Social Protection and Jobs Global Practice, World Bank
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Social Protection and Jobs Global Practice, World Bank
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Last updated September 15, 2023
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Covariate Shocks and Child Undernutrition: A Review of Evidence from Low- and Middle-Income Countries(World Bank, Washington, DC, 2020-06) Debebe, Zelalem Yilma ; Raju, DhushyanthUnexpected adverse events that affect areas or populations widely (covariate shocks) can have major consequences for the welfare of a society. Although the negative effects on households, especially among the poor, are well established in the economics literature, fewer studies have focused on how natural, economic, and social covariate shocks affect individual welfare and particularly child nutrition status. This paper reviews the evidence on the effect of covariate shocks on child nutrition status in low- and middle-income countries, the pathways through which the effect operates, and the relationship between the timing of a child's exposure to a covariate shock and the effect on child nutrition status. The paper also examines whether public interventions can help to mitigate any negative effect and whether the effect of covariate shocks can persist in the long term. Based on findings from the synthesis of evidence, the paper presents considerations and options for public policy and future research.
Publication(World Bank, Washington, DC, 2019-03) Dizon, Felipe ; Josephson, Anna ; Raju, DhushyanthThrough a review of the literature, this paper examines the links of food and agriculture with nutrition in South Asia, a region characterized by a high level of malnutrition. The review finds that the level and stability of food prices play a critical part in food consumption, with rising prices affecting poor households the most. Although public food transfer programs are aimed at addressing this, most are too small to have a marked effect in protecting or promoting nutrition. Several supply-side food and agricultural interventions suggest promise in improving nutrition, although their effects have yet to be well identified. These include the cultivation of home gardens, animal farming, and use of biofortification and post-harvest fortification. All these efforts will be futile, however, without parallel efforts to mitigate the effects of climate change.
Pathways to Better Nutrition in South Asia: Evidence on the Effects of Food and Agricultural Interventions(Elsevier, 2021-03) Dizon, Felipe ; Josephson, Anna ; Raju, DhushyanthIn South Asia, nearly half a billion people are malnourished. This paper examines the links of food and agriculture with nutrition in South Asia, with the goal of informing policy to reduce hunger and malnutrition in the region. We investigate pathways including public food transfer programs, agricultural diversification, and different methods of food fortification. We find that public food transfer programs, used to make food available and affordable to poor households, are often unable to significantly protect or promote nutrition. But several supply-side food and agricultural interventions show promise in improving nutrition, although their effects have yet to be well identified. These include the cultivation of home gardens, animal agriculture, and use of biofortification and post-harvest fortification. All these efforts to reduce hunger and malnutrition will be futile, however, without parallel efforts to mitigate rising challenges in the region, including those posed by climate change, urbanization, food loss and food waste, and food safety hazards.
Publication(Wiley, 2018-11-09) Raju, Dhushyanth ; Kim, Kyoung Yang ; Nguyen, Quynh Thu ; Govindaraj, RameshThis study uses novel household survey data that are representative of Bangladesh's large cities, and of slum and non-slum areas within the cities, to investigate the effects of demographic and socioeconomic factors on child nutrition status in 2013. The study also decomposes the difference in mean child nutrition status between slum and non-slum areas in 2013, and the increase in mean child nutrition status in slum and non-slum areas from 2006 to 2013. Mother's education attainment and household wealth largely explain the cross‐sectional difference and intertemporal change in mean child nutrition status. Although positive in some cases, the effects of maternal and child health services, and potential health‐protective household amenities, on child nutrition status differ by the type of health facility, household amenity, and urban area (slum or non-slum). Focusing on nutrition‐sensitive programs for slum residents and the urban poor is consistent with the results. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions. https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html
Publication(World Bank, Washington, DC, 2017-05) Raju, Dhushyanth ; D'Souza, RitikaPakistan has an extraordinarily high and persistent level of child undernutrition. To effectively tackle the problem, the design of public policies and programs needs to be based on evidence. Toward this end, this paper presents a narrative review of the available empirical and qualitative literature on child undernutrition in Pakistan. It summarizes evidence for the country on, among other things, food consumption, spatial variation and trends in undernutrition rates, levels and effects of generally theorized determinants of undernutrition, and effects of various interventions on undernutrition. Based on patterns revealed in and insights gained from the cumulative evidence, the review lays out considerations and suggestions for further data collection and research, and for policy and practice.
Publication(World Bank, Washington, DC, 2018-11) Torlesse, Harriet ; Raju, DhushyanthPoor breastfeeding and complementary feeding practices predict child stunting and wasting in South Asia, suggesting that initiatives to end undernutrition in the region should focus on improving the diets of young children. This review of the literature finds that South Asia has made relatively good progress in improving breastfeeding practices compared with other regions, but the lack of diversity in complementary foods and low frequency of feeding continue to be problems. Children who are most at risk of experiencing poor feeding include those who are born small, have younger mothers, and live in poorer households or in communities with less access to, or lower uptake of, primary health services. Initiatives to improve feeding practices have not produced substantial improvement, particularly in complementary feeding, because such efforts have lacked the coverage, intensity, comprehensiveness, and continuity needed. Policy, legal, and program actions to protect, promote, and support recommended feeding practices should be informed by situation analyses and formative research on context-specific drivers of poor practices. The actions should involve multiple sectors and stakeholders, including governments, the private sector, communities, and households.
Publication(World Bank, Washington, DC, 2017-06) Raju, Dhushyanth ; Kim, Kyoung Yang ; Nguyen, Quynh T. ; Govindaraj, RameshThis study uses novel household survey data that are representative of Bangladesh's large cities, and of slum and nonslum areas within the cities, to investigate the effects of demographic and socioeconomic factors on early child growth in 2013. The study also decomposes the difference in mean child growth between slum and nonslum areas in 2013, and the increase in mean child growth in slum and nonslum areas from 2006 to 2013. Mother's education attainment and household wealth largely explain the cross-sectional difference and intertemporal change in child growth. Although positive in some cases, the effects of maternal and child health services, and potential health-protective household amenities, differ by the type of health facility, household amenity, and urban area. The results suggest that a focus on nutrition-sensitive programs for slum residents and the urban poor is appropriate.
Publication(Washington, DC: World Bank, 2018) Govindaraj, Ramesh ; Raju, Dhushyanth ; Secci, Federica ; Chowdhury, Sadia ; Frere, Jean-JacquesUrbanization is occurring at a rapid pace in Bangladesh, accompanied by the proliferation of slum settlements, whose residents have special health needs given the adverse social, economic, and public environmental conditions they face. Over the past 45 years, the country’s health and nutrition policies and programs have focused largely on rural health services. Consequently, equitable access of urban populations—particularly the urban poor—to quality health and nutrition services has emerged as a major development issue. However, the knowledge base on urban health and nutrition in Bangladesh remains weak. To address the knowledge gap, Health and Nutrition in Urban Bangladesh: Social Determinants and Health Sector Governance examines the health and nutrition challenges in urban Bangladesh—looking at socioeconomic determinants in general and at health sector governance in particular. Using a mixed methods approach, the study identifies critical areas such as financing, regulation, service delivery, and public environmental health, among others that require policy attention. The study also proposes specific actions within and outside the health sector to address the issues, providing guidance on their sequencing and the specific responsibilities of government agencies and other actors. This study should be useful to policy makers and practitioners working on urban health and nutrition issues in Bangladesh and in other low- and middle-income countries.