Strengthening food-based transfers for maternal health and nutrition: Evidence from Rural India

The first 1000 days of life is a well-known critical period in which nutrition is paramount. Yet, many women remain undernourished during this period, despite rising standards of living globally. Food transfer programs play a critical role in bridging this gap, but there is limited evidence on the effectiveness of many of these programs, limiting evidence-based policymaking in this sphere. This paper examined a natural experiment comparing two large-scale interventions delivered through village-based community centers: (i) nutritious rations offered as ready-to-cook food packets once every two months (ii) the same rations program bundled with daily nutritious cooked meals. I used quasi-experimental methods to construct comparable village- pairs and collected primary data from ~ 930 pregnant women in rural Maharashtra in India. Relative to women who were offered rations only, those offered the bundled program experienced significant increases in daily nutrient intake, an additional 264 calories and 8 grams of energy and protein, leaving the protein-energy ratio unchanged. As compared to women’s first trimester weight that were offered rations only, the bundled program led to additional weight gain of 2.03 kg in third trimester. Also, there are no spillover effects on the overall nutrient intake of women’s existing children under age six, but there is a shift in the composition. Overall, these findings demonstrate that integrating daily cooked meals into existing ration programs can substantially improve maternal dietary intake and gestational weight, while generating benign intra-household spillovers on children.