Publications

PUBLICATIONS

by IFPRI | June 14, 2019

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Food for thought? Experimental evidence on the learning impacts of a large-scale school feeding program
Aurino, Elisabetta; Gelli, Aulo; Adamba, Clement; Osei-Akoto, Isaac; Alderman, Harold. Madison, WI Article in press

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There is limited experimental evidence on the effects of large-scale, government-led interventions on human capital in resource-constrained settings. We report results from a randomized trial of the government of Ghana’s school feeding. After two years, the program led to moderate average increases in math and literacy standardized scores among pupils in treatment communities, and to larger achievement gains for girls and disadvantaged children and regions. Improvements in child schooling, cognition, and nutrition constituted suggestive impact mechanisms, especially for educationally-disadvantaged groups. The program combined equitable human capital accumulation with social protection, contributing to the “learning for all” sustainable development agenda.

Food consumption–production response to agricultural policy and macroeconomic change in Nigeria
Ecker, Olivier; Hatzenbuehler, Patrick L.. Article in press

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Achieving agricultural transformation and farmer resilience in resource‐dependent developing countries like Nigeria is complicated by volatile macroeconomic conditions, which disrupt agricultural supply chains through income, foreign exchange, and risk‐mitigation effects. This study examines the food consumption–production linkage in Nigeria at a time when the national Agricultural Transformation Agenda was implemented and an economic crisis was unfolding. Many farm households responded to expected shocks by planting more staple foods for own consumption at the expense of agricultural commercialization, income growth, and dietary diversification. A policy initiative to improve access to modern farm inputs appeared to mitigate these adverse effects.

Paying for digital information: Assessing farmers’ willingness to pay for a digital agriculture and nutrition service in Ghana
Hidrobo, Melissa; Palloni, Giordano; Aker, Jenny; Gilligan, Daniel O.; Ledlie, Natasha. Article in press

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The impact of an integrated value chain intervention on household poultry production in Burkina Faso: Evidence from a randomized controlled trial
Leight, Jessica; Awonon, Josué; Pedehombga, Abdoulaye; Ganaba, Rasmané; Martinez, Elena M.; Heckert, Jessica; Gelli, Aulo. Article in press

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Trends and factors associated with the nutritional status of adolescent girls in Ghana: A secondary analysis of the 2003-2014 Ghana Demographic and Health Survey (GDHS) data
Azupogo, Fusta; Abizari, Abdul-Razak; Aurino, Elisabetta; Gelli, Aulo; Osendarp, Saskia J. M.; Bras, Hilde; Feskens, Edith J.; Brouwer, Inge D.. Article in press

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Can information drive demand for safer food? Impact of brand-specific recommendations and test results on product choice
Wairimu Kariuki, Sarah; Hoffmann, Vivian. Article in press

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As an unobservable attribute, food safety is likely to be under-provided by markets where regulatory enforcement is weak. In such settings, stimulating consumer demand for safer food can potentially encourage market actors to invest in food safety. Through a randomized trial in Kenya, we test the impact of informing consumers about which maize flour brands are most likely to comply with the regulatory standard for aflatoxin, a carcinogenic fungal byproduct. Providing information on safer brands alone does not significantly affect consumption behavior. However, when the same information is combined with a test performed on the maize flour stocked by the household, the likelihood that a safer brand is consumed 2 months later is 76% higher than in the comparison group. Our findings suggest that providing information on the relative riskiness of substitute foods could encourage consumers to make safer choices.

World Health Organization and knowledge translation in maternal, newborn, child and adolescent health and nutrition
STAGE (Strategic Technical Advisory Group of Experts); Duke, Trevor; AlBuhairan, Fadia S.; Agarwal, Koki; Arora, Narendra K.; Arulkumaran, Sabaratnam; Bhutta, Zulfiqar A.; Ruel, Marie T.. Article in press

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Understanding the pathways to women’s empowerment in Northern Ghana and the relationship with small-scale irrigation
Bryan, Elizabeth; Garner, Elisabeth. Article in press

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Women’s empowerment is often an important goal of development interventions. This paper explores local perceptions of empowerment in the Upper East Region of Ghana and the pathways through which small-scale irrigation intervention targeted to men and women farmers contributes to women’s empowerment. Using qualitative data collected with 144 farmers and traders through 28 individual interviews and 16 focus group discussions, this paper innovates a framework to integrate the linkages between small-scale irrigation and three dimensions of women’s empowerment: resources, agency, and achievements. The relationship between the components of empowerment and small-scale irrigation are placed within a larger context of social change underlying these relationships. This shows that many women face serious constraints to participating in and benefitting from small-scale irrigation, including difficulties accessing land and water and gender norms that limit women’s ability to control farm assets. Despite these constraints, many women do benefit from participating in irrigated farming activities leading to an increase in their agency and well-being achievements. For some women, these benefits are indirect—these women allocate their time to more preferred activities when the household gains access to modern irrigation technology. The result is a new approach to understanding women’s empowerment in relation to irrigation technology.

Interventions to improve calcium intake through foods in populations with low intake
Bourassa, Megan W.; Abrams, Steven A.; Belizán, José M.; Boy, Erick; Cormick, Gabriela; Quijano, Carolina Diaz; Gibson, Sarah; Gomes, Filomena; Hofmeyr, G. Justus. Article in press

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Calcium intake remains inadequate in many low- and middle-income countries, especially in Africa and South Asia, where average intakes can be below 400 mg/day. Given the vital role of calcium in bone health, metabolism, and cell signaling, countries with low calcium intake may want to consider food-based approaches to improve calcium consumption and bioavailability within their population. This is especially true for those with low calcium intake who would benefit the most, including pregnant women (by reducing the risk of preeclampsia) and children (by reducing calcium-deficiency rickets). Specifically, some animal-source foods that are naturally high in bioavailable calcium and plant foods that can contribute to calcium intake could be promoted either through policies or educational materials. Some food processing techniques can improve the calcium content in food or increase calcium bioavailability. Staple-food fortification with calcium can also be a cost-effective method to increase intake with minimal behavior change required. Lastly, biofortification is currently being investigated to improve calcium content, either through genetic screening and breeding of high-calcium varieties or through the application of calcium-rich fertilizers. These mechanisms can be used alone or in combination based on the local context to improve calcium intake within a population.

Food systems and rural wellbeing: Challenges and opportunities
Woodhill, Jim; Kishore, Avinash; Njuki, Jemimah; Jones, Kristal; Hasnain, Saher. Article in press

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The future wellbeing of billions of rural people is interconnected with transforming food systems for equity, nutrition, environmental sustainability, and resilience. This article tackles three blind spots in the understanding of rural poverty and vulnerability: the narrow focus on extreme poverty and hunger that hides a much wider set of inequalities and vulnerabilities, insufficient recognition of the diversity of rural households, and an inadequate appreciation of the impact of rapid structural changes in markets, the physical environment, and the political economic context. A better understanding of these areas is necessary for imagining a new policy landscape that can align progress on rural poverty alleviation with a wider transformation of food systems. The article provides a framework for assessing the dynamics of rural wellbeing and food systems change. It looks at the viability of small-scale farming and the diversification of livelihood options needed to overcome rural poverty and inequality. The analysis suggests that the future prosperity of rural areas will depend on policy reforms to address market failures in the food system, which currently work against equity, good nutrition and sustainability. Investments will also be needed to enable rural economies to capture greater value from the food system, particularly in the midstream of food distribution, processing and services. The likely future scale and nature of rural poverty and inequality is such that improved social protection and humanitarian relief schemes that support those in crisis or being left behind will still be essential.

Stories of change in nutrition in Burkina Faso 1992–2018: A micro-level perspective
Becquey, Elodie; Sombié, Issa; Touré, Mariama; Turowska, Zuzanna; Buttarelli, Emilie; Nisbett, Nicholas. Article in press

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Looking back at what has effectively improved nutrition may inform policy makers on how to accelerate progress to end all forms of malnutrition by 2030. As under-five stunting declined substantially in Burkina Faso, we analyzed its nutrition story at the micro-level. We conducted a regression-decomposition analysis to identify demographic and health drivers associated with change in height-for-age using longitudinal, secondary, nationally-representative data. We triangulated results with findings from semi-structured community interviews (n = 91) in two “model communities” with a history of large stunting reduction. We found that improvement in immunization coverage, assets accumulation and reduction in open defecation were associated with 23%, 10% and 6.1% of the improvement in height-for-age, respectively. Associations were also found with other education, family planning, health and WASH indicators. Model communities acknowledged progress in the coverage and quality of nutrition-specific and nutrition-sensitive sectoral programs co-located at the community level, especially those delivered through the health and food security sectors, though delivery challenges remained in a context of systemic poverty and persistent food insecurity. Burkina Faso’s health sector’s success in improving coverage of nutrition and healthcare programs may have contributed to improvements in child nutrition alongside other programmatic improvements in the food security, WASH and education sectors. Burkina Faso should continue to operationalize sectoral nutrition-sensitive policies into higher-quality programs at scale, building on its success stories such as vaccination. Community leverage gaps and data gaps need to be filled urgently to pressure for and monitor high coverage, quality delivery, and nutrition impact of agriculture, education, and WASH interventions.

Tensions and coalitions: A new trade agreement affects the policy space for nutrition in Vietnam
Harris, Jody; Hrynick, Tabitha; Thien, Mai Thi My; Huynh, Tuyen; Huynh, Phuong; Nguyen, Phuong Hong; Thow, Anne-Marie. Article in press

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Global trade has shaped food systems over centuries, but modern trade agreements are hastening these changes and making them more complex, with implications for public health and nutrition transition. This study aimed to understand the impact of the 2018 Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) on the policy space for public health nutrition in Vietnam. We conducted comparative document review and key informant interviews, and our analysis drew on a framework of policy space and the theory of advocacy coalitions. We identified 10 CPTPP sections with potential public health nutrition implications; and 50 Vietnamese policies relevant to nutrition having one or more tensions with one or more CPTPP sections. A majority of policy tensions were in sections of the CPTPP relating to technical barriers to trade and government procurement; most tensions related to protecting policy-making from vested interests. Different groups of policy actors hold different beliefs and interests on these issues, and therefore promote different framings and policy approaches. We identified two advocacy coalitions working very separately on issues affecting nutrition policy space: a trade coalition holding the policy position that free trade improves nutrition by default; and a nutrition coalition holding the policy position that nutrition should be explicitly considered in trade policy. The policy space for nutrition in Vietnam has important potential constraints through written policy, and the trade and nutrition coalitions will need to interact more regularly and constructively in order to foresee where these tensions will arise in practice, and create plans for their mitigation. This study adds to global evidence of free trade agreement impacts on nutrition policy space, and we extend previous work by explaining these actor groupings in the policy space through the theory of advocacy coalitions.

Translation of policy for reducing undernutrition from national to sub-national levels in Rwanda
Iruhiriye, Elyse; Olney, Deanna K.; Frongillo, Edward A.; Niyongira, Emmanuel; Nanama, Simeon; Rwibasira, Eugene; Mbonyi, Paul; Blake, Christine E.. Article in press

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Understanding how countries improve children’s nutrition can inform policies and contribute to further improvements. We examined the relationship between improvements in nutrition in Rwanda (1992–2017) and political commitment to- and policy coherence in- nutrition. We reviewed nutrition-relevant Rwandan policies and programs (2000–2018) and conducted 90 semi-structured interviews with national (n = 32), mid-level (n = 38), and community (n = 20) nutrition stakeholders and 40 community-level focus group discussions (FGDs). FGDs and sub-national interviews were conducted in ten purposefully selected districts, five each in which stunting decreased (reduced) and increased or stagnated (non-reduced) between the 2010 and 2014/15 Rwanda Demographic and Health Surveys. Analysis consisted of thematic analysis and the assessment of events, policy developments, and strategies that influenced nutrition in Rwanda, including operationalization of political commitment and policy coherence for nutrition. Political and institutional commitment to nutrition increased in Rwanda as evidenced by the adoption of a multisectoral nutrition policy that was reinforced with national and subnational horizontal coordination platforms. These platforms strengthened multisectoral strategies to address nutrition and supported operational and institutional commitment. The role of mid-level actors in nutrition governance increased as responsibilities for planning, implementing, and monitoring nutrition programs were increasingly delegated to sub-national administrative levels. Variations in policy implementation existed between reduced and non-reduced districts. Despite improvements, challenges remained in coordination, financial commitment, and capacity to address, monitor, and evaluate nutrition. Political commitment to- and policy coherence in- nutrition at the national level are important for improving nutrition, and when reinforced institutionally, can be translated to sub-national levels where implementation occurs.

Four-year effects of a 2-year nutrition- and gender-sensitive agricultural program on women’s nutritional status, knowledge, and empowerment in rural Burkina Faso
Bliznashka, Lilia; Becquey, Elodie; Ruel, Marie T.; Olney, Deanna K.. Article in press

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Seasonality and day-to-day variability of dietary diversity: Longitudinal study of pregnant women enrolled in a randomized controlled efficacy trial in rural Burkina Faso
Hanley-Cook, Giles T.; Argaw, Alemayehu; de Kok, Brenda; Toe, Laeticia Celine; Dailey-Chwalibóg, Trenton; Huybregts, Lieven. Article in press

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Background: Panel data indicates that non-pregnant women's dietary diversity fluctuates across climatic seasons in low- and middle income countries. The natural day-to-day variability in food group consumption during gestation is unknown.
Objective: A longitudinal study was conducted, among pregnant women enrolled in the MISAME-III randomized controlled efficacy trial [i.e., daily fortified balanced energy-protein supplement and iron-folic acid (IFA) tablet vs IFA tablet only], to investigate the number of 24-h recalls required to estimate usual prenatal food group (FG) diversity and the seasonality of pregnant women's dietary diversity in Houndé, Burkina Faso.
Methods: FG consumption was assessed twice weekly by qualitative list-based 24-h recalls among 1,757 pregnant women (892 control, 865 intervention). The number of days needed to estimate a women's usual prenatal 10-point FG diversity score was calculated using the within-subject coefficient of variation. Regression models, including truncated Fourier series, were fitted to assess seasonal variations in the FG diversity score and the probability of reaching Minimum Dietary Diversity for Women (MDD-W; i.e., ≥5 FGs).
Results: The monthly mean FG scores (<5 FGs) and MDD-W prevalence (<45%) were low. Five list-based recalls allowed observed FG diversity to lie within 15% of the true mean in 90% of the estimations (mean ± SD: 40.4 ± 20.7 recalls per woman). Both the FG diversity score and prevalence achieving MDD-W showed responsiveness to seasonal variations with peaks at the end of the dry season (i.e., April/May) and troughs in the rainy season (i.e., August). Conclusions: Five list-based recalls are sufficient to estimate usual FG diversity during gestation; although intra-annual seasonal patterns did modestly affect FG diversity score and MDD-W prevalence. Thus, timing of repeated dietary surveys is critical to ensure non-biased inferences of change and trends in Burkina Faso.

Using scenario-based assessments to examine the feasibility of integrating preventive nutrition services through the primary health care system in Bangladesh
Nguyen, Phuong Hong; Pramanik, Priyanjana; Billah, Sk. Masum; Avula, Rasmi; Ferdous, Tarana; Sarker, Bidhan K.; Rahman, Musfikur; Ireen, Santhia; Mahmud, Zeba; Menon, Purnima; Ash, Deborah. Article in press

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The National Nutrition Services of Bangladesh aims to deliver nutrition services through the primary health care system. Little is known about the feasibility of reshaping service delivery to close gaps in nutrition intervention coverage and utilization. We used a scenario-based feasibility testing approach to assess potential implementation improvements to strengthen service delivery. We conducted in-depth interviews with 31 service providers and 12 policymakers, and 5 focus group discussions with potential beneficiaries. We asked about the feasibility of four hypothetical scenarios for preventive and promotive nutrition service delivery: community-based events (CBE) for pregnant women, well-child services integrated into immunization contacts; CBE for well-children, and well-child visits at facilities. Opinions on service delivery platforms were mixed; some recommended new platforms, but others suggested strengthening existing delivery points. CBE for pregnant women was perceived as feasible, but workforce shortages emerged as a key barrier. Challenges such as equipment portability, upset children and a fast-moving service environment suggested low feasibility of integrating nutrition into outreach immunization contacts. In contrast, CBE and facility-based well-child visits emerged as feasible options, conditional on having the necessary workforce, structural readiness and budget support. On the demand side, enabling factors include using interpersonal communication and involving community leaders to increase awareness, organizing events at a convenient time and place for both providers and beneficiaries, and incentives for beneficiaries to encourage participation. In conclusion, integrating preventive and promotive nutrition services require addressing current challenges in the health system, including human resource and logistic gaps, and investing in creating demand for preventive services.

The ambivalent links between internal migration and food security in Uganda
Mekonnen, Daniel A.; Soma, Katrine; Ruben, Ruerd. Article in press

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This study examines the drivers for and consequences of internal migration to household food security in Uganda. Based on the Ugandan National Panel Surveys conducted between 2010/11 and 2015/16, we estimate differences in food energy adequacy of households receiving internal migrants from elsewhere. Besides food energy consumption, this study applies household food consumption score (FCS) and looks at vulnerability in terms of household’s expenditures on food. This enables to explore (a) the extent to which food insecurity is driving internal migration, and (b) whether remittances can reduce food security of the remitter. We find that households are usually worse-off when migrants join the receiving family. This seems a departure from previous studies that tend to find welfare gains to internal migration, mostly due to changes in expenditures or dietary consumption without considering any thresholds for achieving food security. Based on these findings and responding to rising youth employment challenges associated with rapidly growing urban slums in Uganda, policies that simultaneously support employment creation in both urban and rural areas are urgently needed to enable better steering of the flow of voluntary migration and to help ensuring food security.

Using outcome trajectory evaluation to assess HarvestPlus’ contribution to the development of national biofortification breeding programs
Douthwaite, Boru; Johnson, Nancy L.; Wyatt, Amanda. Washington, DC 2022

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While the key role that policy plays in sustainable development has long been recognized, rigorously documenting the influence of research on policy outcomes faces conceptual, empirical and even political challenges. Addressing these challenges is increasingly urgent since improving policies—broadly defined—is at the heart of the structural transformation agenda. This paper describes the use of a new evaluation method—outcomes trajectory evaluation (OTE), based on both evaluation and policy process theory—to explore the influence of HarvestPlus, a large and complex research for development program focused on improving nutrition, on a specific policy outcome, namely the establishment of crop biofortification breeding programs in national agricultural research institutes in Bangladesh, India and Rwanda. The findings support claims of significant HarvestPlus contributions to the establishment of the programs while also raising issues that need to be monitored moving forward to ensure sustainability. The paper also discusses the pros and cons of the OTE approach in terms of both methodological rigor and program learning. In particular, the fact that HarvestPlus is a long-running program allows us to reflect on how a “backward looking” approach such as OTE builds on and complements the more “forward looking,” theory of change-based approaches that informed HarvestPlus programming and evaluation during its earlier, highly-successful phases. Such a long-run perspective is rare in development evaluation and it offers important lessons for how to think about and plan for evaluation over the course of a complex agriculture research for development program.

Livelihoods, poverty, and food insecurity in Myanmar: Survey evidence from June 2020 to December 2021
Myanmar Agriculture Policy Support Activity (MAPSA). Washington, DC 2022

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Ten rounds of the Rural-Urban Food Security Survey (RUFSS) have been conducted between June 2020 and December 2021 to assess the impacts of Myanmar’s economic, political, and health crises on various dimensions of household welfare. RUFSS interviews about 2000 mothers of young children per round from urban Yangon, the rural Dry Zone, and recent migrants from these areas.

A major food transfer program in Bangladesh fell short during the COVID-19 pandemic
Chowdhury, Shyamal K.; Bin Khaled, Muhammad Nahian; Raghunathan, Kalyani; Rashid, Shahidur; Dearlove, Honor. Washington, DC 2022

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Public food transfer programs serve as an important safety net for those facing hunger and food insecurity in both low- and high-income countries around the world. During the COVID-19 pandemic, these programs have become even more crucial, as food insecurity and poverty rates have soared. But lockdowns and other public health restrictions can also disrupt food distribution operations and thus limit their effectiveness.