Page 1. Generating Further Reductions of Child Malnutrition in India's BIMARU St... more Page 1. Generating Further Reductions of Child Malnutrition in India's BIMARU States: What are the Options Now? F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink ... F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink Introduction ...
... Micronutrient Deficiencies Deficiencies in key vitamins and minerals— especially iron, vitami... more ... Micronutrient Deficiencies Deficiencies in key vitamins and minerals— especially iron, vitamin A, zinc ... malnutrition have used two primary strategies: supplementation and food fortification, with some ... crops to boost mi-cronutrient content, as with Golden Rice fortified with vitamin ...
The common practice of reducing food consumption during pregnancy is recognized as a primary caus... more The common practice of reducing food consumption during pregnancy is recognized as a primary cause of poor pregnancy outcomes and, in turn, malnutrition among young children in many developing countries including Bangladesh. This paper analyzes data from the 1998 Mid-Term Evaluation of the Bangladesh Integrated Nutrition Project (BINP) to identify the determinants of pregnancy food consumption. The analysis found that
During the past fifteen years, there has been a significant increase in efforts to monitor and ev... more During the past fifteen years, there has been a significant increase in efforts to monitor and evaluate large scale nutrition projects. This, in turn, stems from an increased appreciation of the importance of M&E in such projects, and from more stringent demands being made by donors. This paper seeks to draw some lessons from this experience drawing on a large number of projects for which M&E documentation is available. These include the Tamil Nadu Integrated Nutrition Project in South India, the Bangladesh Integrated Nutrition Project, the Iringa Project in Tanzania, the Posyandu projects in Indonesia, the Integrated Child Development Service (ICDS) program in India, the UNICEF-assisted Dular project in Bihar state in India, the HKI Nutrition Focused Child Survival Project in Mali, the CARE-assisted Child Survival Project in Nicaragua, the Enhanced Outreach Strategy of the Ethiopian Child Survival Project, Save the Children (US) positive deviance-based projects in Vietnam and its J...
OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolesc... more OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolescents in Sub Saharan Africa. A significant gender difference in adolescent nutritional status has been observed in several developing country studies, with boys appearing to be twice as undernourished as girls. We sought to examine the associations among undernutrition, gender, and sexual maturation in a sample of adolescents from Tanzania. METHODS: This cross-sectional study examined the nutritional status of 670 individuals aged 10-19 years from 28 villages in Kilosa District, Tanzania. Undernutrition was defined as BMI for Age <5th percentile of the NCHS/WHO reference. Logistic regression models tested associations between gender, sexual maturation, and the outcome variable, undernutrition. We also included an interaction term to represent the cross-product of male and mid-adolescence, a period associated with peak linear growth. RESULTS: The prevalence of undernutrition in this sam...
Food insecurity is highly prevalent in many developing countries, with negative implications for ... more Food insecurity is highly prevalent in many developing countries, with negative implications for the health and well-being of affected populations. At the community level, household food security status is affected by inequitable distribution and access to foods. Within households, variation in food allocation influences individual nutritional adequacy. Researchers have argued that age, gender, or household status in developing country societies may influence parents' preferential allocation of food and health care. Examination of intra-household food distribution is pivotal to understanding differential nutritional outcomes among household members. The relationship between adolescent dietary intakes in the context of household food security status in less-developed countries is not well understood. Presently the bulk of intra-household food allocation research focuses on unequal distribution between males and females and between adults and young children. We examined data from ...
Positive deviance is increasingly employed in international development activities to permit the ... more Positive deviance is increasingly employed in international development activities to permit the utilization of proven local solutions. Including positive deviance methods in evaluation analysis, particularly in places like Bihar, India, where the rates of child underweight hover at 55%, can help identify project activities and household characteristics that affect key outcomes. These can, in turn, inform decision-making regarding the intensification of particularly promising activities. To apply positive deviance analysis to the Dular program in Bihar, a community-based nutrition program that seeks to improve the impact of India's Integrated Child Development Services on young children. In order to assure that desired program outcomes were not dependent on higher economic status, the analysis isolated a subset of program beneficiaries--the poorest children with the best nutritional outcomes--and examined the behavioral and project factors that may have brought about positive re...
A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was c... more A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was carried out in rural areas of Punjab State in India 30 years after the original study, and following a period of rapid economic growth. The original 1971 study had found a high prevalence of mortality and malnutrition and the worst gender difference in nutritional status ever recorded in an Indian study. The 2001 follow-up study found dramatic reductions in child mortality, child malnutrition, gender-based imbalances in child well-being and care, and family size, the result of participatory economic growth coupled with broad-based educational, health, and family-planning services. Despite overall improvements in caloric intake, however, 40% of lower-class children in 2001 were still consuming less than 50% of their caloric allowance. With minimal gender-based abortion and significantly reduced neglect and mortality offemale children, gender balance among children in this area of rural Pun...
Page 1. Generating Further Reductions of Child Malnutrition in India&amp;amp;#x27;s BIMARU St... more Page 1. Generating Further Reductions of Child Malnutrition in India&amp;amp;#x27;s BIMARU States: What are the Options Now? F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink ... F. James Levinson, Jessica Barney, Lucy Bassett, Werner Schultink Introduction ...
... Micronutrient Deficiencies Deficiencies in key vitamins and minerals— especially iron, vitami... more ... Micronutrient Deficiencies Deficiencies in key vitamins and minerals— especially iron, vitamin A, zinc ... malnutrition have used two primary strategies: supplementation and food fortification, with some ... crops to boost mi-cronutrient content, as with Golden Rice fortified with vitamin ...
The common practice of reducing food consumption during pregnancy is recognized as a primary caus... more The common practice of reducing food consumption during pregnancy is recognized as a primary cause of poor pregnancy outcomes and, in turn, malnutrition among young children in many developing countries including Bangladesh. This paper analyzes data from the 1998 Mid-Term Evaluation of the Bangladesh Integrated Nutrition Project (BINP) to identify the determinants of pregnancy food consumption. The analysis found that
During the past fifteen years, there has been a significant increase in efforts to monitor and ev... more During the past fifteen years, there has been a significant increase in efforts to monitor and evaluate large scale nutrition projects. This, in turn, stems from an increased appreciation of the importance of M&E in such projects, and from more stringent demands being made by donors. This paper seeks to draw some lessons from this experience drawing on a large number of projects for which M&E documentation is available. These include the Tamil Nadu Integrated Nutrition Project in South India, the Bangladesh Integrated Nutrition Project, the Iringa Project in Tanzania, the Posyandu projects in Indonesia, the Integrated Child Development Service (ICDS) program in India, the UNICEF-assisted Dular project in Bihar state in India, the HKI Nutrition Focused Child Survival Project in Mali, the CARE-assisted Child Survival Project in Nicaragua, the Enhanced Outreach Strategy of the Ethiopian Child Survival Project, Save the Children (US) positive deviance-based projects in Vietnam and its J...
OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolesc... more OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolescents in Sub Saharan Africa. A significant gender difference in adolescent nutritional status has been observed in several developing country studies, with boys appearing to be twice as undernourished as girls. We sought to examine the associations among undernutrition, gender, and sexual maturation in a sample of adolescents from Tanzania. METHODS: This cross-sectional study examined the nutritional status of 670 individuals aged 10-19 years from 28 villages in Kilosa District, Tanzania. Undernutrition was defined as BMI for Age <5th percentile of the NCHS/WHO reference. Logistic regression models tested associations between gender, sexual maturation, and the outcome variable, undernutrition. We also included an interaction term to represent the cross-product of male and mid-adolescence, a period associated with peak linear growth. RESULTS: The prevalence of undernutrition in this sam...
Food insecurity is highly prevalent in many developing countries, with negative implications for ... more Food insecurity is highly prevalent in many developing countries, with negative implications for the health and well-being of affected populations. At the community level, household food security status is affected by inequitable distribution and access to foods. Within households, variation in food allocation influences individual nutritional adequacy. Researchers have argued that age, gender, or household status in developing country societies may influence parents' preferential allocation of food and health care. Examination of intra-household food distribution is pivotal to understanding differential nutritional outcomes among household members. The relationship between adolescent dietary intakes in the context of household food security status in less-developed countries is not well understood. Presently the bulk of intra-household food allocation research focuses on unequal distribution between males and females and between adults and young children. We examined data from ...
Positive deviance is increasingly employed in international development activities to permit the ... more Positive deviance is increasingly employed in international development activities to permit the utilization of proven local solutions. Including positive deviance methods in evaluation analysis, particularly in places like Bihar, India, where the rates of child underweight hover at 55%, can help identify project activities and household characteristics that affect key outcomes. These can, in turn, inform decision-making regarding the intensification of particularly promising activities. To apply positive deviance analysis to the Dular program in Bihar, a community-based nutrition program that seeks to improve the impact of India's Integrated Child Development Services on young children. In order to assure that desired program outcomes were not dependent on higher economic status, the analysis isolated a subset of program beneficiaries--the poorest children with the best nutritional outcomes--and examined the behavioral and project factors that may have brought about positive re...
A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was c... more A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was carried out in rural areas of Punjab State in India 30 years after the original study, and following a period of rapid economic growth. The original 1971 study had found a high prevalence of mortality and malnutrition and the worst gender difference in nutritional status ever recorded in an Indian study. The 2001 follow-up study found dramatic reductions in child mortality, child malnutrition, gender-based imbalances in child well-being and care, and family size, the result of participatory economic growth coupled with broad-based educational, health, and family-planning services. Despite overall improvements in caloric intake, however, 40% of lower-class children in 2001 were still consuming less than 50% of their caloric allowance. With minimal gender-based abortion and significantly reduced neglect and mortality offemale children, gender balance among children in this area of rural Pun...
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