scholarly journals The impact of a Solar Market Garden programme on dietary diversity, women’s nutritional status and micronutrient levels in Kalalé district of northern Benin

2019 ◽  
Vol 22 (14) ◽  
pp. 2670-2681 ◽  
Author(s):  
Halimatou Alaofè ◽  
Jennifer Burney ◽  
Rosamond Naylor ◽  
Douglas Taren
Keyword(s):  
Nutritional Status ◽  
Dietary Diversity ◽  
Nutrition And Health ◽  
Difference In Differences ◽  
Percentage Points ◽  
Quasi Experimental ◽  
Gender Based ◽  
Solar Powered ◽  
The Impact ◽  
Health Programmes

AbstractObjective:To examine the impacts of a Solar Market Garden 1-year solar-powered drip irrigation (SMG) programme in Kalalé district of northern Benin on mothers’ nutritional status and micronutrient levels.Design:Using a quasi-experimental design, sixteen villages were assigned to four groups: (i) SMG women’s groups (WG); (ii) comparison WG; (iii) SMG non-WG (NWG); and (iv) comparison NWG. Difference-in-differences (DID) estimates were used to assess impacts on mothers’ food consumption, diversity, BMI, prevalence of underweight (BMI < 18·5 kg/m2) and anaemia, and deficiencies of iron (ID) and vitamin A (VAD).Setting:Kalalé district, northern Benin.Participants:Non-pregnant mothers aged 15–49 years (n 1737).Results:The SMG programme significantly increased mothers’ intake of vegetables (DID = 25·31 percentage points (pp); P < 0·01), dietary diversity (DID = 0·74; P < 0·01) and marginally increased their intake of flesh foods (DID = 10·14 pp; P < 0·1). Mean BMI was significantly increased among SMG WG compared with the other three groups (DID = 0·44 kg/m2; P < 0·05). The SMG programme also significantly decreased the prevalence of anaemia (DID = 12·86 pp; P < 0·01) but no impacts were found for the prevalence of underweight, ID and VAD.Conclusions:Improving mothers’ dietary intake and anaemia prevalence supports the need to integrate gender-based agriculture to improve nutritional status. However, it may take more than a year, and additional nutrition and health programmes, to impact the prevalence of maternal underweight, ID and VAD.

scholarly journals Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial

2020 ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Weight Status ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Dietary Diversity Score ◽  
Cluster Randomized ◽  
The Impact

Abstract Background: Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children's diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods: A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. ANOVA and descriptive statistics were used to analyzed data. Results: At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p<0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p=0.001). Conclusions: NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial Registration: Clinicaltrials.gov #NCT02638571

Improving Access to Delivery Care and Reducing the Equity Gap Through Voucher Program in Bangladesh: Evidence From Difference-in-Differences Analysis

2018 ◽  
Vol 38 (2) ◽  
pp. 137-145
Author(s):  
Kaji Tamanna Keya ◽  
Benjamin Bellows ◽  
Ubaidur Rob ◽  
Charlotte Warren
Keyword(s):  
Population Based ◽  
Public Health Facility ◽  
Difference In Differences ◽  
Voucher Program ◽  
Percentage Points ◽  
Null Effect ◽  
Demand Side Financing ◽  
Quasi Experimental ◽  
And Control

To test a statistically significant change in delivery by medically trained providers following introduction of a demand-side financing voucher, a population-based quasi-experimental study was undertaken, with 3,300 mothers in 2010 and 3,334 mothers at follow-up in 2012 in government-implemented voucher program and control areas. Results found that voucher program was significantly associated with increased public health facility use (difference-in-differences (DID) 13.9) and significantly increased delivery complication management care (DID 13.2) at facility although a null effect was found in facility-based delivery increase. A subset analysis of the five well-functioning facilities showed that facility deliveries increased DID 5.3 percentage points. Quintile-based analysis of all facilities showed that facility delivery increased more than threefold in lower quintile households comparing to twofold in control sites. The program needs better targeting to the beneficiaries, ensuring available gynecologist–anesthetist pair and midwives, effective monitoring, and timely fund reimbursements to facilities.

scholarly journals A quasi-experimental study estimating the impact of long-lasting insecticidal nets with and without piperonyl butoxide on pregnancy outcomes

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Michelle E. Roh ◽  
Brenda Oundo ◽  
Grant Dorsey ◽  
Stephen Shiboski ◽  
Roly Gosling ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Low Birthweight ◽  
Pyrethroid Resistance ◽  
Controlled Trial ◽  
Piperonyl Butoxide ◽  
Difference In Differences ◽  
Quasi Experimental ◽  
The Impact ◽  
Long Lasting Insecticidal Nets ◽  
In Pregnancy

Abstract Background Long-lasting insecticidal nets (LLINs) are the main vector control tool for pregnant women, but their efficacy may be compromised, in part, due to pyrethroid resistance. In 2017, the Ugandan Ministry of Health embedded a cluster randomized controlled trial into the national LLIN campaign, where a random subset of health subdistricts (HSDs) received LLINs treated with piperonyl butoxide (PBO), a chemical synergist known to partially restore pyrethroid sensitivity. Using data from a small, non-randomly selected subset of HSDs, this secondary analysis used quasi-experimental methods to quantify the overall impact of the LLIN campaign on pregnancy outcomes. In an exploratory analysis, differences between PBO and conventional (non-PBO) LLINs on pregnancy outcomes were assessed. Methods Birth registry data (n = 39,085) were retrospectively collected from 21 health facilities across 12 HSDs, 29 months before and 9 months after the LLIN campaign (from 2015 to 2018). Of the 12 HSDs, six received conventional LLINs, five received PBO LLINs, and one received a mix of conventional and PBO LLINs. Interrupted time-series analyses (ITSAs) were used to estimate changes in monthly incidence of stillbirth and low birthweight (LBW; <2500 g) before-and-after the campaign. Poisson regression with robust standard errors modeled campaign effects, adjusting for health facility-level differences, seasonal variation, and time-varying maternal characteristics. Comparisons between PBO and conventional LLINs were estimated using difference-in-differences estimators. Results ITSAs estimated the campaign was associated with a 26% [95% CI: 7–41] reduction in stillbirth incidence (incidence rate ratio (IRR) = 0.74 [0.59–0.93]) and a 15% [-7, 33] reduction in LBW incidence (IRR=0.85 [0.67–1.07]) over a 9-month period. The effect on stillbirth incidence was greatest for women delivering 7–9 months after the campaign (IRR=0.60 [0.41–0.87]) for whom the LLINs would have covered most of their pregnancy. The IRRs estimated from difference-in-differences analyses comparing PBO to conventional LLINs was 0.78 [95% CI: 0.52, 1.16] for stillbirth incidence and 1.15 [95% CI: 0.87, 1.52] for LBW incidence. Conclusions In this region of Uganda, where pyrethroid resistance is high, this study found that a mass LLIN campaign was associated with reduced stillbirth incidence. Effects of the campaign were greatest for women who would have received LLINs early in pregnancy, suggesting malaria protection early in pregnancy can have important benefits that are not necessarily realized through antenatal malaria services. Results from the exploratory analyses comparing PBO and conventional LLINs on pregnancy outcomes were inconclusive, largely due to the wide confidence intervals that crossed the null. Thus, future studies with larger sample sizes are needed.

scholarly journals The effectiveness of interventions on nutrition social behaviour change communication in improving child nutritional status within the first 1000 days: Evidence from a systematic review and meta-analysis

2021 ◽  
Author(s):  
Rashidul Alam Mahumud ◽  
Sophiya Uprety ◽  
Nidhi Wali ◽  
Andre M.N. Renzaho ◽  
Stanley Chitekwe
Keyword(s):  
Systematic Review ◽  
Nutritional Status ◽  
Dietary Diversity ◽  
Meta Analysis ◽  
Grey Literature ◽  
Child Feeding ◽  
Random Effects Models ◽  
Young Child Feeding ◽  
Child Nutritional Status ◽  
The Impact

Abstract This systematic review and meta-analysis aimed to assess the robustness of designs and tools used in NSBCC interventions and establish their effectiveness. EBSCOhost as an umbrella database including Medline (Ovid) and CINAHL, EMBASE and ProQUEST databases were searched for peer-reviewed articles from January 1960 to October 2018. Additional sources were searched to identify all relevant studies including grey literature. Studies’ biases were assessed according to Cochrane handbook. Pooled estimate of effectiveness of interventions on infant and young child feeding (IYCF) practices and child nutritional status with 95% confidence intervals were measured using random-effects models. Eighty studies were included in this review: Fifty-one (64%) were cluster randomised trials (RCTs), 13 (16%) were RCTs and 16 (20%) quasi-experimental. Of the included studies, 22 (27%) measured early initiation of breastfeeding, 38 (47%) measured exclusive breastfeeding, 29 (36%) measured minimum dietary diversity, 21 (26%) measured minimum meal frequency, 26 (32%) measured HAZ, 23 (29%) measured WHZ, 27 (34%) measured WAZ, 20 (25%) measured stunting, 14 (17%) measured wasting, and 11 (14%) measured underweight. The overall intervention’s effect was significant for EBF (OR = 1.73; 95% CI: 1.35–2.11, p < 0.001), HAZ (Standardized Mean Differences, SMD = 0.19; 95% CI: 0.17–0.21; p < 0.001), WHZ (SMD = 0.02; 95% CI: 0.004 to 0.04; p < 0.001), and WAZ (SMD = 0.04; 95% CI: 0.02 to 0.06; p < 0.001). Evidence shows the effectiveness of NSBCC in improving EBF and child anthropometric outcomes. Further research should test the impact on child nutritional status with clearly specified and detailed NSBCC interventions.

scholarly journals Impact of the Salud Mesoamerica Initiative on delivery care choices in Guatemala, Honduras, and Nicaragua

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Bernardo Hernandez ◽  
Katie Panhorst Harris ◽  
Casey K. Johanns ◽  
Erin B. Palmisano ◽  
Rebecca Cogen ◽  
...  
Keyword(s):  
Health Facility ◽  
Delivery Care ◽  
Care Services ◽  
Percentage Points ◽  
Quasi Experimental ◽  
Facility Level ◽  
The One ◽  
The Impact ◽  
Salud Mesoamérica Initiative

Abstract Background The Salud Mesoamérica Initiative (SMI) is a public-private collaboration aimed to improve maternal and child health conditions in the poorest populations of Mesoamerica through a results-based aid mechanism. We assess the impact of SMI on the staffing and availability of equipment and supplies for delivery care, the proportion of institutional deliveries, and the proportion of women who choose a facility other than the one closest to their locality of residence for delivery. Methods We used a quasi-experimental design, including baseline and follow-up measurements between 2013 and 2018 in intervention and comparison areas of Guatemala, Nicaragua, and Honduras. We collected information on 8754 births linked to the health facility closest to the mother’s locality of residence and the facility where the delivery took place (if attended in a health facility). We fit difference-in-difference models, adjusting for women’s characteristics (age, parity, education), household characteristics, exposure to health promotion interventions, health facility level, and country. Results Equipment, inputs, and staffing of facilities improved after the Initiative in both intervention and comparison areas. After adjustment for covariates, institutional delivery increased between baseline and follow-up by 3.1 percentage points (β = 0.031, 95% CI -0.03, 0.09) more in intervention areas than in comparison areas. The proportion of women in intervention areas who chose a facility other than their closest one to attend the delivery decreased between baseline and follow-up by 13 percentage points (β = − 0.130, 95% CI -0.23, − 0.03) more than in the comparison group. Conclusions Results indicate that women in intervention areas of SMI are more likely to go to their closest facility to attend delivery after the Initiative has improved facilities’ capacity, suggesting that results-based aid initiatives targeting poor populations, like SMI, can increase the use of facilities closest to the place of residence for delivery care services. This should be considered in the design of interventions after the COVID-19 pandemic may have changed health and social conditions.

scholarly journals Eating More but Not Better at School? Impacts of Boarding on Students’ Dietary Structure and Nutritional Status in Rural Northwestern China

2018 ◽  
Vol 10 (8) ◽  
pp. 2753 ◽  
Author(s):  
Qihui Chen ◽  
Chunchen Pei ◽  
Qiran Zhao
Keyword(s):  
Nutritional Status ◽  
Dietary Diversity ◽  
School Students ◽  
Policy Makers ◽  
Diet Diversity ◽  
Food And Agriculture ◽  
Rich Food ◽  
Food And Agriculture Organization ◽  
Protein Rich ◽  
The Impact

While the impact of boarding on students’ development has attracted considerable attention from researchers and policy makers, rigorous analysis of students’ food consumption behavior and nutritional status has been rare. This study fills this gap by analyzing data on nearly 7600 rural primary school students from two northwestern Chinese provinces, using students’ home-to-school distance as an instrumental variable for their boarding status. Our estimation results suggest that boarding significantly reduces students’ dietary diversity, as measured by a Diet Diversity Score constructed following guidelines provided by the Food and Agriculture Organization of the United Nations. While the reduced dietary diversity does not undermine students’ overall nutrition intake, as measured by their body mass index (BMI) for age, it does increase their probability of being anemic. Further investigation reveals that boarders consume significantly less protein-rich food and significantly more carbohydrate-rich food than their non-boarding counterparts.

scholarly journals Scaled-up nutrition education on pulse-cereal complementary food practice in Ethiopia: a cluster-randomized trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demmelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Dietary Diversity Score ◽  
End Point ◽  
Cluster Randomized ◽  
The Impact

Abstract Background Improving children’s weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers’ knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children’s diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midpoint, and end point. ANOVA and descriptive statistics were used to analyzed data. Results At baseline and end point, maternal KAP and the dietary diversity score of the children (mean age at end point 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p < 0.001) at midpoint and end point compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p = 0.001). Conclusions NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial registration Clinicaltrials.gov #NCT02638571. Date of registration: 12/18/2015. Prospectively registered.

scholarly journals Pandemics and protectionism: evidence from the “Spanish” flu

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nina Boberg-Fazlic ◽  
Markus Lampe ◽  
Maja Uhre Pedersen ◽  
Paul Sharp
Keyword(s):  
Standard Deviation ◽  
World War ◽  
Difference In Differences ◽  
Standard Deviation Increase ◽  
Percentage Points ◽  
The First World War ◽  
Macroeconomic Impact ◽  
Spanish Flu ◽  
The Impact ◽  
First World

AbstractThe impact of COVID-19 on recent tendencies towards international isolationism has been much speculated on but remains to be seen. We suggest that valuable evidence can be gleaned from the “Spanish” flu of 1918–20. It is well-known that the world fell into a protectionist spiral following the First World War, but scholars have almost exclusively ignored the impact of the pandemic. We employ a difference-in-differences strategy and find that the flu had a significant impact on trade policy, independent of the war. In our preferred specification, a one standard deviation increase in excess deaths during the outbreak implied 0.022 percentage points higher tariffs subsequently, corresponding to an increase of one third of a standard deviation in tariffs. Health policy should aim to avoid the experience of the interwar period and consider the international macroeconomic impact of measures (not) taken.

scholarly journals Nutrition Education of Mothers and Zinc Supplementation among Children in the Rural Community, Cameroon

2021 ◽  
pp. 59-69
Author(s):  
Nicolas Policarpe Nolla ◽  
Marie Modestine Kana Sop ◽  
Marlyne Joséphine Mananga ◽  
Inocent Gouado
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Rural Community ◽  
Maternal Education ◽  
Zinc Supplementation ◽  
Dietary Diversity ◽  
Public Health Problem ◽  
Baseline Survey ◽  
Control Group ◽  
The Impact

Aims: Malnutrition among children, especially stunting is a public health problem in Cameroon. This study assesses the impact of zinc supplementation of children and nutrition education of mothers on the nutritional status of the children in the Bangang rural community. Study Design: This was a descriptive and prospective study. Place and Duration of Study: The study took place in the Bangang community in the Region of West Cameroon, during the period from March to December 2015. Methodology: The children aged 6 to 48 months and mothers aged 20 to 34 years were selected after the baseline survey and enrolled. Dietary surveys were used to evaluate the frequency of foods consumed by 150 children. Zinc supplementation group of children (ZSG, n= 25) received 10 mg of zinc sulfate tablets per day for 14 days and control group (CG, n=25) was formed by children whose mothers received nutrition counseling. The nutrition education sessions organized into 4 modules were conducted quarterly for 9 months on a sample of 100 mothers. After interventions, impact of zinc supplementation and maternal education was assessed by determining height for age and weight for age indices, and biochemistry parameters. Results: The results showed that zincemia of ZSG varied significantly (P = .0001) and not significantly (P = .23) for CG. After nutrition education, dietary diversity was improved; reduction of chronic malnutrition (10.9%) and increasing number of children with good nutritional status (6.6%) were observed. Increased for phosphoremia (3.6 ± 2.4 to 5.7 ± 1.8 mg/dl; P = .001) and albuminemia (34.8 ± 15.5 to 46.9 ± 8.9 g/l; P = .002) were significant which was not the case of calcemia, zincemia, magnesemia and serum iron. Conclusion: This study showed positive impact of zinc supplementation and maternal education on the nutritional status of children.

scholarly journals COVID-19 Vaccination Mandates and Vaccine Uptake

2021 ◽  
Author(s):  
Alexander Karaivanov ◽  
Dongwoo Kim ◽  
Shih En Lu ◽  
Hitoshi Shigeoka
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Vaccine Uptake ◽  
Difference In Differences ◽  
Vaccination Rates ◽  
Series Analysis ◽  
Percentage Points ◽  
Canadian Provinces ◽  
The Impact ◽  
Approach Time

Abstract We evaluate the impact of government mandated proof of vaccination requirements for access to public venues and non-essential businesses on COVID-19 vaccine uptake. We find that the announcement of a mandate is associated with a rapid and significant surge in new vaccinations (more than 60% increase in weekly first doses) using the variation in the timing of these measures across Canadian provinces in a difference-in-differences approach. Time-series analysis for each province and for France, Italy and Germany corroborates this finding, and we estimate cumulative gains of up to 5 percentage points in provincial vaccination rates and 790,000 or more first doses for Canada as a whole as of October 31, 2021 (5 to 13 weeks after the provincial mandate announcements). We also find large vaccination gains in France (3 to 5 mln first doses), Italy (around 6 mln) and Germany (around 3.5 mln) 11 to 16 weeks after the proof of vaccination mandate announcements.JEL codes: I18, I12, C23

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