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Implementation and effects of India's national school-based iron supplementation program

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  • Berry, James
  • Mehta, Saurabh
  • Mukherjee, Priya
  • Ruebeck, Hannah
  • Shastry, Gauri Kartini

Abstract

Reducing the rate of anemia is a primary public health concern in many developing countries. This paper studies the Indian government's school-based Iron and Folic Acid (IFA) supplementation program. We provide a descriptive analysis of program implementation patterns across 377 schools in the state of Odisha. We document that the more advantaged blocks had more consistent tablet distribution, and that distribution within the less advantaged blocks was less predictable, and plausibly random. We use this quasi-random variation to estimate the causal effect of the policy using a difference-in-differences strategy. The IFA program had no effect on hemoglobin levels at the mean, but there is a significantly larger effect for moderately anemic students in schools that were more recently distributing tablets, relative to schools that had run out of tablets. These results suggest that school-based supplementation has the potential to improve hemoglobin levels, but that breaks in supplementation – either due to inconsistent tablet distribution or the constraints of a school calendar – limit the long-term efficacy of school-based supplementation programs.

Suggested Citation

  • Berry, James & Mehta, Saurabh & Mukherjee, Priya & Ruebeck, Hannah & Shastry, Gauri Kartini, 2020. "Implementation and effects of India's national school-based iron supplementation program," Journal of Development Economics, Elsevier, vol. 144(C).
  • Handle: RePEc:eee:deveco:v:144:y:2020:i:c:s0304387818314317
    DOI: 10.1016/j.jdeveco.2019.102428
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    1. von Grafenstein, Liza & Kumar, Abhijeet & Kumar, Santosh & Vollmer, Sebastian, 2021. "Impacts of Double-Fortified Salt on Anemia and Cognition: Four-Year Follow-up Evidence from a School-Based Nutrition Intervention in India," IZA Discussion Papers 14627, Institute of Labor Economics (IZA).
    2. Berry, James & Mehta, Saurabh & Mukherjee, Priya & Ruebeck, Hannah & Shastry, Gauri Kartini, 2021. "Crowd-out in school-based health interventions: Evidence from India’s midday meals program," Journal of Public Economics, Elsevier, vol. 204(C).

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    More about this item

    Keywords

    School nutrition programs; Micronutrient supplementation; Anemia;
    All these keywords.

    JEL classification:

    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H40 - Public Economics - - Publicly Provided Goods - - - General

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