Phuong Nguyen

Business aspects along the rural-urban continuum, outlet type, and gender of ownership among MSMEs in the Vietnamese food environment

Concurrent with its rapid economic growth, Viet Nam has been experiencing a food systems transformation. Broad changes in the food environment have been a key part of this transition. While the availability of processed food is ubiquitous, the food environment continues to be largely dominated by micro, small, and medium enterprises (MSMEs). So, to build strategies to improve the availability and affordability of healthy foods, MSMEs are a key entry point. In this paper, we use primary survey data to separate key sources of variation in MSMEs’ organizational dimensions and business practices by type of outlet, rural-urban location, and gender of the owners. We focus on outcomes related to employment, food sources, business finance, good business practices, and nutrition knowledge and attitudes. We find limited differences in this set of outcomes in terms of whether an outlet is located in a rural, peri-urban, or urban area, or in terms of the gender of its owners. Instead, most of the variation in outcomes can be linked to the type of outlet, raising specific types of outlets as a key focus when seeking to foster the supply of healthier foods in the food environment.

Nurturing care in the first 10 years of life: Results from a Vietnamese longitudinal study

Can district level support enhance coverage and equity? Evidence from India’s nutrition program

Importance: India’s Integrated Child Development Services (ICDS) program is among the world’s largest nutrition and health programs that offers services to pregnant, lactating mothers, and young children. To support national investments towards universalization of ICDS interventions, between 2016 and 2020, the Indian government in collaboration with multiple partners, introduced system strengthening mechanisms at the district (subnational administrative unit) level in 64% of India’s districts. Objectives: To examine national-level trends in coverage and equity of ICDS interventions and the role of district-level support mechanisms in improving equitable coverage. Design, Setting, and Participants: This quasi-experimental assessment used data (N=393,097 mother-child pairs) from three rounds of nationally representative surveys in 2006, 2016, and 2020. We used inequity indices and regression models to assess changes in equity by wealth, caste, and residence. We applied difference-in-differences (DID) models to investigate changes in coverage due to district support mechanisms between 2016 and 2020. Intervention: The district support mechanisms were introduced between 2016 and 2020 and included a combination of input features such as capacity building of frontline workers, additional human resources, financial, infrastructural, and technological support, among others. Main Outcomes and Measures: Our primary outcomes were the receipt of thirteen ICDS services during pregnancy, lactation, and early childhood. District support mechanisms were grouped into three treatment arms for DID analyses using an intention-to-treat approach with heterogeneous treatments. Results: ICDS utilization continued to increase from 2016 to 2020, with the most improvement observed in health and nutrition education (20-21pp). Unlike 2006-2016, there were large improvements in coverage equity between 2016-2020. DID models show, on average, that districts receiving any programmatic support had significant and faster improvements in coverage (2.2-14.7pp). Pooled effects sizes were larger, on average, for districts that received financial support in addition to human resources (8.9pp, 95% CI 7.3-10.74) compared to districts that only received human resource support (4.5pp, 95% CI 3.4-5.7). Conclusions: India’s programmatic efforts to further strengthen the ICDS were successful in increasing coverage of ICDS program at the national-level and reducing coverage inequities that persisted earlier. Focused district support mechanisms enabled faster progress in coverage and equity.