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Improving nutritional status through behavioral change : lessons from Madagascar

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Author Info
Galasso, Emanuela
Umapathi, Nithin

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Abstract

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.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 4424.

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Date of creation: 01 Dec 2007
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Handle: RePEc:wbk:wbrwps:4424

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Related research
Keywords: Population Policies; Health Monitoring&Evaluation; Early Child and Children's Health; Housing&Human Habitats; Nutrition;

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This paper has been announced in the following NEP Reports: References listed on IDEAS
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  1. Currie, J. & Thomas, D., 1995. "Does Head Start make a Difference?," Papers 95-10, RAND - Reprint Series.
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  2. Alderman, Harold, 2007. "Improving Nutrition through Community Growth Promotion: Longitudinal Study of the Nutrition and Early Child Development Program in Uganda," World Development, Elsevier, vol. 35(8), pages 1376-1389, August. [Downloadable!] (restricted)
  3. Jalan, Jyotsna & Ravallion, Martin, 2001. "Does piped water reduce diarrhea for children in rural India ?," Policy Research Working Paper Series 2664, The World Bank. [Downloadable!]
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  4. Galasso, Emanuela & Yau, Jeffrey, 2006. "Learning through monitoring : lessons from a large-scale nutrition program in Madagascar," Policy Research Working Paper Series 4058, The World Bank. [Downloadable!]
  5. Keisuke Hirano & Guido W. Imbens & Geert Ridder, 2003. "Efficient Estimation of Average Treatment Effects Using the Estimated Propensity Score," Econometrica, Econometric Society, vol. 71(4), pages 1161-1189, 07. [Downloadable!] (restricted)
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