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Crowd-out in school-based health interventions: Evidence from India’s midday meals program

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

Abstract

Governments often rely on schools to implement multiple programs targeting child outcomes. How to improve the implementation of these programs is an important, open question. As part of a randomized controlled trial in Odisha, India, we measured the impacts of a nutrition program and a monitoring intervention on the implementation of a pre-existing school-based nutrition program, specifically the Indian government’s iron and folic acid supplementation (IFA) program. The new nutrition intervention distributed a micronutrient mix (MNM) to be added to school meals while the monitoring intervention varied the intensity of monitoring activities. We find that high intensity monitoring improved implementation of the government’s IFA program, while the MNM intervention crowded it out. The net effect is that high intensity monitoring improved child health, while the MNM intervention did not. Both crowd-out of the IFA program and sensitivity to monitoring were predominantly found among schools that were resource or capacity constrained.

Suggested Citation

  • 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).
  • Handle: RePEc:eee:pubeco:v:204:y:2021:i:c:s0047272721001882
    DOI: 10.1016/j.jpubeco.2021.104552
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    More about this item

    Keywords

    Public service delivery; Micronutrient fortification; Nutrition programs; Monitoring;
    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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