35 research outputs found
Take-home rations in the Integrated Child Development Services (ICDS): Study of coverage and uptake in Tamil Nadu
No full textIntegrated Child Development Services (ICDS), a flagship program of the Government of India, offers nutrition services to support child development. One major component of ICDS is the Supplementary Nutrition Program (SNP), which provides take-home rations for all children under 6 years of age and pregnant and lactating women to bridge the calorie and protein gaps in their diets. Current SNP guidelines recommend providing the rations in the form of micronutrient-fortified food or energy-dense food to bridge the nutrient gap between the Recommend Dietary Allowance and Average Daily Intake (MoWCD 2014). In Tamil Nadu, the take-home rations are a fortified-blended product called Sathumaavu. Coverage of take-home rations in Tamil Nadu is above the national average for all beneficiary groups, but variability across districts is high (IIPS and ICF 2021). Little is known about household use of Sathumaavu, perceptions of its quality, or its integration into standard diets. This study, a collaboration between LEAD at Krea University and the International Food Policy Research Institute (IFPRI) with the Government of Tamil Nadu, explored the uptake and use of Sathumaavu among women and children across the state. The study aimed to: • Assess the uptake and use of the ICDS-provided Sathumaavu in Tamil Nadu• Examine demand- and supply-side factors related to the coverage and use of SathumaavuNon-PR2 Promoting Healthy Diets and Nutrition for all; IFPRI1; POSHAN; DCANutrition, Diets, and Health (NDH); Food and Nutrition Polic
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
Moderate accuracy of survey responses about infant and young child feeding counseling reported by mothers with children less than one year of age in India
No full textBackground: Counseling on infant and young child feeding (IYCF) to support optimal breastfeeding and complementary feeding practices is an essential intervention, and accurate coverage data is needed to identify gaps and monitor progress. However, coverage information captured during household surveys have not yet been validated.
Objectives: We examined the validity of maternal report of IYCF counseling received during community-based contacts and factors associated with reporting accuracy.
Methods: Direct observations of home visits conducted by community workers in 40 villages in Bihar, India, served as the “gold standard” to maternal report of IYCF counseling received during 2-week follow-up surveys (n=444 mothers with children less than 1 year of age, interviews matched to direct observations). Individual-level validity was assessed by calculating sensitivity, specificity, and area under ROC curve (AUC). Population-level bias was measured using the inflation factor (IF). Multivariable regression models were used to examine factors associated with response accuracy.
Results: Prevalence of IYCF counseling during home visits was very high (90.1%). Maternal report of any IYCF counseling received in the past 2 weeks was moderate (AUC=0.60, 95% CI: 0.52, 0.67), and population bias was low (IF=0.90). However, recall of specific counseling messages varied. Maternal report of any breastfeeding, exclusive breastfeeding, and dietary diversity messages had moderate validity (AUC>0.60), but other child feeding messages had low individual validity. Child age, maternal age, maternal education, mental stress, and social desirability were associated with reporting accuracy of multiple indicators.
Conclusions: Validity of IYCF counseling coverage was moderate for several key indicators. IYCF counseling is an information-based intervention that may be received from various sources, and it may be challenging to achieve higher reporting accuracy over a longer recall period. We consider the modest validity results as positive and suggest that these coverage indicators may be useful for measuring coverage and tracking progress over time.PRIFPRI3; ISI; 2 Promoting Healthy Diets and Nutrition for all; DCA; DataDENTPHND; Nutrition, Diets, and Health (NDH); Food and Nutrition Polic
State nutrition profile: Punjab
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
State nutrition profile: Haryana
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
State nutrition profile: Jharkhand
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
State nutrition profile: Mizoram
No full textThis Data Note describes the trends for a set of key nutrition and health outcomes, determinants, and coverage of interventions. The findings here are based on data from the National Family Health Survey (NFHS) 3 (2005-2006), 4 (2015-2016) and 5 (2019-2020). In addition to standard prevalence-based analyses, this Data Note includes headcount-based analyses, aligned to the POSHAN Abhiyaan monitoring framework and using data from NFHS- 5 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 & men and identifies areas where the state has potential to improve.Non-PRIFPRI1; POSHAN; CRP4; 2 Promoting Healthy Diets and Nutrition for all; DCASAR; PHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
Feeding India’s babies: Insights on trends and patterns from the National Family Health Surveys, 2015-16 to 2019-21
No full textEarly life nutrition sets the stage for the health, nutrition, and development of young children. Optimal infant and young child feeding (IYCF) practices begin with timely initiation of breastfeeding, followed by exclusive breastfeeding and complementary feeding. This Data Note provides an overview of trends and patterns in IYCF practices in India at the national-, state-, and district levels based on the 2015-16 and 2019-21 National Family Health Surveys (NFHS) data. IYCF indicators were created following World Health Organization and UNICEF’s 2021 guidelines.Non-PRIFPRI1; POSHAN; 2 Promoting Healthy Diets and Nutrition for all; CRP4Nutrition, Diets, and Health (NDH); Food and Nutrition Policy; SAR; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
Disruptions, restorations and adaptations to health and nutrition service delivery in multiple states across India over the course of the COVID-19 pandemic in 2020: An observational study
No full textModeling studies estimated severe impacts of potential service delivery disruptions due to COVID-19 pandemic on maternal and child nutrition outcomes. Although anecdotal evidence exists on disruptions, little is known about the actual state of service delivery at scale. We studied disruptions and restorations, challenges and adaptations in health and nutrition service delivery by frontline workers (FLWs) in India during COVID-19 in 2020.PRIFPRI4; 2 Promoting Healthy Diets and Nutrition for all; ISI; DCA; POSHANPHN
Using cognitive interviewing to bridge the intent-interpretation gap for nutrition coverage survey questions in India
No full textDesigning survey questions that clearly and precisely communicate the question's intent and elicit responses based on the intended interpretation is critical but often undervalued. We used cognitive interviewing to qualitatively assess respondents' interpretation of and responses to questions pertaining to maternal and child nutrition intervention coverage. We conducted interviews to cognitively test 25 survey questions with mothers (N = 21) with children less than 1 year in Madhya Pradesh, India. Each question was followed by probes to capture information on four cognitive stages—comprehension, retrieval, judgement, and response. Data were analysed for common and unique patterns across the survey questions. We identified four types of cognitive challenges: (1) retention of multiple concepts in long questions: difficulty in comprehending and retaining questions with three or more key concepts; (2) temporal confusion: difficulty in conceptualizing recall periods such as “in the last 6 months” as compared to life stages such as pregnancy; (3) interpretation of concepts: mismatch of information being asked, meaning of certain terms and intervention scope; and (4) understanding of technical terms: difficulty in understanding commonly used technical words such as “breastfeeding” and “antenatal care” and requiring use of simple alternative language. Findings from this study will be useful for stakeholders involved in survey design and implementation, especially those conducting large-scale household surveys to measure coverage of essential nutrition interventions.PRIFPRI3; ISI; CRP4; DataDENTPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH
