Anemia remains one of the most intractable public health challenges in South Asia. This paper analyzes individual-level and household-level determinants of anemia among children and women in Nepal and Pakistan. Applying multivariate modified Poisson models to recent national survey data, we find that the prevalence of anemia was significantly higher among women from the poorest households in Pakistan (adjusted prevalence ratio and more than 5% of all years lost to disability (YLD) globally (2013).In 2012, South Asia accounted for 38% of the entire world's YLD associated with anemia (Kassebaum et al., 2014;Stevens et al., 2013). The region has made little progress in resolving this problem, despite decades of economic growth. The modeled data suggest that between 1995 and 2011, the prevalence of anemia among nonpregnant women in South Asia declined slightly from 53% (95% credibility interval: 42-64%) to 47% (33-59%) and there --------------------------------------------------------------------------------------------------------------------------------This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

BackgroundNutrition-sensitive interventions supporting enhanced household food production have potential to improve child dietary quality. However, heterogeneity in market access may cause systematic differences in program effectiveness depending on household wealth and child age. Identifying these effect modifiers can help development agencies specify and target their interventions.ObjectiveThis study investigates mediating effects of household wealth and child age on links between farm production and child diets, as measured by production and intake of nutrient-dense food groups.MethodsTwo rounds (2013 and 2014) of nationally representative survey data (n = 5,978 observations) were used to measure production and children’s dietary intake, as well as a household wealth index and control variables, including breastfeeding. Novel steps used include measuring production diversity in terms of both species grown and food groups grown, as well as testing for mediating effects of family wealth and age of child.ResultsWe find significant associations between child dietary diversity and agricultural diversity in terms of diversity of food groups and of species grown, especially for older children in poorer households, and particularly for fruits and vegetables, dairy and eggs. With each additional food group produced, log-odds of meeting minimum dietary diversity score (≥4) increase by 0.25 (p = 0.01) for children aged 24–59 months. For younger children aged 18–23 months there is a similar effect size but only in the poorest two quintiles of household wealth, and for infants 6–18 months we find no correlation between production and intake in most models.ConclusionsChild dietary intake is associated with the composition of farm production, most evident among older preschool children and in poorer households. To improve the nutrition of infants, other interventions are needed; and for relatively wealthier households, own farm production may displace market purchases, which could attenuate the impact of household production on child diets.

In resource constrained countries, animal-sourced foods (ASFs) are an important nutrient-dense source of vitamins, minerals and macronutrients. While several studies have suggested the value of ASFs to child growth, most empirical evidence is based on cross-sectional data which can only provide information about the contemporaneous relationship between diet and anthropometric outcomes. This study uses longitudinal panel data for Nepal, Bangladesh, and Uganda to assess the association between contemporaneous as well as past ASF consumption and linear growth of children aged 6-24 months. Fixed effects models found that ASF consumption was significantly correlated with lower stunting, with a decline in stunting prevalence as high as 10% in Nepali children who had consumed any ASF in the previous year.Consuming two or more ASFs showed an even higher magnitude of association, ranging from a 10% decline in prevalence of stunting associated with lagged consumption in Bangladesh to a 16% decline in Nepal.