Designing and evaluating nutritional programmes

Delivering effective nutritional programmes in developing countries is resource-intensive, often requiring the involvement of large numbers of well-trained frontline health workers. Success also depends on disseminating information that can help bring about lasting behavioural change, and convincing policy-makers of the vital role of nutrition in underpinning the future socio-economic development of their countries.

There are many questions still to be answered in this area. Our exploratory work includes looking at ways of ensuring that direct nutrition programmes and nutrition-sensitive initiatives work effectively and efficiently and reach the most vulnerable people. We are also looking at how pilot nutritional interventions can be tailored to very specific geographical and cultural contexts, and then scaled up by governments.

In Pakistan, we are evaluating the impact of the government’s Benazir Income Support Programme (BISP), a cash transfer programme which targets the poorest 20% of families. With the initial evaluation complete, we are now helping DfID to design and recommend  complementary nutrition activities to help the government boost the impact of the cash transfers. One option is to deliver short quizzes on health and nutrition knowledge via cash transfer delivery platforms such as SMS and AMTs. Correct answers trigger an extra cash payment. SMS and AMTs can also be used to communicate simple messages, for example about appropriate foods for weaning, or basic hygiene measures like boiling water and hand-washing.

We are also helping the Emergency Nutrition Network (ENN) to assess the cost-effectiveness of innovative interventions to prevent and treat moderate acute malnutrition among children in emergency settings. The initiative aims to test alternatives to the traditional targeted supplementary feeding programme, for which evidence of impact is weak. The alternatives include blanket food distributions, cash transfers, food vouchers and expanded general food rations which are provided to all at-risk individuals or households. Armed with new information, ENN will advise governments on the most effective ways of preventing acute malnutrition, curring immediate healthcare costs and enhancing children’s future economic productivity.