66 research outputs found
Stakeholders prioritization of climate-smart agriculture interventions: Evaluation of a framework
No full textThis paper presents a framework to prioritize locally suitable climate-smart agricultural (CSA) interventions and implementation suitability assessments with key stakeholders: state and district agriculture departments, extension offices, agriculture research institutions, NGOs and donor agencies, private sector and farmers. Prioritization of appropriate interventions for given contexts is needed to assist relevant stakeholders to make strategic decisions and improve adaptability and efficiency of agriculture production system in the face of climate change and variability.PRIFPRI3; DCA; ISI; CRP7PHNDCGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS
How to support students and the learning process during India’s COVID-19 school closures
No full textThe COVID-19 pandemic has affected 1.6 billion learners worldwide, and school closures could lead to a loss of 0.3–0.9 years of schooling, according to World Bank estimates; a global shutdown of five months could result in lost earnings of $10 trillion over students’ lifetimes. The pandemic’s economic shocks are likely to increase school drop-out rates. Evidence suggests that the poor, girls, and other marginalized groups disproportionately suffer the consequences of school closures.Non-PRIFPRI4; CRP4PHND; DGO; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
Changes in anemia and anthropometry during adolescence predict learning outcomes: Findings from a 3-year longitudinal study in India
No full textBackground: Anemia and poor physical growth during adolescence have far-ranging consequences, but limited longitudinal evidence exists on how changes in these factors relate to changes in learning skills as adolescents mature.
Objectives: We examined the association between changes in anemia and physical growth during adolescence and learning outcomes.
Methods: We used longitudinal data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) project, which surveyed adolescents aged 10–19 years in northern India in 2015–16 and 2018–19 (n = 5963). We used multilevel mixed-effects logistic regression models to examine associations between changes in anemia/thinness/stunting status (four groups: never, improved, new, and persistent) and reading (ability to read a story) and math proficiency (ability to solve division problems) at follow-up.
Results: Persistent anemia and stunting were higher among girls than boys (46% vs.8% and 37% vs. 14%, respectively), but persistent thinness was lower (7% vs. 16%). Improvement in anemia, thinness and stunting was 1.4–1.7 times higher among boys than girls. Boys who were anemic in both waves were 74% (adjusted odds ratio [AOR] 0.26, 95% confidence interval [CI)]: 0.12,0.59) and 65% (AOR 0.35, 95%CI: 0.16,0.76) less likely to be able to read a story and solve division problems, respectively, compared to boys who were non-anemic in both waves. Persistent thinness in boys was negatively associated with both reading (AOR 0.37, 95% CI: 0.21,0.66) and math proficiency (AOR 0.27, 95% CI: 0.16,0.46). Persistent stunting contributed to lower reading and math proficiency in boys and girls (AORs: 0.29 to 0.46). Boys whose anemia or thinness status improved and girls whose stunting status improved had similar learning skills at follow-up as those who were never anemic/thin/stunted.
Conclusions: Persistent anemia, thinness and short stature during adolescence was associated with poor learning. Programs targeted at adolescents should contribute to nurturing environments that foster healthy growth and learning.PRIFPRI3; ISI; POSHAN; 2 Promoting Healthy Diets and Nutrition for all; IFPRIOAPHND; SA
Routine growth monitoring processes in nutrition programs in India have multiple falter points with implications for quality of care
No full textGrowth monitoring (GM) and promotion is a routine part of primary healthcare for children in >80% of countries. In India, 57.5 million children are measured every month by frontline workers to assess their growth and to trigger preventive or curative services. Standard guidance for anthropometry suggests that quality can be compromised by the choice of measurement equipment, placement of equipment, and positioning of children during measurement. Little is known about the quality of measurement processes during GM. We compared child height and weight measurement processes with standards for anthropometry to assess GM quality.Non-PRIFPRI5; CRP4; POSHANPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
Provision and utilization of health and nutrition services during the COVID-19 pandemic in urban Bangladesh
No full textObjectives: The COVID-19 pandemic is expected to have extensive effects on healthcare systems. The Government of Bangladesh has concerns about diminished coverage and quality of maternal and child health services, but little published information exists on service provision, utilization, and adaptations. We examined changes to maternal and child health and nutrition service delivery and utilization in urban Bangladesh during and after the enforcement of COVID-19 restrictions and identified adaptations and potential solutions to strengthen service delivery and uptake.
Methods: We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children < 2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic.
Results: Most services for pregnant women remained available during COVID-19 restrictions, with the provision of antenatal care (ANC) services falling by 6.6 percentage points (pp). Services for women and children which require proximity, however, were more severely affected; weight and height measurements fell by 20–29pp for pregnant women and 37–57pp for children, and child immunizations fell by 38pp. Declines in service utilization were large, including drops in facility visitations (35pp among pregnant women and 67pp among mothers), health and nutrition counseling (up to 73pp), child weight measurements (50pp), and immunizations (61pp). The primary method of adaptation was provision of services over phone (37% for ANC services and 44–49% for counselling of pregnant women or mothers with young children).
Conclusions: Despite adaptations to service provisions, continued availability of routine maternal and child health services did not translate into service utilization. Further investments are needed to provide timely and accurate information on COVID-19 to the public, improve COVID-19 training and provide incentives for health care providers, and ensure availability of personal protective equipment for both providers and beneficiaries.Non-PRIFPRI5; CRP4; POSHAN; Alive and Thrive; 2 Promoting Healthy Diets and Nutrition for allPHND; A4NH; SARCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
Feeding India's babies: Trends and patterns in infant and young child feeding practices across India's states and districts
No full textAppropriate nutrition during early life, coming mainly from adequate infant and young child feeding (IYCF) practices, is essential for optimal growth and development. This Data Note describes the trends and patterns in key IYCF practices and food consumption patterns among children, summarizing state and district data from the third and fourth rounds of National Family Health Surveys (2006 & 2016).Non-PRIFPRI1; POSHAN; CRP4; 2 Promoting Healthy Diets and Nutrition for allPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
India's 2.42 million frontline health workers enable restoration of health and nutrition service delivery after early COVID-19 lockdowns
No full textObjectives: Modeling studies have estimated impacts of potential service delivery disruptions due to COVID-19 pandemic on maternal and child nutrition outcomes, but little is known about actual delivery status. We studied disruptions and restorations of health and nutrition services by frontline workers (FLWs) in India during COVID-19.
Methods: We conducted phone surveys with 5500 FLWs in seven states between August–October 2020, asking about service delivery during April 2020 (T1) and in the August-October period (T2) and analyzed changes between T1 and T2. We also analyzed publicly available administrative data (AD) from 704 districts including the pre-pandemic period (T0) to examine disruptions and restoration of services.
Results: Phone surveys suggest, in T1, opening of village centers, fixed day events, growth monitoring, and immunization services was 33% in >= 3 states. Food supplementation was least disrupted both in T1 and T2. AD highlights geographic variability both in disruptions in T1 compared to T0 and restorations in T2. FLWs’ adaptations to ensure service provision included home delivery (60 to 96%), ensuring physical distancing (33 to 86%), coordinating with other FLWs (7 to 49%), and using phone (∼2 to 65%). Challenges included personal fears, walking long distances, and beneficiaries’ non-cooperation.
Conclusions: Services to mothers and children were disrupted during lockdown and restored thereafter. Rapid policy guidance and local adaptations by a strong cadre of FLWs likely enabled service resumption. However, gaps remain, and more research is needed on use of services by clients.Non-PRIFPRI5; POSHAN; CRP4PHND; A4NH; SARCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
State nutrition profile: Uttarakhand
No full textThis Data Note describes the trends for a set of key nutrition and health outcomes, determinants, and coverage of interventions. The findings are based on estimates using unit-level data, data from national and state reports from the National Family Health Survey (NFHS)-3 (2005-2006) and NFHS-4 (2015-2016), and data from state factsheets and reports from NFHS-5 (2019-2021). In addition to standard prevalence-based analyses, this Data Note includes headcount-based analyses aligned to the POSHAN Abhiyaan monitoring framework to provide evidence that helps identify priority districts and number of districts in the state with public health concern as per the WHO guidelines. The Data Note includes a color-coded dashboard to compare the coverage of nutrition interventions across all the districts in the state. It concludes with key takeaways for children, women, and men, and identifies areas where the state has potential to improve.Non-PRIFPRI1; POSHAN; 2 Promoting Healthy Diets and Nutrition for all; DCAPHND; SA
Anemia in Indian men predicts fewer work hours and lower earnings: Evidence from nationally representative health and labor surveys
No full textAnemia is globally recognized as an important public health problem in women and children, thus the consequences of anemia have predominantly been described in these two groups. India's large population, high anemia prevalence and male-dominated workforce imply that productivity consequences of anemia in men could have large implications. We sought to explore the association between local anemia rates and productivity outcomes in Indian men.Non-PRIFPRI5; CRP4; DCAPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
Teenage birth leads to short stature and anemia: Evidence from a longitudinal study of 10,000 girls in India
No full textObjectives: Home to one in five adolescents globally and a tradition of marrying young, India faces a huge challenge of teenage births. Early birth can be detrimental to the health and wellbeing of the teenage mother and her child, but few studies have followed teenage girls over time to understand these effects. We assessed the impact of early birth on female adolescents' undernutrition status.
Methods: We used longitudinal data collected under a project called UDAYA that surveyed adolescent girls in northern India (Uttar Pradesh and Bihar) in 2015–16, with a follow-up round in 2018–19. Girls with no prior birth in round one were grouped as follows: still no birth in round two (reference group; n = 7,197), birth at age = 19 years by round two (later birth group; LB; n = 1,474). Using multivariate logistic and ordinary least square regression models, we examined whether EB or LB predicted height for age z-score (HAZ), stunting, BMI for age z-score (BMIZ), thinness, hemoglobin (Hb), and anemia. Models were controlled for cluster sampling design and individual and household characteristics.
Results: The prevalence of undernutrition was higher in the EB group (stunting: 53%, thinness: 23%, anemia: 77%) and the LB group (stunting: 55%, thinness: 29%, anemia: 64%) compared to the reference group (stunting: 35%, thinness: 16%, anemia: 63%). The EB group was more likely to be short for their age (adjusted odds ratio (AOR): 1.30, 95% confidence interval (95%CI): 0.96,1.76), thin (AOR: 1.09, 95%CI: 0.68, 1.75), and anemic (AOR: 2.01, 95%CI: 1.39, 2.90) compared to the reference group. HAZ and Hb levels were on average 0.16 SD (95%CI: –0.30, –0.03) and 0.49 gm/DL (95%CI: –0.76, –0.22) lower, respectively, and BMIZ level was 0.22 SD (95%CI: 0.00, 0.43) higher for the EB group. Similar findings were observed for the LB group but were non-significant. The impact of EB on stunting and thinness was non-significant.
Conclusions: In adolescent girls, early birth can contribute to stunting and anemia. Policy initiatives to increase age at marriage and at birth would likely also benefit nutritional outcomes in adolescents.Non-PRIFPRI5; CRP4PHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
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