Suaahara: Evaluation of the Impact of a Multisectoral Nutrition Program in Nepal

Objective:
Suaahara is an integrated nutrition program in Nepal that uses a comprehensive, household-based approach to improve access to, and consumption of, nutritious foods in areas with very poor nutrition indicators. Its main objective is to improve the nutritional status of pregnant and lactating women and children under two years of age directly addressing the vulnerable points of development which result in stunting. The program will focus on improving nutrition; maternal, newborn, and child health (MNCH) services; family planning services; water, sanitation and hygiene; and home-based gardening. Behavior change communications and continued support for micronutrient supplementation will be key components of Suaahara’s strategy. The program will also work with health facilities to improve nutritional counseling and care services and connect families to reproductive health and MNCH services. One of the distinguishing elements of Suaahara is the integration of various sectors—including agriculture—to achieve improved nutrition for vulnerable populations.

Approach:
Suaahara is designed to assess at the project-level the impact it had on child stunting and anemia (among children under five years of age), infant and young child feeding practices (among children 0-24 months of age).

The evaluation design for Suaahara is based on a district and village level longitudinal study (where baseline and endline are carried out in the same districts and villages) with matching at two levels: 1) matching districts at the time of sampling and design, and 2) matching individual households at the time of impact analysis. The baseline survey for this evaluation will be done in 2012 and it is anticipated that an endline survey will be done in 2015.

Timeline: 2011-2016

Geographical Coverage: Nepal

Assessment of Public Health Impact of Sprinkles in Bangladesh

Objective:
Assess the public health impact of using Sprinkles within an existing network of community-based health workers who are a part of BRAC's Essential Health Care program in Bangladesh that sells Sprinkles in communities and provide information on their use.

Approach:
The project will investigate the feasibility and operational aspects of using Sprinkles, testing the primary hypothesis that a door-to-door market-based approach to distributing Sprinkles will reduce anemia among infants and young children and improve infant and young child feeding practices in Bangladesh, when compared to no micronutrient intervention, or when compared to behavior change communication promoting local foods.

There are multiple benefits anticipated from the study findings. Firstly, this study will provide the first-ever evidence on the impact of a market-based strategy to improve diet quality through micronutrient Sprinkles in a South Asian context. In the political economy of infant and young child feeding in South Asia, generating more evidence on the potential of micronutrient powders and market-based strategies can help inform the policy dialogue around the use of home fortification. Secondly, the study will generate a solid understanding of the factors that can “make or break” a market-based approach to improving diet quality. This second benefit will be achieved through the planned thoughtful and rigorous process evaluation carried out by IFPRI.

Timeline: 2009-2013

Geographical Coverage: Bangladesh

Partnerships and Opportunities to Strengthen and Harmonize Actions for Nutrition in India (POSHAN)

POSHAN ProjectObjective:
POSHAN aims to build evidence on effective actions for nutrition and support the use of evidence in decision-making in India by bringing diverse stakeholders together and actively facilitating dialogue that moves knowledge into practice.  POSHAN will build on existing initiatives, action networks, consortia and coalitions, with the primary goal of strengthening evidence-based dialogue and action. POSHAN has two major objectives:  (1) Analyze direct and indirect nutrition-relevant interventions to generate knowledge on optimal approaches that address major bottlenecks to improve maternal and child nutrition outcomes in India; (2) Mobilize evidence-based and actionable knowledge to inform policy formulation and support program planning for nutrition at the national level and in 3-4 key states.

Approach:
Proposed activities under objective 1 include the following:  development of a framework for analysis, review of key program successes and synthesis of program experiences that can be replicated; field assessment of 4-6 program innovations judged to be the most transferable with the highest potential for impact; experimental studies of 2-3 core operational innovations to rigorously pressure-test them in current implementation systems. Proposed activities under objective 2 include the following:  engagement with State and Central Government level policy makers, and a core of strategic partners in early consultations, program reviews, field assessments, and field experiments; convening of a wide knowledge mobilization and learning community for stakeholders implementing or evaluating actions to accelerate the reductions in undernutrition; establishment and maintenance of a knowledge management system to bring together, in one virtual space, critical learning about program successes and failures in India.

IFPRI’s monitoring and evaluation approach will have two main focus areas. First, will routinely monitor progress on activities together with primary stakeholders and advisory members using a variety of project specific documents, reports, and network evolution. Second, IFPRI will ensure a keen focus on learning regarding processes through which networks of policy and program stakeholders engage with evidence and move evidence into practice, and on how behaviors are influenced. IFPRI will use state-of-the-art methods from the policy sciences to build this learning into the project, also engaging with eminent researchers in the nutrition policy sciences and health policy.

Timeline: 2011-2015

Geographical Coverage: India

Transform Nutrition (TN)

Transform Nutrition programObjective:
The Transform Nutrition research programme consortium is a six-year programme of research, capacity strengthening and policy communications led by the International Food Policy Research Institute. The consortium includes the International Centre for Diarrhoeal Disease Research, Bangladesh, the Institute of Development Studies, UK, Public Health Foundation of India, Save the Children, UK, University of Nairobi, Kenya. Transform Nutrition will address the following key questions:

  • How can direct nutrition-specific interventions targeted to a window of opportunity be appropriately prioritized, implemented, scaled up and sustained in different settings?
  • How can social protection, agriculture, and women’s empowerment interventions have a greater impact on improving nutrition during the window of opportunity?
  • How can an enabling environment be promoted, and existing and enhanced political and economic resources be used most effectively to improve nutrition?

Timeline:  2011-2017

Geographical Coverage: India, Bangladesh, Ethiopia, Kenya

Alive and Thrive

Alive and Thrive ProgramObjective:
Alive and Thrive is three country initiative that combats global child undernutrition through the promotion of appropriate infant and young child feeding (IYCF) practices, using Vietnam, Ethiopia and Bangladesh as demonstration countries. This initiative is built on evidence showing the importance of good nutrition in the first 2 years of life. The Alive and Thrive program implements large-scale interventions and policy awareness initiatives to address the behavioral, social and policy barriers to optimal infant and young child feeding (IYCF) practices in these three countries.

Approach:
IFPRI’s role in this program, which is led by the Academy for Educational Development (AED), is to evaluate the impact and cost-effectiveness of integrated approaches to improving IYCF practices and childhood stunting. Impact evaluations in all three countries use rigorous impact evaluation methods, including randomization where possible, and process evaluations which will provide insight into how program impacts are achieved. In addition, evaluation research in all three countries will include research on policy processes, since one of the major objectives of the Alive and Thrive programs is to influence the policy environment for optimal IYCF practices.

Timeline: December 2008- December 2014

Geographical Coverage: Bangladesh, Vietnam and Ethiopia

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