Mehrab Bakhtiar

To defer or to differ: Experimental evidence on the role of cash transfers in Nigerian couples’ decision–making

Trends and inequities in adequacy of micronutrient intakes in rural Bangladesh

Background Micronutrient deficiencies pose a significant public health challenge, yet limited evidence exists on micronutrient intakes over time in Bangladesh. Objective We assessed trends and adequacies in micronutrient intakes and examined the changes in inequities by age group, sex, and expenditure quintile. Methods We used panel data from the 2011 and 2018 Bangladesh Integrated Household Survey (n =21,475 and 21,589 household members aged ≥2y, respectively). Food consumption data were collected using a household dietary recall. Changes in micronutrient intakes were assessed using non-parametric Mann-Whitney-Wilcoxon rank sum test. Inequities in outcomes were examined using the Slope Index of Inequality and Concentration Index. Results Micronutrient intakes remained suboptimal across 2011 and 2018, with low adequacy (<0.50) for all nutrients except niacin. While vitamin A intake increased across various demographics, trends for other micronutrient intakes differed by age. Intakes improved for 10 micronutrients among children aged 2-<5y, but increased for only half of examined micronutrients among children aged 5-9y. For adolescents and adults, most micronutrient intakes slightly declined, with greater inadequacies observed among females versus males. Pregnant women experienced sharper declines in adequacy of micronutrient intakes than lactating women. The mean probability of adequacy (MPA) was low (around one-third) for all age groups with lower MPA among poorer compared to richer households across age, sex and survey years. Inequity gaps in MPA mostly declined, except for females ≥50y and pregnant women. Conclusions Micronutrient intakes and adequacies remain suboptimal and have decreased marginally over time for many nutrients and MPA across most age groups. Inequities in micronutrient intakes persist by age, sex, and income levels, disproportionately affecting the poor, adults, and women. Our study calls for evidence-based policies and programs that incorporate a range of proven approaches and tailored solutions to effectively tackle persisting inequities and ensure access to healthy diets for all.

Social assistance and adaptation to flooding in Bangladesh

As climate change exacerbates weather shocks, there is growing interest in understanding whether social assistance programs can support coping among poor rural households and whether program effects vary by gender. We assess whether a social assistance program – the Transfer Modality Research Initiative (TMRI) –influenced the effects of prior monsoon flooding on household consumption and adult diets in southern Bangladesh. TMRI provided cash or food transfers, with or without nutrition behavior change communication, from 2012-2014. Within the study sites and years, flooding was substantial but moderate. Our findings suggest that, without TMRI, a one-standard-deviation increase in lagged flooding led to households smoothing consumption by drawing down savings and reducing diet quality among both men and women. In contrast, among TMRI treatment households, lagged flooding did not reduce savings, and both men’s and women’s diet quality improved. Effects on diet quality appeared largely driven by legumes and by fruits and vegetables, and improvements appeared strongest among households receiving both transfers and behavior change communication. Results indicate that social assistance can help households cope with effects of moderate flooding in southern Bangladesh, protecting household savings and improving both men’s and women’s diets.