Evaluation Overview and Results
- Problem: Children under five years old in Nepal suffer from one of the highest rates of malnutrition and stunting in the world, and women generally don’t gain enough weight during pregnancy. The Government of Nepal wants to improve young children’s development, especially cognitive and physical, by strengthening the nutritional intake of pregnant women and their youngest children. Researchers evaluated the effect of providing information about nutrition and parenting versus providing the same information with an unconditional cash transfer.
- RESULTS: In communities where health workers spoke about nutrition and healthy child development, women’s knowledge improved. The biggest improvement was seen in communities where women also received the cash transfer. Children in these communities who were younger than two years old when the program started showed improvement in fine and gross motor skills.
- TWO YEARS LATER: The research team went back into these communities in late 2016 to test whether improvements continued as the original group of children neared primary school age. The researchers found that in areas where women received cash and information, they were more likely to know about and be implementing appropriate health and nutrition practices. However, gains children showed previously had disappeared.
- NEXT STEPS: Researchers are interested in looking at why improving mothers’ knowledge and behavior was not enough to lead to sustained child development gains.
Research area: Early Childhood Nutrition, Development, and Health
Evaluation Sample: 78 rural community clinics and 2574 households
Timeline: 2013 - 2016 (Completed)
Intervention: Nutrition, Information. Stimulation, Health
Researchers: Gayatri Acharya, World Bank; Prashant Bharadwaj, University of California, San Diego; Michael Levere, University of California, San Diego; Bishnu Bahadur Thapa, World Bank; Karishma Wasti, World Bank; Kanchan Tamang, Poverty Alleviation Fund; Frauke Jungbluth; Jasmine Rajbhandary
Pregnant women and young children need nutritious food for healthy development, especially in the first 1,000 days of life (from conception through the age of two). Without the right nutrition, children can become malnourished and their growth gets stunted. This damage, which affects the body and the brain, is often irreparable and can hurt children’s development forever.
Policymakers often use conditional cash transfers to improve family’s income flow and make it easier for them to buy the food they need. But imposing conditions doesn’t always lead to behavior change, and it doesn’t ensure that families spend the money on healthy and nutritious food, or that it’s shared equally among those who need it. Imposing conditions on cash transfers also requires high administrative capacity and resources, which can be costly and difficult for some states to handle. This intervention looks at the impact of providing nutrition and parenting information to families, along with unconditional cash transfers, which are easier to implement because they don’t have conditions that need to be monitored.
Nepal has made considerable progress in reducing deaths among pregnant women and children, but chronic malnutrition among pregnant women and children is still a problem. Nepal’s economy is estimated to lose up to 3 percent annually in gross domestic product because of the economic effects of malnutrition on economic development.
Nepal’s government has run a number of campaigns to raise awareness on the importance of a balanced diet, proper sanitation and hygiene, breastfeeding, and other health matters. The results have been mixed. The Government needs to understand to what extent lack of family income perpetuates malnutrition, and whether cultural and social practices in Nepal are in part responsible. This evaluation will help the government better understand what can be done to improve nutrition and child development.
|In Nepal, 46.7 percent of children under five are stunted.
(Nepal Living Standard Survey for 2010/11)