Improving Nutritional Status Through Behavioral Change: Lessons from Madagascar

This brief summarizes the results of a gender impact evaluation study, entitled Improving nutritional status through behavioral change : lessons from Madagascar, conducted between 1999 and 2002 in Madagascar. The study observed the impact of large-scale intervention that focuses on the quality of nutritional and child care inputs during the early stages of life. The empirical strategy uses a combination of double-difference and weighting estimators in a longitudinal survey to address the purposive placement of participating communities and estimates the effect of the availability of the program at the community level on nutritional outcomes on the child level. The program significantly improved weight for age z- scores and reduced the proportion of children who were underweight. The program improved the weight for age z-score by 0.15 to 0.22 standard deviations and reduced the incidence of underweight by 5.2 to 7.6 percentage points. The program also led to a significant reduction in stunting. The evidence suggests that these effects indicate significant impacts on longer-term nutritional outcomes. There is some heterogeneity in program impacts, more educated and wealthier mothers reap more benefits from the program. Funding for the study derived from the World Bank Research Grant Community Nutrition: Evaluation of Impacts in Africa.