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Improving nutritional status through behavioral change : lessons from Madagascar

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  • Galasso, Emanuela
  • Umapathi, Nithin

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.

Suggested Citation

  • Galasso, Emanuela & Umapathi, Nithin, 2007. "Improving nutritional status through behavioral change : lessons from Madagascar," Policy Research Working Paper Series 4424, The World Bank.
  • Handle: RePEc:wbk:wbrwps:4424
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    References listed on IDEAS

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    1. Jalan, Jyotsna & Ravallion, Martin, 2003. "Does piped water reduce diarrhea for children in rural India?," Journal of Econometrics, Elsevier, vol. 112(1), pages 153-173, January.
    2. 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.
    3. 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, July.
    4. Currie, Janet & Thomas, Duncan, 1995. "Does Head Start Make a Difference?," American Economic Review, American Economic Association, vol. 85(3), pages 341-364, June.
    5. 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.
    6. Stuart Gillespie & Milla McLachlan & Roger Shrimpton, 2003. "Combating Malnutrition : Time to Act," World Bank Publications, The World Bank, number 15120.
    7. Jason K. Luellen & William R. Shadish & M. H. Clark, 2005. "Propensity Scores," Evaluation Review, , vol. 29(6), pages 530-558, December.
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    Cited by:

    1. repec:eee:wdevel:v:99:y:2017:i:c:p:173-185 is not listed on IDEAS
    2. Marian Meller & Stephan Litschig, 2014. "Saving Lives: Evidence from a Conditional Food Supplementation Program," Journal of Human Resources, University of Wisconsin Press, vol. 49(4), pages 1014-1052.
    3. Fitzsimons, Emla & Malde, Bansi & Mesnard, Alice & Vera-Hernández, Marcos, 2016. "Nutrition, information and household behavior: Experimental evidence from Malawi," Journal of Development Economics, Elsevier, vol. 122(C), pages 113-126.
    4. Vinod Thomas & Xubei Luo, 2011. "Overlooked Links in the Results Chain," World Bank Publications, The World Bank, number 2347.
    5. 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.
    6. Fitzsimons, Emla & Malde, Bansi & Mesnard, Alice & Vera-Hernández, Marcos, 2012. "Household Responses to Information on Child Nutrition: Experimental Evidence from Malawi," CEPR Discussion Papers 8915, C.E.P.R. Discussion Papers.
    7. Álvarez, Begoña & Vera-Hernández, Marcos, 2013. "Exploiting subjective information to understand impoverished children's use of health care," Journal of Health Economics, Elsevier, vol. 32(6), pages 1194-1204.
    8. Maryanne Sharp & Ioana Kruse, 2011. "Health, Nutrition, and Population in Madagascar 2000-09," World Bank Publications, The World Bank, number 5957.
    9. Shiladitya Chatterjee & Amitava Mukherjee & Raghbendra Jha, 2010. "Approaches to Combat Hunger in Asia and the Pacific," MPDD Working Paper Series WP/10/10, United Nations Economic and Social Commission for Asia and the Pacific (ESCAP).

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    Keywords

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

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