Improving Nutritional Status Through Behavioral Change: Lessons from Madagascar

33 Pages Posted: 20 Apr 2016

See all articles by Emanuela Galasso

Emanuela Galasso

World Bank - Development Research Group (DECRG)

Nithin Umapathi

University College London

Date Written: December 1, 2007


This paper provides evidence of the effects of a 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 estimate the effect of the availability of the program at the community level on nutritional outcomes. The authors find that the program helped 0-5 year old children in the participating communities to bridge the gap in weight for age z-scores and the incidence of underweight. The program also had significant effects in protecting long-term nutritional outcomes (height for age z-scores and incidence of stunting) against an underlying negative trend in the absence of the program. Importantly, the effect of the program exhibits substantial heterogeneity: gains in nutritional outcomes are larger for more educated mothers and for villages with better infrastructure. The program enables the analysis to isolate responsiveness to information provision and disentangle the effect of knowledge in the education effect on nutritional outcomes. The results are suggestive of important complementarities among child care, maternal education, and community infrastructure.

Keywords: Population Policies, Health Monitoring & Evaluation, Early Child and Children's Health, Housing & Human Habitats, Nutrition

Suggested Citation

Galasso, Emanuela and Umapathi, Nithin, Improving Nutritional Status Through Behavioral Change: Lessons from Madagascar (December 1, 2007). World Bank Policy Research Working Paper No. 4424, Available at SSRN:

Emanuela Galasso (Contact Author)

World Bank - Development Research Group (DECRG) ( email )

1818 H. Street, N.W.
Washington, DC 20433
United States
202-473-3902 (Phone)
202-522-1153 (Fax)

Nithin Umapathi

University College London ( email )

Gower Street
London, WC1E 6BT
United Kingdom

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