Session/Event: Double Burden of Malnutrition (Oral 16)

(OR16-08-22) Impact Evaluation of a Community Nutrition and Livelihood Program on Child Nutrition in Rural Bangladesh

On Demand

Presenting Author(s)

YK

Yunhee Kang, PhD

Assistant Scientist
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, United States

Disclosure: Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

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Co-Author(s)

IP

Indira Prihartono

Johns Hopkins School of Public Health
MH

MD.Iqbal Hussein, N/A

World Vision Bangladesh
Dhaka, Dhaka, Bangladesh
JB

Jaganmay Biswas, N/A

World Vision Bangladesh
Dhaka, Dhaka, Bangladesh
SM

Shinhye Min

World Vision Korea
HK

Heeyeon Kim, Ph.D

Independent researcher
Independent Researcher
Pasadena, California, United States
YC

Yoonho Cho, MA

World Vision Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea
SH

Seungheon Han, PhD

Seoul National University
Seoul, Seoul-t'ukpyolsi, Republic of Korea
HK

Hee Sun Kim

Seoul National University

Objectives: Child undernutrition remains high in Bangladesh. Multi-sectoral approaches involving livelihood programs are needed to address the burden of undernutrition. This study examined the impact of an economic development (ED) program receiving poultry assets with/without gardening training added to the Positive Deviant (PD)/Hearth program in rural Bangladesh, compared to the PD/Hearth only (PDH), on child nutrition and health.

Methods: A total of 1,125 children aged 6-13 months with weight-for-age (WAZ) z-score< -1.0 who attended PD/Hearth sessions in September – November 2018 were enrolled in a cohort group in July – August 2019 for the program evaluation. Out of them, 532 were from ED households (PDH/ED). The cohort group was re-assessed in November 2020. A year of program impact between 2019 and 2020 on food security, dietary quality, and health behaviors, accounting for the socio-economic differences between two groups, was estimated using a difference-in-differences approach.

Results: The prevalence of underweight in the PDH and PDH/ED group decreased to 18.6% and 24.7% (p=0.02) in 2019, but increased to 47.7% vs. 56.2% (p=0.003) in 2020 without significant difference in program impact by adding the ED. Compared to the PDH group, the PDH/ED group increased a child dietary diversity score by 0.32 score and minimum dietary diversity (defined as four out of seven food groups) by 13.7 percentage points (pp), and a maternal dietary score by 0.28 score. The PDH/ED increased the proportion of food secured households by 12.6 pp, diversified crop production for banana (9.7 pp), papaya (11.7 pp), carrot (3.8 pp), and lemon (5.9 pp) (all p< 0.05), compared to the PD group. The proportion of households having income ≥ 84000 Taka during the last year increased by 12.4 pp among PDH/ED group, compared to the PDH group (p=0.003). There was no significant impact on child morbidity, maternal hand-washing practices.

Conclusions: Adding an ED program to the PD/Hearth program improved food security and dietary diversity among children and mothers in rural Bangladesh.

Funding Sources: World Vision Bangladesh