition (ICN2) have marked the rapid rise of nutrition on the global policy and research agenda. These developments reverse years of relative neglect for nutrition. Undernutrition is a global challenge with huge social and economic costs. It kills millions of young children annually, stunts growth, erodes child development, reduces the amount of schooling children attain, and increases the likelihood of their being poor as adults, if they survive. Stunting persists through a lifetime and beyond—underweight mothers are more likely to give birth to underweight children, perpetuating undernutrition across generations. Undernutrition reduces global gross domestic product by US$1.4–$2.1 trillion a year—the size of the total economy of Africa south of the Sahara.
