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Improving Nutritional Status through Behavioral Change: Lessons from Madagascar (World Bank- 2007)

Improving Nutritional Status through Behavioral Change: Lessons from Madagascar (World Bank- 2007)

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Published by HayZara Madagascar
This paper provides evidence of the effects of a largescale 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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World Bank 2007
This paper provides evidence of the effects of a largescale 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.
********************************
World Bank 2007

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Published by: HayZara Madagascar on Aug 05, 2011
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Improving Nutritional Status throughBehavioral Change:
Lessons rom Madagascar
Emanuela GalassoNithin Umapathi 
The World Bank Development Research GroupPoverty TeamDecember 2007
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Produced by the Research Support Team
 Abstract 
The Impact Evaluation Series has been established in recognition o the importance o impact evaluation studies or World Bank operations and or development in general. The series serves as a vehicle or the dissemination o fndings o those studies. Papers in this series are part o the Bank’s Policy Research Working Paper Series. The papers carry the names o the authors and should be cited accordingly. The fndings,interpretations, and conclusions expressed in this paper are entirely those o the authors. They do not necessarily represent the views o the International Bank or Reconstruction and Development/World Bank and its afliated organizations, or those o the Executive Directors o  the World Bank or the governments they represent.
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This paper provides evidence o the eects o a large-scale intervention that ocuses on the quality o nutritional and child care inputs during the early stageso lie. The empirical strategy uses a combinationo double-dierence and weighting estimators in alongitudinal survey to address the purposive placemento participating communities and estimate the eect o the availability o the program at the community levelon nutritional outcomes. The authors fnd that theprogram helped 0-5 year old children in the participatingcommunities to bridge the gap in weight or age z-scoresand the incidence o underweight. The program also hadsignifcant eects in protecting long-term nutritionalThis paper—a product o the Poverty Team, Development Research Group—is part o a larger eort in the departmentto promote rigorous impact evaluations o anti-poverty programs. Policy Research Working Papers are also posted on the Web at http://econ.worldbank.org. The author may be contacted at egalasso@worldbank.org.outcomes (height or age z-scores and incidence o stunting) against an underlying negative trend in theabsence o the program. Importantly, the eect o the program exhibits substantial heterogeneity: gainsin nutritional outcomes are larger or more educatedmothers and or villages with better inrastructure. Theprogram enables the analysis to isolate responsivenessto inormation provision and disentangle the eecto knowledge in the education eect on nutritionaloutcomes. The results are suggestive o importantcomplementarities among child care, maternal education,and community inrastructure.
 
 Improving Nutritional Status through Behavioral Change: Lessonsfrom Madagascar
Emanuela Galasso andNithin Umapathi
 Development Research Group
 
World Bank 
 
University College London, Institute for Fiscal Studies and Centre for  Microdata Methods and Practice
(JEL I12, I18, J13, O15) 
Keywords: Community-based program, nutrition, behavioral change, Madagascar
This research has been sponsored by the World Bank Research Grant “Community Nutrition: Evaluation of Impacts in Africa”. We thank Claudia Rokx, the project task manager at the onset of the evaluation for herenthusiastic support and Harold Alderman, Anne Bossuyt for very useful discussions, Pedro Carneiro and ImranRasul for detailed comments on various drafts. We are extremely grateful to the project management unit and tothe provincial directors of the Seecaline program in Madagascar for sharing their vast knowledge on the details of the program. We thank Bart Minten for having shared the data on the Commune Census. These are the views of the authors and do not reflect those of the World Bank, its Executive Directors, or the countries they represent.All errors are our own. Correspondence by email toegalasso@worldbank.orgorn.umapathi@ucl.ac.uk .

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