Journal Articles

Nutrition Smoothing: Can Proximity to Towns and Cities Protect Rural Children against Seasonal Variation in Agroclimatic Conditions at Birth?

Published: January 2017 Authors: Amelia F. Darrouzet-Nardi, Willliam A. Masters Journal: Plos One
A large literature links early-life environmental shocks to later outcomes. This paper uses seasonal variation across the Democratic Republic of the Congo to test for nutrition smoothing, defined here as attaining similar height, weight and mortality outcomes despite different agroclimatic conditions at birth. We find that gaps between siblings and neighbors born at different times of year are larger in more remote rural areas, farther from the equator where there are greater seasonal differences in rainfall and temperature. For those born at adverse times in...

Food insecurity, but not HIV-infection status, is associated with adverse changes in body composition during lactation in Ugandan women of mixed HIV status

Published: January 2017 Authors: Elizabeth Widen, Claire Biribawa, Daniel Acidri, Winifred Achoko, Harriet Achola, Jeffrey Griffiths, Sera Young Journal: The American Journal of Clinical Nutrition
A cohort of 246 women [36.5% of whom were HIV positive (HIV+) and were receiving ART] were followed to 12 mo postpartum. Repeated measures included weight, fat mass, fat-free mass, mid upper arm circumference, triceps skin fold thickness [which allowed for the derivation of arm muscle area (AMA) and arm fat area (AFA)], breastfeeding, and individual food insecurity. Longitudinal regression models were constructed to assess associations between HIV and food insecurity and changes in body composition over time.

Markets, transportation infrastructure and food prices in Nepal

Published: December 2016 Authors: Gerald Shively, Ganesh Thapa Journal: American Journal of Agricultural Economics
We study transportation infrastructure and food markets in Nepal over the period 2002 to 2010, combining monthly price data from 37 local and regional markets and 7 Indian border markets. We use a series of autoregressive models to study price determination, spatial and temporal price transmission, and price variance. We account for district-level agricultural production, correcting for bi-directional causality between output and prices using ground station rainfall data. In addition, to test hypotheses regarding the importance of transportation infrastructure we incorporate information on road and...

Climatic conditions and child height: Sex-specific vulnerability and the protective effects of sanitation and food markets in Nepal

Published: December 2016 Authors: Prajula Mulmi, William A. Masters Journal: Science Direct
Abstract Environmental conditions in early life are known to have impacts on later health outcomes, but causal mechanisms and potential remedies have been difficult to discern. This paper uses the Nepal Demographic and Health Surveys of 2006 and 2011, combined with earlier NASA satellite observations of variation in the Normalized Difference Vegetation Index (NDVI) at each child’s location and time of birth to identify the trimesters of gestation and periods of infancy when climate variation is linked to attained height later in life. We find...

Optimizing the Multisectoral Nutrition Policy Cycle: A Systems Perspective

Published: December 2016 Authors: Sascha Lamstein, Amanda Pomeroy-Stevens, Patrick Webb, Eileen Kennedy Journal: Food and Nutrition Bulletin
Based on the data collected in Uganda, Nepal, and Ethiopia, the papers included in this supplement fill a critical gap in evidence regarding multisectoral National Nutrition Action Plans. The studies offer new data and new thinking on how and why governance, effective financial decentralization, and improved accountability all matter for nutrition actions in low-income countries. This introductory paper offers an overview of the current state of evidence and thinking on the multisectoral nutrition policy cycle, including how governance and financing support that process. It also...

Implementing Multisector Nutrition Programs in Ethiopia and Nepal: Challenges and Opportunities From a Stakeholder Perspective

Published: December 2016 Authors: Eileen Kennedy, Shibani Gosh, Kedar Baral, Dale Davis, Diplav Sapkota, Patrick Webb Journal: Food and Nutrition Bulletin
Effective governance is essential for effective nutrition program implementation. There are additional challenges in launching multisector plans to enhance nutritional status. The present study compares the challenges and opportunities in Ethiopia and Nepal in designing and implementing a multisector plan for nutrition. A semi-quantitative questionnaire with open-ended questions was used to solicit information from senior national-level policy officials and other key stakeholders. The nature of the major nutrition problems in each country was similar; these include malnutrition (particularly stunting), food insecurity, and micronutrient malnutrition. The...

Prioritizing and Funding the Uganda Nutrition Action Plan

Published: December 2016 Authors: Amanda Pomeroy-Stevens, Hannah Foehringer Merchant, Abel Muzoora, Ezekiel Mupere, Lidan Du Journal: Food and Nutrition Bulletin
In 2010, Uganda began developing its first multisectoral nutrition plan, the Uganda Nutrition Action Plan (UNAP), to reduce malnutrition. While the UNAP signals high-level commitment to addressing nutrition, knowledge gaps remain about how to successfully implement such a plan. We tracked the UNAP’s influence on the process of priority setting and funding for nutrition from 2013 to 2015

Assessing Progress in Implementing Uganda’s Nutrition Action Plan: District-Level Insights

Published: December 2016 Authors: Edgar Agaba, Shibani Ghosh, Jeffrey K. Griffiths Journal: Food and Nutrition Bulletin
The 2011 Uganda Nutrition Action Plan (UNAP) established 2016 maternal and child nutrition targets. However, there is a lack of routine district-level data collection to assess UNAP implementation.  The Nutrition Innovation Lab collected serial household-level survey data (n = 3600) in 6 districts, including 2 UNAP implementation districts, in 2012 and 2014. Questionnaires focused on food security, nutrition, and health, among others, and included specific indicators relevant to UNAP’s targets.

Prioritizing and Funding Nepal’s Multisector Nutrition Plan

Published: December 2016 Authors: Amanda Pomeroy-Stevens, Kusum Hachhethu, Indu Sharma, Jolene Wun Journal: Food and Nutrition Bulletin
Nepal has a long tradition of designing good multisectoral nutrition policy. However, success of policy implementation has varied. More evidence on how to successfully carry out multisector nutrition policy is needed. This study used a mixed-method longitudinal design to track qualitative and budgetary changes related to MSNP processes nationally as well as in 3 districts. Qualitative changes in each study area were assessed through interviews, observation, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation...

Measuring Nutrition Governance: An Analysis of Commitment, Capability, and Collaboration in Nepal

Published: December 2016 Authors: Patrick Webb, Grace Namirembe, Sabi Gurung, Diplav Sapkota, Winnie Fay Bell, Eileen Kennedy, Shailes Neupane, Swetha Manohar, Kedar Baral Journal: Food and Nutrition Bulletin
Global commitments to nutrition have supported calls for better evidence to support effective investments at national level. However, too little attention has so far been paid to the role of governance in achieving impacts. This article explores the ways by which the commitment and capabilities of policy implementers affect collaborative efforts for achieving nutrition goals.