Nepal

Overview

The Nutrition Innovation Lab focuses on three major over-arching research questions:

  1. In what ways do investments in agriculture achieve significant measurable impacts in nutrition? As a corollary, can pathways to impact be empirically demonstrated?
  2. How can large-scale programs best incorporate such knowledge into cost-effective multi-sectoral interventions aimed at improving nutrition?
  3. How can policy and program implementation processes be enhanced to support both nutrition-specific and nutrition-sensitive actions?

These three overarching questions form the framework for a host of nested studies that are generating concrete evidence that responds to priority developing country concerns while supporting the goals of USAID’s Feed the Future initiative. The research is pursued in ways that seek to enhance policymaker understanding of how to overcome constraints in policy and program design and implementation, while also producing global public goods in the form of new scientific knowledge of relevant and diverse settings.

Research Activities

PoSHAN Community Studies in Nepal

The Policy and Science for Health Agriculture and Nutrition (PoSHAN) Community Studies is a large dataset of over 40,000 person-visits conducted during four annual, nationally representative surveys (2013-2016). Four seasonal surveys in district sites were designed, led, and overseen by the Johns Hopkins University (JHU) team through collaborative NGOs in Nepal (New ERA and NTAG) across the mountains, hills and Terai of the country.

PoSHAN Policy and Governance within Nutrition and Agriculture

The PoSHAN policy process survey collected data from roughly 500 government and non-government civil servants and other professionals at various administrative tiers across Nepal in the same areas as the PoSHAN Community Studies.  The goal is to measure and understand the role of enhanced ‘nutrition governance’ in meeting the goals of policies seeking to enhance nutrition. 

Action Against Malnutrition through Agriculture (AAMA)

The AAMA program was implemented by the Helen Keller International in the three districts of Western Nepal from 2009 through 2012, with the period of implementation being the longest in Kailali followed by Baitadi and Bajura districts. All three districts were exposed to at least one program component, that is, the homestead food gardening (HFP). A qualitative survey was conducted by the Nutrition Innovation Lab using focus group discussions and in-depth interview methods from 114 AAMA program implementers and beneficiaries across three intervention districts of Nepal. The survey rolled out in January 2017 and was completed in February 2017.

The research contributes to better understanding of the linkages and agriculture to nutrition impact pathways. This research includes the Nutrition Lab’s innovative focus on policy implementation efficiency, measuring the capacity of implementing partners at the front-line level, and changes in household nutrition outcomes.

Diet Diversity and Iron Status of Pregnant Women and their Offspring

Harvard SPH partners together with Tribhuvan University’s Institute of Medicine are working to improve the ability to measure diet and link it to indicators of malnutrition among children and women in a Nepali context, capture shifts in dietary consumption that may be happening in a peri-urban setting in Nepal, and build applied skills and knowledge related to nutrition and nutritional epidemiology at all levels.

Ages and Stages Questionnaire (ASQ)

Collaborating with Heifer International, Tufts University, the Institute of Medicine at Tribhuvhan University and the University of Bergen, Norway, researchers from Harvard T.H. Chan School of Public Health are field testing a tool called the Ages and Stages Questionnaire (ASQ) in the context of a remote rural setting in the far Western region of Nepal. The tool is used to assess the developmental progress of children between the ages of one month and 5 1/2 years and has two main virtues: it’s ease-of-use and parent-centric approach. The main goal of the study is to test whether a locally adapted tool (translated into Nepali and adapted to the context of rural Nepal) can be administered by trained enumerators in a village setting at the homes of households. If successful the tool can be used to broaden our understanding of the linkages between nutritional and exposures and early childhood development. Data collection is complete and researchers are currently analyzing the data.

AflaCohort Study

Collaborating with Helen Keller International, the Patan Academy of Health Sciences and the Government of Nepal Ministry of Health and Population Department of Health Services Child Health Division, Tufts University researchers launched the AflaCohort study on December 6th, 2015 in 17 VDCs of the Banke district in the mid Western region of Nepal. This birth cohort aims to further the understanding of the causal relationship between past and current aflatoxin exposure (maternal and infant), birth outcomes and length-for-age in Nepali infants and young children. The study will also seek to validate the use of low cost data collection methods (e.g. dried blood spots versus venous blood samples) for aflatoxin analysis.

Child Nutrition in Nepal: The Effects of Community Development Interventions and Nutrition Education on Health and Nutrition Outcomes

During years 1 and 2 of the Nutrition Innovation Lab baseline and basic longitudinal data have been collected assessing the success of Heifer International Nepal’s community livestock programming approach on improving nutritional outcomes in intervention groups. Based upon positive results from the initial project, research will continue to build a larger database of longitudinal data, introduce a nutrition curriculum, and understand more clearly how provision of livestock, animal husbandry training, and building of social capital each interact with the improvements in health and nutritional status being observed in the study population.

Local Contact

Kedar Prasad Baral
Project Investigator, Nutrition Innovation Lab
Professor of Public Health
Department of Community Health Sciences
Patan Academy of Health Sciences
P.O. Box No. 26500
Kathmandu, Nepal
Lagankhel, Lalitpur
Nepal

Dale Davis
Investigator, Nutrition Innovation Lab
Helen Keller International Nepal Country Director
tel: 977-1-5260459, 5260247, 5260837 | fax: 977-1-5260459 | ddavis@hki.org | Skype: dale.davis21
Helen Keller International Nepal| Green Block, Ward No. 10, Chakupat, Lalitpur | P.O. Box: 3752
www.hki.org | https://www.facebook.com/HelenKellerInternational