Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs

Childhood malnutrition is still a public health concern in Malawi. Since 2013 the government of Malawi (GoM) has been implementing a large-scale multisectoral nutrition program, which expanded to all districts of the country with the World Bank Gro...

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Main Authors: Osendarp, Saskia J.M., Shilpi, Forhad, Gondwe, Timothy, Pangapanga-Phiri, Innocent, Kalimbira, Alexander, Mtimuni, Beatrice, Kafere, Deusdedit, Chuitsi, Gabriella, Phiri, Felix, Hyder, Ziauddin
Format: Working Paper
Language:English
Published: World Bank, Washington, DC 2019
Subjects:
Online Access:http://documents.worldbank.org/curated/en/297601565964816621/Determinants-of-Reductions-in-Childhood-Stunting-n-Malawis-Community-based-Nutrition-Programs
http://hdl.handle.net/10986/32302
id okr-10986-32302
recordtype oai_dc
spelling okr-10986-323022021-05-25T09:27:26Z Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs Osendarp, Saskia J.M. Shilpi, Forhad Gondwe, Timothy Pangapanga-Phiri, Innocent Kalimbira, Alexander Mtimuni, Beatrice Kafere, Deusdedit Chuitsi, Gabriella Phiri, Felix Hyder, Ziauddin NUTRITION STUNTING MALNUTRITION CHILD FEEDING INFANT NUTRITION Childhood malnutrition is still a public health concern in Malawi. Since 2013 the government of Malawi (GoM) has been implementing a large-scale multisectoral nutrition program, which expanded to all districts of the country with the World Bank Group and other donor funding. At the start of this program a national baseline survey was conducted, and in early 2018, an endline survey was conducted. The endline survey followed a mixed-methods approach similar to the 2013 baseline survey, using both quantitative and qualitative data collection measurements. An Oaxaca-Blinder decomposition analysis was used to determine the pathways that contributed most to the program’s success. In addition, a panel dataset was constructed to compare the nutritional outcomes of children within the same household who were born before and after the program intervention. The findings of the endline survey confirm the positive trends observed in childhood malnutrition in Malawi. Between 2013 and 2018, nutrition indicators improved and the percentage of children under age five who were stunted fell from forty-two percent in 2013 to thirty-seven percent in 2018. Improvements were observed in some underlying factors: the percentage of deliveries attended by a skilled birth attendant and handwashing both improved significantly between 2013 and 2018. The findings from the decomposition analysis and cross-sectional and panel data suggest that improvements in water, sanitation, and hygiene (WASH), in particular, handwashing and antenatal care (ANC) practices, were largely responsible for the observed improvements in child nutrition. The findings of the Community-Based Nutrition (CBN) Survey further suggest that the country should consider investing in more coordination and capacity at the district and community levels and should address inequalities in program performance across districts, delivering more context-specific investments and program designs while moving forward 2019-08-21T19:54:03Z 2019-08-21T19:54:03Z 2019-04 Working Paper http://documents.worldbank.org/curated/en/297601565964816621/Determinants-of-Reductions-in-Childhood-Stunting-n-Malawis-Community-based-Nutrition-Programs http://hdl.handle.net/10986/32302 English Health, Nutrition, and Population Discussion Paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Publications & Research Publications & Research :: Working Paper Africa Malawi
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
topic NUTRITION
STUNTING
MALNUTRITION
CHILD FEEDING
INFANT NUTRITION
spellingShingle NUTRITION
STUNTING
MALNUTRITION
CHILD FEEDING
INFANT NUTRITION
Osendarp, Saskia J.M.
Shilpi, Forhad
Gondwe, Timothy
Pangapanga-Phiri, Innocent
Kalimbira, Alexander
Mtimuni, Beatrice
Kafere, Deusdedit
Chuitsi, Gabriella
Phiri, Felix
Hyder, Ziauddin
Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs
geographic_facet Africa
Malawi
relation Health, Nutrition, and Population Discussion Paper;
description Childhood malnutrition is still a public health concern in Malawi. Since 2013 the government of Malawi (GoM) has been implementing a large-scale multisectoral nutrition program, which expanded to all districts of the country with the World Bank Group and other donor funding. At the start of this program a national baseline survey was conducted, and in early 2018, an endline survey was conducted. The endline survey followed a mixed-methods approach similar to the 2013 baseline survey, using both quantitative and qualitative data collection measurements. An Oaxaca-Blinder decomposition analysis was used to determine the pathways that contributed most to the program’s success. In addition, a panel dataset was constructed to compare the nutritional outcomes of children within the same household who were born before and after the program intervention. The findings of the endline survey confirm the positive trends observed in childhood malnutrition in Malawi. Between 2013 and 2018, nutrition indicators improved and the percentage of children under age five who were stunted fell from forty-two percent in 2013 to thirty-seven percent in 2018. Improvements were observed in some underlying factors: the percentage of deliveries attended by a skilled birth attendant and handwashing both improved significantly between 2013 and 2018. The findings from the decomposition analysis and cross-sectional and panel data suggest that improvements in water, sanitation, and hygiene (WASH), in particular, handwashing and antenatal care (ANC) practices, were largely responsible for the observed improvements in child nutrition. The findings of the Community-Based Nutrition (CBN) Survey further suggest that the country should consider investing in more coordination and capacity at the district and community levels and should address inequalities in program performance across districts, delivering more context-specific investments and program designs while moving forward
format Working Paper
author Osendarp, Saskia J.M.
Shilpi, Forhad
Gondwe, Timothy
Pangapanga-Phiri, Innocent
Kalimbira, Alexander
Mtimuni, Beatrice
Kafere, Deusdedit
Chuitsi, Gabriella
Phiri, Felix
Hyder, Ziauddin
author_facet Osendarp, Saskia J.M.
Shilpi, Forhad
Gondwe, Timothy
Pangapanga-Phiri, Innocent
Kalimbira, Alexander
Mtimuni, Beatrice
Kafere, Deusdedit
Chuitsi, Gabriella
Phiri, Felix
Hyder, Ziauddin
author_sort Osendarp, Saskia J.M.
title Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs
title_short Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs
title_full Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs
title_fullStr Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs
title_full_unstemmed Determinants of Reductions in Childhood Stunting n Malawi's Community-based Nutrition Programs
title_sort determinants of reductions in childhood stunting n malawi's community-based nutrition programs
publisher World Bank, Washington, DC
publishDate 2019
url http://documents.worldbank.org/curated/en/297601565964816621/Determinants-of-Reductions-in-Childhood-Stunting-n-Malawis-Community-based-Nutrition-Programs
http://hdl.handle.net/10986/32302
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