Assessing interventions to improve child nutrition: a theory‐based impact evaluation of the Bangladesh Integrated Nutrition Project

Abstract

The Community-Based Nutrition Component of the Bangladesh Integrated Nutrition Project sought to improve nutritional status through nutritional counselling and supplementary feeding for malnourished children and pregnant women. This paper presents a theory-based impact evaluation of this programme. Both counselling and feeding suffered from problems of inappropriate targeting strategies and a failure to reach intended groups. While counselling has changed women's knowledge it has had less of an impact on behaviour. There is a knowledge-practice gap, which is explained by resource constraints faced by women, including lack of time, which prevent them from putting the advice into practice. The impact of the project on anthropometric outcomes of infants, children and mothers has not been large. Copyright © 2006 John Wiley & Sons, Ltd.

An impact assessment of the Child Growth, Development and Care Program in the Caribbean Region of Colombia

“…A similar result was found by an assessment of the Bangladesh Integrated Nutrition Project (PINB) which also showed that the project had no significant impact on wasting in children 22 . However, our results differ from those found by an assessment of the Bolsa Familia program in Brazil which found that the intervention led to an improvement in nutritional status among participating children 23 .…”

Supplementary feeding for improving the health of disadvantaged infants and young children

“…65 In Bangladesh, the program of supplementary feeding with nutrition education was based on the premise that 'bad' habits' and poor nutritional knowledge were responsible for child undernutrition. 75 Thus, in this study as in others, 75 caregivers were given nutritional counseling. In some studies where supplementation had limited impact, levels of health and nutritional literacy in the local community were extremely low, hence programmes began from a low base and sometimes had to counter prevailing folk myths and 'lay epidemiology'.…”

“…43 Authors of the Bangladesh study attributed poor results, in part, to the fact that they hadn't reached out to other members of the family (father, mother-inlaw) who made nutritional decisions. 75 Third, the caregiver must be open to the suggestion that an undernourished child may need to be treated differently and 'favoured' over other children in the family. This is difficult to achieve.…”

Supplementary feeding for improving the health of disadvantaged infants and children: what works and why?

“…For example, a study conducted in Bangladesh attributed poor results in part to engaging with the mother only, instead of also engaging with other members of the family who made decisions about nutrition. 87 Some communities may have strong social norms about nutrition and infant feeding that compete with the instructions from the programme. For example, for a supplementary feeding programme to be successful, a caregiver needs to believe and act on the idea that an undernourished child may need to be treated differently and 'favoured' over other children in the family.…”