Improving Nutritional Status through Behavioral Change : Lessons from Madagascar

This paper provides evidence of the effects of a large-scale intervention that focuses on the quality of nutritional and child care inputs during the early stages of life. The empirical strategy uses a combination of double-difference and weighting estimators in a longitudinal survey to address the purposive placement of participating communities and estimate the effect of the availability of the program at the community level on nutritional outcomes. The authors find that the program helped 0-5 year old children in the participating communities to bridge the gap in weight for age z-scores and the incidence of underweight. The program also had significant effects in protecting long-term nutritional outcomes (height for age z-scores and incidence of stunting) against an underlying negative trend in the absence of the program. Importantly, the effect of the program exhibits substantial heterogeneity: gains in nutritional outcomes are larger for more educated mothers and for villages with better infrastructure. The program enables the analysis to isolate responsiveness to information provision and disentangle the effect of knowledge in the education effect on nutritional outcomes. The results are suggestive of important complementarities among child care, maternal education, and community infrastructure.

Bibliographic Details

Main Authors:	Galasso, Emanuela, Umapathi, Nithin
Language:	English
Published:	World Bank, Washington, DC 2007-12
Subjects:	APPLIED NUTRITION, BEHAVIOR CHANGE, BEHAVIORAL CHANGES, BREASTFEEDING, CENTRAL AMERICA, CHILD CARE, CHILD DEVELOPMENT, CHILD FEEDING, CHILD FEEDING PRACTICES, CHILD GROWTH, CHILD HEALTH, CHILD NUTRITION, CHILD-CARE, CHILDHOOD MALNUTRITION, COMMUNES, COMMUNITIES, COMMUNITY NUTRITION WORKERS, COMPLEMENTARY FOOD, COOKING, DEMOGRAPHIC FACTORS, DESCRIPTION, DEVELOPING COUNTRIES, DIARRHEA, DIET, DISEASES, DISSEMINATION, DISTRICTS, EARLY CHILD DEVELOPMENT, EARLY CHILDHOOD, ECONOMIC DEVELOPMENT, ECONOMIC GROWTH, ECONOMIC RESOURCES, EDUCATED MOTHERS, FEMALE, FEMALES, FOOD INTAKE, FOOD SECURITY, GENDER, GROWTH MONITORING, GROWTH PROMOTION, GROWTH RETARDATION, HEALTH OUTCOMES, HEALTH PRODUCTION, HEALTH SERVICES, HEALTH STATUS, HOME VISITS, HOSPITAL, HOSPITALS, HOUSEHOLDS, HOUSING, HUMAN DEVELOPMENT, HYGIENE, HYGIENE PRACTICES, ILLNESS, ILLNESSES, INFANT, INTERVENTION, LABOR MARKET, LACTATING MOTHERS, LARGE CITIES, LESS EDUCATED MOTHERS, LIVING CONDITIONS, LOCAL INFRASTRUCTURE, LOW BIRTH WEIGHT, MALNUTRITION, MALNUTRITION RATES, MICRONUTRIENT SUPPLEMENTATION, MODERATE MALNUTRITION, MORTALITY, MORTALITY RATES, MOTHER, NUTRIENTS, NUTRITION, NUTRITION EDUCATION, NUTRITION INTERVENTIONS, NUTRITION KNOWLEDGE, NUTRITION POLICY, NUTRITION PROGRAMS, NUTRITION PROJECTS, NUTRITION STATUS, NUTRITIONAL OUTCOMES, NUTRITIONAL STATUS, NUTRITIONAL STATUS OF INFANTS, OCCUPATION, OLD CHILDREN, PEDIATRICS, PERSONAL COMMUNICATION, PNC, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POPULATION CENSUS, POPULATION SIZE, PREGNANCY, PREGNANT WOMAN, PRIMARY EDUCATION, PRODUCTIVITY, PROGRESS, PROTEIN, PROTEIN-ENERGY MALNUTRITION, PROVISION OF INFORMATION, PUBLIC HEALTH, PUBLIC SERVICES, QUALITY SERVICES, RADIO, RESPECT, RURAL AREAS, SAFE WATER, SECONDARY EDUCATION, SECONDARY SCHOOL, SECONDARY SCHOOLS, SERVICE DELIVERY, SEVERE MALNUTRITION, SOCIAL PROGRAMS, SPILLOVER, STAGES OF LIFE, STUNTING, TETANUS, TRADITIONAL PRACTICES, UNDERNUTRITION, URBAN AREAS, URBAN CENTER, URBAN POPULATIONS, VILLAGE LEVEL, VILLAGES, VITAMIN, VITAMIN A, VITAMIN A SUPPLEMENTATION, VULNERABILITY, WASTING, WOMAN, WORKERS, WORLD HEALTH ORGANIZATION, YOUNG AGES, YOUNG CHILD, YOUNG CHILDREN,
Online Access:	http://documents.worldbank.org/curated/en/2007/12/8877154/improving-nutritional-status-through-behavioral-change-lessons-madagascar https://hdl.handle.net/10986/7607
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