Publication:
Improving Women’s Leadership for Strengthening Health and Nutrition Outcomes in Nagaland, India: Lessons from a Process Evaluation of Community Action for Health and Nutrition

Loading...
Thumbnail Image
Files in English
English PDF (867.65 KB)
150 downloads
English Text (12.63 KB)
17 downloads
Date
2019-07
ISSN
Published
2019-07
Editor(s)
Abstract
Under the term “communitization,” in 2002 the state government of Nagaland transferred responsibility for local services to Village Councils and sector specific Committees. In the health sector, Village Health Committees were made responsible for management of local health services, including salary payment as well as use of small funds transferred by the state government. Some 1,300 Village Health Committees have been constituted and their level of functionality varies widely, with many hardly active. In 2016, the World Bank-financed NagalandHealth Project included a US 15 million dollar component to provide technical and financial support to strengthen implementation of the communitization strategy. With the objective of improving participation and leadership of women for planning and managing health and nutrition services in the community, the project mandates that all committees appoint a woman Co-chair, in addition to a Chair (who could be a man or woman). The project was initially piloted in 30 villages across two districts, and has been scaled-up in a phased matter since late 2017 to about 450 sites in all 11 districts of the state.
Link to Data Set
Citation
“World Bank Group. 2019. Improving Women’s Leadership for Strengthening Health and Nutrition Outcomes in Nagaland, India: Lessons from a Process Evaluation of Community Action for Health and Nutrition. Health, Nutrition and Population Knowledge Brief,no. 6;. © World Bank. http://hdl.handle.net/10986/32149 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Situational Analysis Improving Economic Outcomes by Expanding Nutrition Programming in Tajikistan
    (World Bank, Washington, DC, 2012-02-08) World Bank; UNICEF
    Undernutrition in Tajikistan remains an important public health challenge, albeit a hidden problem. Stunting, iodine deficiency, and maternal and child anemia represent the largest burden of undernutrition in Tajikistan. In 2009, around 29 percent of children in all regions of the country were stunted. Iodine deficiency was observed in 53 percent of children and in 58.6 percent of women. The national prevalence of anemia in children was 28.8 percent; however, rates were as high as 39.8 percent in Ghorno-Badakhshan Autonomous Province and in 32 percent directly ruled districts (DRD). The prevalence of anemia among mothers was 24.2 percent. The long-term effects of these conditions negatively affect the health of adults throughout their life, as well as their potential productivity in the work force and possible economic contribution to the nation. The highest priority interventions will improve infant and young child feeding. Strengthening and scaling up breastfeeding promotion will save lives and help to reduce stunting as would complementary feeding for babies six months and older. Promoting exclusive breastfeeding for infants under six months is the most efficacious intervention to save lives, averting nearly 20 percent of deaths in children under-five. Effective programs need to be designed to make more women aware of the benefits of breastfeeding and sound nutrition. A comprehensive, multi-sector approach is needed to ensure success of these interventions. This report also makes several other recommendations including: supplementing pregnant women with either iron folic acid or multiple micronutrients, maintain twice-annually vitamin A supplementation, implementing a deworming program, support for flour fortification, scale up and maintain zinc for the management of diarrhea, and address the underlying and basic causes of undernutrition through other sectors.
  • Publication
    Improving Effectiveness and Outcomes for the Poor in Health, Nutrition, and Population : An Evaluation of World Bank Group Support since 1997
    (Washington, DC: World Bank, 2009) Independent Evaluation Group
    This evaluation aims to inform the implementation of the most recent the World Bank and International Finance Corporation (IFC) health, nutrition, and population (HNP) strategies to enhance the effectiveness of future support. It covers the period since fiscal year 1997 and is based on desk reviews of the portfolio, background studies, and field visits. The evaluation of the HNP support of the World Bank focuses on the effectiveness of policy dialogue, analytic work, and lending at the country level, while that of IFC focuses on the performance of health investments and advisory services before and after its 2002 health strategy. The themes it covers are drawn from the two strategies and the approaches adopted by international donors in the past decade. Independent Evaluation Group (IEG) has previously evaluated several aspects of the Bank's HNP support. IFC's support for the health sector has never been fully evaluated. Many lessons have been learned over the past decade about the successes and pitfalls of support for health reform: First, the failure to assess fully the political economy of reform and to prepare a proactive plan to address it can considerably diminish prospects for success. Political risks, the interests of key stakeholders, and the risk of complexity- issues the evaluation case studies found to be critical are often neglected in risk analysis in project appraisal documents for health reform projects. Second, reforms based on careful prior analytic work hold a greater chance of success, but analytic work does not ensure success. Third, the sequencing of reforms can improve political feasibility, reduce complexity, ensure that adequate capacity is in place, and facilitate learning. When implementation is flagging, the Bank can help preserve reform momentum with complementary programmatic lending through the Ministry of Finance, as it did in Peru and the Kyrgyz Republic. Finally, monitoring and evaluation are critical in health reform projects-to demonstrate the impact of pilot reforms to garner political support, but also because many reforms cannot work without a well-functioning management information system.
  • Publication
    Improving Child Nutrition Outcomes in India : Can the Integrated Child Development Services Program Be More Effective?
    (World Bank, Washington, DC, 2005-06) Das Gupta, Monica; Lokshin, Michael; Gragnolati, Michele; Ivaschenko, Oleksiy
    Levels of child malnutrition in India fell only slowly during the 1990s, despite significant economic growth and large public spending on the Integrated Child Development Services (ICDS) program, of which the major component is supplementary feeding for malnourished children. To unravel this puzzle, the authors assess the program's placement and its outcomes using National Family Health Survey data from 1992 and 1998. They find that program placement is clearly regressive across states. The states with the greatest need for the program - the poor northern states with high levels of child malnutrition and nearly half of India's population - have the lowest program coverage and the lowest budgetary allocations from the central government. Program placement within a state is more progressive: poorer and larger villages have a higher probability of having an ICDS center, as do those with other development programs or community associations. The authors also find little evidence of program impact on child nutrition status in villages with ICDS centers.
  • Publication
    Gender-inclusive Nutrition Activities in South Asia : Volume 2. Lessons from Global Experiences
    (World Bank, Washington, DC, 2013-04) Lesser Blumberg, Rae; Dewhurst, Kara; Sen, Soham G.
    This paper examines promising approaches from a wide array of literatures to improve gender-inclusive nutrition interventions in South Asia. It is the second of a series on gender and nutrition in South Asia. The first paper explored why gender matters for undernutrition in the region and conducted a mapping of regional nutrition initiatives to find that gender is too narrowly addressed in most programs if at all. Adequately addressing gender2 requires nutrition programs to focus not only on health services and information for the mother and her children, but also on her autonomy and the support she receives from her partner, other household members, and the broader community. This focus is especially important for adolescent mothers in the region, who have very low status. The present study drew from the conceptual framework of the previous paper and investigated four types of innovations in nutrition initiatives that address gender. These entail promoting: (1) women s household autonomy; (2) household support for the woman and her own and her children s nutrition; (3) community support for the woman and her own and her children s nutrition; and (4) help for adolescent girls. Though the ideal "gender-inclusive nutrition interventions" package (GINI for short) was never found, based on the findings of this review, it can be described. Indeed, it is quite consonant with this study s conceptual framework. The most effective programs would encompass the following "success factors": (a) ensure that the targeted women not only earn but control income (as in the HKI homestead garden projects in Bangladesh, Nepal and Cambodia); (b) get the powerful members of young married women s households - men and paternal grandmothers - on board by means of peer advocacy and community-oriented programs that (c) provide them with information on nutrition and women s child welfare-focused spending patterns, (d) as well as (small) incentives so they don t seize control of income or marketable food generated by those women. These programs also would (e) train forward-looking local women (including grandmothers) and men for volunteer roles (preferably with small incentives for sustainability). (f) They would provide BCC on nutrition and help increase support by community leaders, religious figures and members for young women s livelihoods as well as mother/child nutrition. (g) Finally, the ideal GINI would also target teen girls, offering them nutrition information, along with incentives to parents to keep them in school and programs for the girls to earn money. Positive examples encountered in the literature are presented below (along with some partial successes that need further refinement). If polished and scaled up, such programs could put a big dent in the "South Asian Enigma" and both the gender inequities and malnutrition that define it.
  • Publication
    Institutional Arrangements for Nutrition in India : An Assessment of Capacity
    (World Bank, Washington, DC, 2014-03) Kathuria, Ashi Kohli; Orbach, Eliezer; Anand, Deepika
    The report consists of the following seven chapters. The present chapter provides the context and the rationale for the study, and outlines the methodology. Chapter two describes the nutrition system in detail and discusses the capacity issues related to the division of labor (DoL) between the two primary programs of the nutrition system and within the Integrated Child Development Services, or ICDS. Chapter three delves into the factors that constrain leadership capacity at all levels chapter four discusses the key capacity constraints related to HR that limit the effective delivery of nutrition services. Chapter five discusses the training system as a sub-system of HR and its capacity constraints, and Chapter six covers the capacity assessment pertaining to monitoring, evaluation and management of information in the nutrition system. Chapter seven discusses the capacity constraints related to General Management Practices, or GMPs in the ICDS, especially focusing on supervision, accountability and work practices and procedures.

Users also downloaded

Showing related downloaded files

  • Publication
    The Journey Ahead
    (Washington, DC: World Bank, 2024-10-31) Bossavie, Laurent; Garrote Sánchez, Daniel; Makovec, Mattia
    The Journey Ahead: Supporting Successful Migration in Europe and Central Asia provides an in-depth analysis of international migration in Europe and Central Asia (ECA) and the implications for policy making. By identifying challenges and opportunities associated with migration in the region, it aims to inform a more nuanced, evidencebased debate on the costs and benefits of cross-border mobility. Using data-driven insights and new analysis, the report shows that migration has been an engine of prosperity and has helped address some of ECA’s demographic and socioeconomic disparities. Yet, migration’s full economic potential remains untapped. The report identifies multiple barriers keeping migration from achieving its full potential. Crucially, it argues that policies in both origin and destination countries can help maximize the development impacts of migration and effectively manage the economic, social, and political costs. Drawing from a wide range of literature, country experiences, and novel analysis, The Journey Ahead presents actionable policy options to enhance the benefits of migration for destination and origin countries and migrants themselves. Some measures can be taken unilaterally by countries, whereas others require close bilateral or regional coordination. The recommendations are tailored to different types of migration— forced displacement as well as high-skilled and low-skilled economic migration—and from the perspectives of both sending and receiving countries. This report serves as a comprehensive resource for governments, development partners, and other stakeholders throughout Europe and Central Asia, where the richness and diversity of migration experiences provide valuable insights for policy makers in other regions of the world.
  • Publication
    Argentina Country Climate and Development Report
    (World Bank, Washington, DC, 2022-11) World Bank Group
    The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.
  • Publication
    World Development Report 2006
    (Washington, DC, 2005) World Bank
    This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.
  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    Lebanon Economic Monitor, Fall 2022
    (Washington, DC, 2022-11) World Bank
    The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.