IFPRI Publications: Journal Articles

Reconciling conservation and development requires enhanced integration and broader aims: A cross- continental assessment of landscape approaches

Expectations for agricultural landscapes in subtropical and tropical regions are high, aiming for conservation and development amid climate change, unfair trade, poverty, and environmental degradation. Landscape ap- proaches (LAs) are gaining momentum as means to reconcile expectations, although they face multiple chal- lenges, including unclear distinctions among LAs and stakeholder involvement. We studied 380 LAs from three continents via questionnaires with landscape managers (2012–2015 and 2021) and identified three LA types through cluster analysis: an ‘‘integrated’’ type with longer-term, multisectoral goals involving various stakeholders early in the design and two shorter-term types focused on sectoral priorities of preservation or production. Better-performing LAs are associated with longevity, inclusivity, and diversified investments across goals, notably those enabling social justice. International stakeholder analysis shows broad support for LAs but identifies gaps between support and LAs’ needs. The growing interest in LAs is promising. Yet, underpinning effective and lasting LAs that reconcile multiple expectations requires better support.

Making complementary agricultural resources, technologies, and services more gender-responsive

Rural women in low- and middle-income countries face multiple constraints in accessing and benefiting from essential complementary resources, technologies, and services for agricultural production and participation in the agrifood system. This paper highlights recent thinking around these constraints and how to overcome them. The complementary factors we consider are: (1) networks and social capital, (2) information and communications technologies, (3) other agricultural tech nologies, (4) agricultural extension and advisory services, (5) financial services, and (6) social assistance. We first analyze constraints women face in accessing and benefiting from these complementary factors and describe the potential benefits of reducing these constraints and gender inequities in the agrifood system. We then provide evidence on what has been effective for improving women’s access to and ability to benefit from the six complementary factors. We conclude by highlighting the importance of considering the different preferences of men and women when designing policies and interventions; challenging customs, norms and perceptions; and reforming formal rules and institutions toward more inclusive agrifood systems.

Diet quality and associations with motivation and ability to consume a healthy diet among adolescents from urban low-income households in Bangladesh

In low- and middle-income countries, particularly in urban areas, adolescent diets consist mainly of energy-dense and nutrient-poor foods, putting them at risk of malnutrition and non-communicable diseases (NCD). In Bangladesh, little is known about the diet quality of adolescents, their food choices and the drivers of such choices. This study assessed motivations and ability to consume a healthy diet among adolescent girls and boys from low-income urban families and how these drivers were associated with dietary diversity and diet quality. A cross-sectional survey was conducted among 299 adolescents (15–19 years) from low-income households in Dhaka city during September–October 2020. The Diet Quality Questionnaire was used to collect non-quantitative food intake in the previous day or night to calculate diet quality indicators of food group diversity score, % of adolescents achieving minimum dietary diversity, NCD-Protect and NCD-Risk and the Global Dietary Recommendations score. Motivation was measured by 11 food choice motives. Ability was measured by belief in own ability to engage in healthy eating behaviors (self-efficacy). Adolescent diets showed a mean food group diversity of 4.9 out of 10, with 60% of adolescents achieving minimum dietary diversity, but lacked health-promoting foods (average of 2.7 out of 9 food groups) yet included few foods to avoid and limit (1.6 out of 9). Adolescents valued food choice motive ‘safety’ the most, followed by ‘health’, ‘taste’, ‘price’, ‘convenience’ and ‘local or seasonal’. A higher motivation to consume ‘local or seasonal’ and a lower motivation driven by ‘price’, and a higher perceived self-efficacy were associated with better diet quality. Future interventions should address self-efficacy, concerns about food price and increase local and seasonal foods availability in the urban poor food environment of Dhaka to improve overall diet quality.

Toilet construction under the Swachh Bharat Mission and infant mortality in India

Improvement of water and sanitation conditions may reduce infant mortality, particularly in countries like India where open defecation is highly prevalent. We conducted a quasi-experimental study to investigate the association between the Swachh Bharat Mission (SBM)—a national sanitation program initiated in 2014—and infant (IMR) and under five mortality rates (U5MR) in India. We analyzed data from thirty-five Indian states and 640 districts spanning 10 years (2011–2020), with IMR and U5MR per thousand live births as the outcomes. Our main exposure was the district-level annual percentage of households that received a constructed toilet under SBM. We mapped changes in IMR and U5MR and toilet access at the district level over time. We fit two-way fixed effects regression models controlling for sociodemographic, wealth, and healthcare-related confounders at the district-level to estimate the association between toilets constructed and child mortality. Toilet access and child mortality have a historically robust inverse association in India. Toilets constructed increased dramatically across India following the implementation of SBM in 2014. Results from panel data regression models show that districts with > 30% toilets constructed under SBM corresponds with 5.3 lower IMR (p < 0.05), and 6.8 lower U5MR (p < 0.05). Placebo, falsification tests and robustness checks support our main findings. The post-SBM period in India exhibited accelerated reductions in infant and child mortality compared to the pre-SBM years. Based on our regression estimates, the provision of toilets at-scale may have contributed to averting approximately 60,000–70,000 infant deaths annually. Our findings show that the implementation of transformative sanitation programs can deliver population health benefits in low- and middle-income countries.

Spatial typology for food system analysis: Taking stock and setting a research agenda

Economic AI on the move: the relationship between sugar-sweetened beverages consumption and weight gain in Kyrgyzstan

The prevalence of overweight and obesity has been increasing in Central Asia. Among numerous potential dietary determinants of overweight and obesity, sugar-sweetened beverages (SSBs) have received a great deal of attention because they are a significant source of calories and added sugars in both children and adults. In this study, we examine the relationship between SSB consumption and overweight and obesity in Kyrgyzstan using household-level data from the Kyrgyzstan Integrated Household Survey 2011 using propensity score matching in tandem with machine-learning models. The findings of our study indicate SSBs consumption is associated with 1.6 percentage point higher risk of obesity among both men and women in the context of Kyrgyzstan. Besides, we have observed the positive association between age, income, calorie intake, and share of calorie intake from staples and the likelihood of being obese.

Rising atmospheric carbon dioxide concentrations increase gaps of rice yields between low- and middle-to-high-income countries

The rising carbon dioxide concentrations are expected to increase future rice yields. However, variations in the CO2 fertilization effect (CFE) between rice subspecies and the influence of concurrent global warming introduce uncertainty in future global rice yield projections. Here we conducted a meta-analysis of rising carbon dioxide field experiments and employed crop modelling to assess future global rice yields for the top 14 rice producing countries. We found a robust parabolic relationship between rice CFE and temperature, with significant variations between rice subspecies. Our projections indicate that global rice production in the 2050s is expected to increase by 50.32 million tonnes (7.6%) due to CFE compared with historical production. Because low-income countries will experience higher temperatures, the gaps (difference of Δyield) between middle-to-high-income and low-income countries are projected to widen from the 2030s to the 2090s under elevated carbon dioxide. These findings underscore the critical role of CFE and emphasize the necessity to increase investments in research and technology for rice producing systems in low-income countries.

Irrigation technologies and management and their environmental consequences: Empirical evidence from Ethiopia

The main objective of this study is to understand the interlinkages between different irrigation technologies and management systems and environmental outcomes. We use a unique and comprehensive household and plot-level dataset covering ten districts of Ethiopia complemented with remotely sensed data and qualitative information collected from the study sites. The econometric results show that compared to open-access plots equipped with pump irrigation, other irrigated configurations, and especially private groundwater-based systems, have higher vegetation cover and show less susceptibility to the most common environmental concerns mentioned in the survey regions: water logging, soil salinity, and erosion externalities.

Scaling community-based aquaculture for enhanced nutrition and women’s empowerment: lessons from Odisha, India

Introduction: Aquatic foods, particularly fish, are essential for addressing malnutrition, especially in vulnerable populations like children and women. In India, traditional aquaculture practices centered around carp species often overlooked the production of nutrient-rich small fish. To address this, nutrition-sensitive aquaculture approaches advocate for integrating species like mola carplet (Amblypharyngodon mola) rich in micronutrients, into existing systems. In Odisha, India, where poverty and food insecurity are prevalent, the government initiated a program to empower women through aquaculture, focusing on nutrition-sensitive carp-mola polyculture in community ponds through Women Self-Help Groups (WSHGs). Methods: This study evaluates the effectiveness of this government program in enhancing income, household nutrition, and women’s empowerment. Data from field surveys conducted across all 30 districts of Odisha were analyzed to assess participation, capacity building, adoption of better management practices (BMPs), productivity of carp-mola polyculture, household fish consumption, and profitability. Results and discussion: The study found widespread participation and adoption of BMPs among WSHGs, leading to increased productivity and income. Carp-mola polyculture systems showed higher productivity and consumption rates, contributing to improved nutrition among WSHGs and their communities. Despite challenges such as input costs and limited mola availability, WSHGs reported profitability from fish farming, with carp-mola polyculture systems yielding higher net income. Factors influencing productivity and profitability included water retention period, stocking density, feed application, and training. The program’s impact extended beyond economic benefits, encompassing environmental improvement, women’s empowerment, and enhanced nutrition outcomes. The study highlights the success of the government program in promoting sustainable aquaculture practices and improving nutrition outcomes in Odisha. Continued support, capacity building, and collaboration among stakeholders are essential for scaling up nutrition-sensitive aquaculture interventions and ensuring long-term sustainability. Strengthening dissemination processes, addressing challenges, and further research on small indigenous fish production techniques are crucial for maximizing the program’s impact on food security and rural development.

Individual interventions, collective lessons: Developing mid-range theory on women’s groups to improve health

Background Interventions with women’s groups have been widely implemented to improve health outcomes in low- and middle-income settings, particularly India. While there is a large evidence base on the effectiveness of single interventions, it is challenging to predict whether a women’s group intervention delivered in one setting can be expected to work in another. Methods We applied realist principles to develop and refine a mid-range theory on the effectiveness of women’s groups interventions, summarised key lessons for implementation, and reflected on the process. We synthesised primary data from several interventions in India, a systematic review, and an analysis of behaviour change techniques. We developed mid-range theories across three areas: maternal and newborn health, nutrition, and violence against women, as well as an overarching mid-range theory on how women’s groups can improve health. Results Our overarching mid-range theory suggested that effective interventions should: build group or community capabilities; focus on health outcomes relevant to group members; and approach health issues modifiable through women’s individual or collective actions. We identified four key lessons for future interventions with women’s groups, including the importance of skilled and remunerated facilitation, sufficient intensity, supply-side strengthening, and the need to adapt delivery during scale up while maintaining fidelity to intervention theory. Conclusions Our experience demonstrated the feasibility of developing mid-range theory from a combination of evidence and insights from practice. It also underscored the importance of community engagement and ongoing research to ‘thicken’ mid-range theories to design effective and scalable women’s groups interventions in India and similar settings.

Beyond the consumer food price index: Measuring the cost of a healthy diet in India

Learning together for groundwater management: A case of the Devnadi Basin, Nashik, Maharashtra, India

This paper documents the process of co-learning spaces for transdisciplinary learning for participatory groundwater and ecosystem management across research-practice-community collectives in the Devnadi River Basin, Sinnar Block of Nashik District in Maharashtra, India. The Devnadi river supported a groundwater-dependent ecosystem, but now flows for less than four months in a year due to excessive groundwater depletion. A group model building workshop was designed to build a collective vision among experts and community members, create shared ownership and set the tone for transdisciplinarity in understanding groundwater management. This could be an additional tool in a Participatory Groundwater Management toolbox. This process involved surfacing values and mental models through participatory Causal Loop Diagram building. The actors included hydrologists, hydrogeologists, ecologists, agricultural value chain experts, and community leaders. In a process of answering questions participants were working towards combining diverse knowledge(s) and values into equitable and effective collective action to gain shared benefits from a complex, contested, and often poorly understood resource.

The causal effect of early marriage on women’s bargaining power: Evidence from Bangladesh

Early marriage restrains women’s agency and bargaining strength in postmarital households, impairing their ability to make meaningful contributions to household decision making. This paper employs a comprehensive measure of women’s empowerment in the domestic and productive spheres, and isolates the causal effect of age at marriage, instrumented by age at menarche, on their bargaining strength, using nationally representative data from Bangladesh. Results suggest that delayed marriages result in significantly higher empowerment scores and probability of being empowered for women, because of higher likelihood in achieving adequacy in their autonomy in agricultural production, control over income, ownership of assets and rights in those assets, and ability to speak in public. Favorable impacts of delayed marriage are also found on women’s freedom of mobility, fertility choices, and their ability to decide on household expenses and investments, with the impacts likely coming via improvements in education and labor market outcomes when women married later.

School meals are evolving: Has the evidence kept up?

School meal programs are popular social programs. They are provided to 61 percent of primary students in high-income countries but to a smaller share of students in less wealthy countries. There is a body of evidence documenting their contribution to education, health and nutrition, and social protection. But in each domain, program objectives have evolved: schooling is recognized to be more about learning than grades obtained; nutrition goals include healthy diets that reduce risks of non-communicable diseases and are more environmentally responsible; social protection programs aim to respond to acute crises and address chronic poverty. In addition to assisting in these sectors, school meal programs are tasked with creating food systems that assist smallholder farmers, an endeavor that has yet to be extensively studied. This review examines the latest evidence on these evolving dimensions of school meal programs. Findings suggest that while there is a strong evidence base for school meals, there are also specific gaps in the evidence of effectiveness and a particular lack of clarity around costs. The country-led School Meals Coalition, developed in response to COVID pandemic-related school closures, has brought new momentum to national programs and new urgency for reliable evidence on effectiveness and costs.

The paper of how: Estimating treatment effects using the front-door criterion

We illustrate the use of Pearl’s (1995) front-door criterion with observational data with an application in which the assumptions for point identification hold. For identification, the front-door criterion leverages exogenous mediator variables on the causal path. After a preliminary discussion of the identification assumptions behind and the estimation framework used for the front-door criterion, we present an empirical application. In our application, we look at the effect of deciding to share an Uber or Lyft ride on tipping by exploiting the algorithm-driven exogenous variation in whether one actually shares a ride conditional on authorizing sharing, the full fare paid, and origin–destination fixed effects interacted with two-hour interval fixed effects. We find that most of the observed negative relationship between choosing to share a ride and tipping is driven by customer selection into sharing rather than by sharing itself. In the Appendix, we explore the consequences of violating the identification assumptions for the front-door criterion.

Global food value chains and obesity in low- and middle-income countries

Low- and middle-income countries (LMICs) are experiencing disproportional increases in overweight or obesity rates. Parallel to this trend, many LMICs are witnessing significant growth in their participation in global food value chains (GFVCs). This paper aims to shed light on the public health implications of increasing participation in GFVCs. Leveraging macro- and micro-level data spanning 25 years, we study the relationship between countries’ participation in GFVCs and women’s overweight or obesity rates. We explore heterogeneous implications by disaggregating countries’ participation into backward and forward linkages in GFVCs, as well as across rural and urban areas. We find that temporal increases in countries’ participation in GFVCs are significantly associated with increasing overweight or obesity rates, primarily when countries participate in backward linkages and for urban populations. Participation in GFVCs involving forward linkages appears to have negligible implications, and the relationship between participation in GFVCs and obesity disappears for rural women. Furthermore, we find that an increase in countries’ participation in GFVCs is associated with an increase in consumption of energy-dense foods such as sugar, commonly linked with obesity. Our findings have important implications for informing public policies aimed at addressing the increasing obesity rates and associated economic and health burdens in LMICs. JEL Codes: F13, I10, Q17, Q18

From streets to tables: Bottom-up cocreation case studies for healthier food environments in Vietnam and Nigeria

Current food systems fail to provide equity, sustainability, and positive health outcomes, thus underscoring the critical need for their transformation. Intervening in food environments holds substantial promise for contributing to this much-needed transformation. Despite scholars and practitioners often recognizing the necessity for bottom-up approaches, there is a dearth of empirical investigations evaluating the potential of these approaches to contribute to food system transformations in low- and middle-income countries (LMICs). Our study aims to address this research gap, providing a unique perspective in this regard. Drawing on evidence from two co-creation case studies conducted with small-scale informal fruit and vegetable vendors and poor consumers in Vietnam and Nigeria from January 2020 to December 2021, we explore the relevance of bottom-up community-engaged co-creation processes in intervening within LMICs’ food retail environments. Employing a mixed-methods approach that includes quantitative surveys, qualitative interviews, participatory workshops, and focus group discussions, we demonstrate that bottom-up co-creation processes involving marginalized socioeconomic groups can generate retail-level innovations that are tailored to informal retail contexts, while remaining aligned with established top-down theories and literature pertaining to food environments and healthy diets. We provide empirical evidence highlighting how both vendors and consumers respond positively to the co-created innovations. Expanding upon our results, we offer methodological insights applicable to interventions targeted at food environments in LMICs, and considerations for future research or development initiatives in this domain. Our findings reveal the capacity of vulnerable stakeholders to actively engage in public health initiatives and contribute to developing innovative solutions that are context-specific and conducive to the adoption of healthier dietary practices. These results confirm the potential of bottom-up, co-creation, real-world interventions within informal settings to contribute towards fostering inclusive transformation of food systems.

Emerging outsource agricultural services enable farmer adaptation in agrifood value chains: A product cycle perspective

Outsource agricultural service enterprises emerged a century ago in high-income countries and in the past several decades in developing regions. We contribute by analyzing and illustrating the emergence of these services from the perspective of phases of the Product Cycle. These services help farmers adapt to international and domestic agrifood value chains: (1) in the commoditization phase, e.g., with rice combine harvesting services in China and Myanmar for domestic and export markets; (2) in the early product differentiation phase into quality traits, e.g., with horticultural services to Ethiopian and Indonesian farmers for urban wholesale markets; (3) in the advanced product differentiation phase into environmental traits, e.g., with A-Z services to help French farmers grow eco-labeled vegetables for supermarkets. These services addressed farmers’ shortfalls in information, skills, labor, and equipment. The services are supplied by medium/large farmers with excess capacity say of a combine; by wholesalers who want to reduce search costs and risks; by input “agro-dealers”; and by agribusinesses servicing their outgrowers. In new cases shown in France, outsource firms partner with farm input companies such as Bayer or with robot/drone companies. Governments have – and can do much more to – support the emergence of these services such as in developing regions today through: (1) promotion of a business ecosystem, based on policies of investment in hard and soft infrastructure, favoring the coadaptation of these firms with farmers’ needs; (2) policies facilitating access, such as through import liberalization, of equipment and seeds and chemicals.

Educational impacts of an unconditional cash transfer program in Mali

In rural West Africa, the rate of out-of-school children is high and delayed entry to primary school is common, particularly for girls. Using the randomized roll-out of a large-scale unconditional cash transfer program in Mali, we examine its impact on child schooling by age and sex. The program leads to significant improvements in schooling outcomes for girls, but not boys. Improvements are especially salient among younger (ages 6–9) and older (ages 15–18) girls. Complementary analysis reveals that the program reduces the time younger girls spend in agricultural work at home and the time older girls spend in domestic work as well as self-employment. Households in the program also spend more on education for older girls in terms of school fees, materials, and transport.

Sustained underweight in rural areas and emergence of overweight in urban Ethiopian women: A multivariate analysis of EDHS data 2000–2016

A growing body of evidence indicates the emergence of overweight/obesity in developing countries before the battle against undernutrition has been won. We conducted this study to quantify the reduction of underweight and the emergence of overweight among Ethiopian women from 2000 to 2016 and evaluate factors explaining the progress. We used the four Ethiopian Demographic and Health Surveys (2000–2016) to analyze body mass index (BMI) trends among women. Data from 43,815 non-pregnant, non-puerperal reproductive-age women was used to evaluate the linear change in BMI and changes in the percentage of overweight and underweight over time. Using multivariate decomposition analysis of change in underweight and overweight percentages, we identified sources of change in BMI in the past 16 years of the survey periods. The BMI of Ethiopian reproductive-age women increased by 0.88 kg/m2 from 2000 to 2016. The increment was pronounced in urban areas with 1.46 kg/m2. There has been a significant reduction in underweight women since 2000 (p-value < 0.001), and 87.62% of the changes were attributed to behavioral changes toward weight management. And there was a significant upswing in overweight women from 2000 to 2016 (p-value < 0.001) as well. A compositional change of factors including region, women’s age, women’s educational status, religion, type of place of residence, and use of contraceptives contributed to 57.51% of the observed increment in the percentage of overweight women. A relatively slow decrease in underweight and an increment in overweight have been observed. This progress can be disaggregated into persistent underweight in the rural and poorest, and swift development of overweight in the urban and richest communities. Targeted nutrition interventions for both underweight and overweight women are mandatory. Nutritional interventions in Ethiopia should focus on behavioral change to reduce hunger and malnutrition as well as to avert the emergence of overweight or obesity in the affected communities.

Geospatial variation in dietary patterns and their association with heart disease in Bangladeshi population: Evidence from a nationwide survey

Heart disease is a significant public health threat, and its burden is increasing worldwide. Recent evidence suggests that dietary pattern is a key modifiable factor for heart disease. Research regarding dietary patterns and heart disease in Bangladesh with their spatial variability is limited. In this study, the spatial variation and relationship between dietary patterns and heart disease among Bangladeshi people was investigated. The country-representative Household Income and Expenditure Survey 2016 dataset was used, and a total of 77,207 participants aged 30 years and over were included. A principal component analysis was conducted to derive the dietary patterns. Both statistical and spatial analyses were performed. The overall prevalence of heart disease was 3.6%, with a variation of 0.6% to 10.4% across districts of Bangladesh. Three major dietary patterns, named “festival pattern”, “pickles and fast foods pattern”, and “rice and vegetable pattern” were identified, accounting for 25.2% of the total dietary variance. Both the dietary pattern and heart disease rate varied across the region. A higher risk of heart disease was persistent in the western-south, southern, central, and eastern regions, as was greater adherence to the “festival pattern” and “pickles and fast foods pattern.” After adjusting for confounders, participants with the highest adherence to the “rice and vegetable pattern” were associated with a lower likelihood of developing heart disease (AOR: 0.78, 95% CI: 0.64–0.95, p <0.05), while the highest adherence to the "pickles and fast foods pattern" was associated with a higher likelihood of developing heart disease (AOR: 1.50, 95% CI: 1.27–1.76, p <0.001). The spatial disparities in the prevalence of heart disease and dietary patterns underscore the significance of prioritizing intervention at the district level, especially in the western-south, southern, central, and eastern regions, to control the rising heart disease trends in Bangladesh.

Understanding differential reductions in undernutrition among districts in Rwanda through the perspectives of mid‐level and community actors on policy commitment and policy coherence

Understanding the drivers of improvements in child undernutrition at only the national level can mask subnational differences. This paper aimed to understand the contributions of factors in the enabling environment to observed differences in stunting reduction between districts in Rwanda. In 2017, we conducted 58 semi-structured interviews with mid-level actors (n = 38) and frontline workers (n = 20) implementing Rwanda’s multi-sectoral nutrition policy in five districts in which stunting decreased (reduced districts) and five where it increased or stagnated (non-reduced districts) based on Rwanda’s 2010 and 2014/15 Demographic and Health Surveys. Mid-level actors are government officials and service providers at the subnational level who represent the frontline of government policy. Interviews focused on political commitment to and policy coherence in nutrition, and contributors to nutrition changes. Responses were coded to capture themes on the changes and challenges of these topics and compared between reduced and non-reduced districts. Descriptive statistics described district characteristics. Political commitment to nutrition was high in both reduced and non-reduced districts. Respondents from reduced districts were more likely to define commitment to nutrition as an optimal implementation of policy, whereas those from non-reduced districts focused more on financial commitment. Regarding coherence, respondents from reduced compared to non-reduced districts were more likely to report the optimal implementation of multi-sectoral nutrition planning meetings, using data to assess plans and progress in nutrition outcomes and integration of nutrition into the agriculture sector. In contrast, respondents from non-reduced districts more often reported challenges in their relationships with national-level stakeholders and nutrition and/or monitoring and evaluation capacities. Enhancing the integration of nutrition in different sectors and improving mid-level actors’ capacity to plan and advocate for nutrition programming may contribute to reductions in stunting.

Effects of a large-scale alcohol ban on population-level alcohol intake, weight, blood pressure, blood glucose, and domestic violence in India: A quasi-experimental population-based study

Background Globally, alcohol consumption is a leading risk factor for deaths and disability and a causal factor in over 200 diseases, injuries, and health conditions. In April 2016, the manufacture, transport, sale, and consumption of alcohol was banned in Bihar, a populous Indian state. We sought to estimate the impacts of this ban on health outcomes and domestic violence. Methods Data from the Indian National Family Health Surveys (2005–06, 2015–16, 2019–21), Annual Health Survey (2013), and District Level Household Survey (2012), were used to conduct difference-in-differences (DID) analysis, comparing Bihar (n = 10,733 men, n = 88,188 women) and neighbouring states (n = 38,674 men, n = 284,820 women) before and after the ban. Outcomes included frequent (daily or weekly) alcohol consumption, underweight, obesity, hypertension, diabetes, and intimate partner violence. A triple difference model adding male–female interaction to the DID model was also estimated. Attributable averted cases were calculated to estimate the impact of the ban. Findings Across all models, the ban led to reduced frequent alcohol consumption (DID: −7.1 percentage points (pp) (95% CI −9.6pp, −4.6pp), lower overweight/obesity (−5.6pp (−8.9, −2.2) among males, and reduced experiences of emotional (−4.8pp (−8.2pp, −1.4pp) and sexual (−5.5pp (−8.7pp, −2.3pp) violence among females. The ban prevented approximately 2.4 million cases of daily/weekly alcohol consumption and 1.8 million cases of overweight/obesity among males, and 2.1 million cases of intimate partner violence among females. Interpretation Strict alcohol regulation policies may yield significant population level health benefits for frequent drinkers and many victims of intimate partner violence.

Predictors of prediabetes/diabetes and hypertension in Ethiopia: Reanalysis of the 2015 NCD STEPS survey using causal path diagrams

The objective of our study was to reanalyse the Ethiopia STEPwise approach to Surveillance Noncommunicable Disease Risk Factors survey (NCD STEPS), using causal path diagrams constructed using expert subject matter knowledge in conjunction with graphical model theory to map the underlying causal network of modifiable factors associated with prediabetes/diabetes and hypertension. We used data from the 2015 Ethiopia NCD STEPS representative cross-sectional survey (males; n = 3977 and females; n = 5823 aged 15–69 years) and performed directed acyclic graph-informed logistic regression analyses. In both sexes, a 1-unit higher in body mass index (BMI) and waist circumference (WC) were positively associated with prediabetes/diabetes (BMI: males: adjusted odds ratio [aOR]: 1.07 [95% confidence interval: 1.0, 1.1], females aOR: 1.03 [1.0, 1.1]; WC: males: aOR: 1.1 [0.9, 1.2], females: aOR: 1.2 [1.1, 1.3]) and hypertension (BMI: males: aOR: 1.2 [1.1, 1.2], females aOR: 1.1 [1.0, 1.1]; WC: males: aOR: 1.6 [1.4, 1.8], females: aOR: 1.3 [1.2, 1.5]). Although residing in urban settings was associated with higher odds of hypertension in both males (aOR: 1.79 [1.49, 2.16]) and females (aOR: 1.70 [1.49, 1.95]), it was only associated with prediabetes/diabetes in males (aOR: 1.56 [1.25, 1.96]). Males and females in pastoralist areas had lower odds of prediabetes/diabetes compared with their agrarian counterparts (males: aOR: 0.27 [0.14, 0.52], females: aOR: 0.31 [0.16, 0.58]). Physical activity was associated with lower odds of prediabetes/diabetes among females (aOR: 0.75 [0.58, 0.97]). Other diet-related modifiable factors such as consumption of fruit and vegetable, alcohol or salt were not associated with either prediabetes/diabetes or hypertension. Our findings highlight the need to implement interventions that prevent overweight/obesity and nutrition-related NCDs, particularly in urban areas.

Drivers of change in weight-for-height among children under 5 years of age in Ethiopia: Risk factors and data gaps to identify risk factors

The prevention of wasting should be a public health priority as the global burden of acute malnutrition is still high. Gaps still exist in our understanding of context-specific risk factors and interventions that can be implemented to prevent acute malnutrition. We used data from the four rounds of the Ethiopia Demographic and Health Survey (2000–2016) to identify risk factors that have contributed to the change in weight-for-height z-score (WHZ) among children under 5 years of age. We performed a pooled linear regression analysis followed by a decomposition analysis to identify relevant risk factors and their relative contribution to the change in WHZ. Modest improvements in WHZ were seen between 2000 and 2016. The sharpest decrease in mean WHZ occurred from birth to 6 months of age. Perceived low weight at birth and recent diarrhoea predicted a decline in WHZ among children aged 0–5, 6–23 and 23–59 months. Less than 50% of the change in WHZ was accounted for by the change in risk factors included in our regression decomposition analysis. This finding highlights data gaps to identify context-specific wasting risk factors. The decline in the prevalence of recent diarrhoea (15% of the improvement), decline in low birth size (7%–9%), and an increase in wealth (15%–30%) were the main risk factors that accounted for the explained change in WHZ. Our findings emphasize the importance of interventions to reduce low birthweight, diarrhoea and interventions that address income inequities to prevent acute malnutrition.

Child growth faltering dynamics in food insecure districts in rural Ethiopia

Child undernutrition disproportionally affects children in low- and middle-income countries. In Ethiopia, both wasting and stunting are serious public health concerns, with high human and economic costs. Understanding the dynamics in ponderal and linear growth faltering is critical to inform the design of innovative interventions that can prevent both wasting and stunting in poor and complex settings. Using two longitudinal studies conducted in 2017 and 2019 in four highland regions of Ethiopia, we evaluated the dynamics and drivers of child growth faltering in children 6–23 months of age (N = 5003). Child wasting prevalence peaked during the first 6 months of life, whereas stunting increased significantly after 6 months of age. Male sex, child illnesses (i.e., diarrhoea or fever) and low consumption of fruits and vegetables were associated with higher odds of acute undernutrition (P < 0.05). The consumption of animal source foods (ASF) was associated with increases (β: 95% CI) in weight-for-length Z-score (WLZ; 0.12: 0.0002; 0.242), whereas fruit or vegetables consumption was associated with increases in midupper arm circumference (MUAC; 0.11 cm: 0.003; 0.209). Only consumption of ASF was the statistically significant predictor of future linear growth (0.14: 0.029; 0.251). Distinct trends in WLZ and MUAC were observed by child sex and age. Improving diet quality through improved nutrition knowledge and increased access and affordability of ASFs, along with effective infection prevention/control measures could prevent both child wasting and stunting concurrently.

The relationships between optimal infant feeding practices and child development and attained height at age 2 years and 6–7 years

Limited evidence exists on the long-term effects of early feeding practices on child growth and development. We examined the relationships between infant feeding practices and child height and development at ages 2 and 6–7 years. We studied 885 mother–child dyads from a randomized controlled trial of preconception supplementation in Vietnam. Early initiation of breastfeeding (EIBF), exclusive breastfeeding (EBF), breastfeeding (BF) duration and minimum dietary diversity (MDD) were assessed using World Health Organization (WHO) guidelines. Child development was assessed by the Bayley Scales of Infant Development-III at 2 years and the Wechsler Intelligence Scale for Children® – IV at 6–7 years. Child height-for-age z-score (HAZ) was calculated from child height and age. Multivariable regression and structural equation models were used in analyses that controlled for confounding. EIBF and EBF at 6 months occurred in 52% and 62% of children, respectively. Mean breastfeeding duration was 18 months and 83% achieved MDD at 1 year. EIBF was associated with motor (β = 0.13, 95% confidence interval [CI]: 0.00, 0.28) and cognitive development at 2 years (β = 0.12, 95% CI: −0.01, 0.26), which in turn were positively associated with cognitive development at 6–7 years. EBF was directly associated with development at 6–7 years (β = 0.21, 95% CI:0.08, 0.34) whereas motor and cognitive development at 2 years explained 41%–75% of the relationship between EIBF and development at 6–7 years. HAZ at 2 years also mediated 70% of the association between MDD at 1 year and HAZ at 6–7 years. BF duration was not associated with child development and HAZ. Early infant feeding practices, especially EIBF and EBF, have important long-term implications for optimizing child linear growth and cognition as they begin school.

Understanding delays in the introduction of complementary foods in rural Ethiopia

Age-appropriate breastfeeding and introduction to complementary foods can shape child feeding practices, ensure adequate energy and nutrient intake and prevent linear growth faltering. This study aimed to assess mothers’ and health workers’ knowledge of timely introduction to complementary foods and evaluate the relationship between delays in complementary feeding and subsequent linear growth. We conducted two rounds of surveys (March/August 2017) among 249 health workers (n = 249) and caregivers (n = 2635) of children 6–23 months of age. We collected information about socio-demographic characteristics, knowledge and practice related to timely introduction to complementary foods. The study was conducted in households from the Productive Safety Net Programme (PSNP) districts, in four highland regions of Ethiopia. Delays in the introduction to complementary feeding were widespread with 53% of children 6–8 months of age not consuming solid, semisolid or soft foods in the past 24 h. After controlling for child, caregiver and household characteristics, children not introduced to complementary foods by 6–8 months had a 0.48 SD lower length-for-age z-score at 12–15 months. Caregivers’ knowledge was strongly and inversely correlated with untimely introduction of complementary foods in logistic regressions (OR = 0.55, p < 0.01). In turn, local health extension worker's knowledge was strongly correlated with caregiver's knowledge. Consequently, frequent and timely visits by health extension workers emphasising not only on what to feed but also when and how to feed a child are needed. Innovative ways of increasing reach, intensity and frequency of nutrition messaging by using the PSNP interactions as an additional point of contact would need to be explored further.

It’s all in the stars: The Chinese zodiac and the effects of parental investments on offspring’s cognitive and noncognitive skill development

Parental investments in children’s cognitive and noncognitive outcomes are deeply important to policymakers. However, because parental investments are arguably endogenous, estimating their importance empirically poses a challenge. To address this challenge, this paper exploits a rich and novel dataset, the China Family Panel Studies, and proposes a culture‐specific instrumental variable based on the Chinese zodiac. By comparing the outcomes of children born just before and just after the cutoff for a “lucky” (or ‘unlucky’) zodiac sign, we find that parents’ investments have significant effects on offspring’s development of both cognitive and noncognitive skills.

The impact of large-scale agricultural investments in low-income economies

Recent years have witnessed an increasing interest in large-scale agricultural land acquisitions in developing countries. The accompanying socio-economic implications have been areas of debate among politicians, policymakers and development agents. This paper argues that the traditional way of simulating the impacts of these investments in developing countries is misleading as the approach implies that the new investments are identical to the semi-subsistence way of farming that dominates agricultural practices in the host countries. In this study, we incorporate the peculiarity of large-scale agro-investments into an existing database for economy-wide models, i.e., social accounting matrix (SAM), and capture welfare and distributional outcomes properly. SAM-based multiplier models applied to Ethiopian data justify the need to account for the peculiarity of the investments in terms of production technology and their geographic distribution.

Civil conflict, cash transfers, and child nutrition in Yemen

Estimating the cost and affordability of healthy diets: How much do methods matter?

Recently developed cost and affordability of healthy diet (CoAHD) metrics have quickly become mainstream food security indicators. However, published research on the sensitivity of estimation methods is limited. This paper focuses on two important innovations in CoAHD measurement at the global level. First, we develop a demographic scaling factor to adjust healthy diet costs for cross-country differences in age structures, since younger populations generally require fewer calories than older populations. Second, we improve the way in which household expenditure available for purchasing food (“food budgets”) are derived. In addition, we explore sensitivity of global CoAHD estimates to potential problems with the representativeness and food product coverage of global food price data and vary assumptions for activity levels that shape energy expenditure requirements. We apply these explorations to the EAT-Lancet reference diet in 137 countries using price data from 2017. Relative to the conventional methods, we find that demographic scaling and improved food budget derivation substantially reduces the estimated population who cannot afford a healthy diet, from 3.02 to 2.13 billion. Adjustments for low product coverage can lead to modest reductions for specific regions and food groups, while higher physical activity assumptions increase the share of people who cannot afford a healthy diet, though perhaps implausibly so. Methods clearly matter in CoAHD estimation, and more accurate and timelier CoAHD estimates have substantial scope to improve policy analysis, design and targeting.

The demographic transition and rural industrialization in China

Low Global Diet Quality Score (GDQS) among adolescents in Vietnam is due to inadequate consumption of fruits and vegetables rather than high consumption of unhealthy foods

Objectives: Rapid urbanization coupled with a nutrition transition has catalyzed significant shifts in lifestyle and diets in mega-cities around the world, but the impacts on adolescent diets are poorly understood. This study aims to fill this gap, comparing diet quality (measured by the Global Diet Quality Score, GDQS) and adequacy of micronutrient intakes among adolescents in urban, peri-urban, and rural areas of Vietnam. Methods: We collected data on adolescents (11-19 y) from low-income neighborhoods in urban (n=868), peri-urban (n=937), and rural (n=1056) areas and assessed dietary intake using multi-pass 24-hour recalls (15% repeated measures). We classified foods consumed into 25 GDQS food groups (score 0-49; GDQS healthy (+): 0-32; unhealthy (-): 0-17), with a higher score reflecting a lower risk of poor diet quality. Nutrient intakes were derived using food composition tables; and micronutrient probability of adequacy (PA) was calculated using the National Cancer Institute (NCI) method. Differences in diet quality and adequacy by residence were compared using ANOVA with Bonferroni post-hoc tests. Results: GDQS+ was low (6.6-7.1 over 32 points) while GDQS- was ∼11 over 17 points across the three areas. The risk of poor diet quality was slightly higher in rural (23.4%) than peri-urban (18.5%) and urban areas (17.1%), and was driven by low consumption of healthy foods (fruits, vegetables, legumes, and eggs) rather than excessive consumption of unhealthy foods. Refined grains and baked goods were universally consumed, but sweets, ice cream, and sugar-sweetened beverages were consumed by 20% or less of our sample. Consumption of high-fat dairy (32.9%) and red meat (74%) was higher in urban compared to rural areas. The PA of micronutrient intakes was low (< 0.5) for most micronutrients except iron, zinc and vitamin C and mean PA was very low (0.32-0.35). Conclusions: Diet quality among Vietnamese adolescents is generally poor across residential areas, mostly due to inadequate consumption of healthy foods. The very low PA for micronutrients across all three areas is concerning. Efforts are needed to stimulate increased consumption of healthy foods, to reduce consumption of red meat and replace high-fat dairy with low-fat options, and to maintain a low consumption of other unhealthy foods.

A multi-sectoral community development intervention has a positive impact on diet quality and growth in school-age children in rural Nepal

Poor diet quality (diet diversity and animal-source food [ASF] consumption) during childhood negatively affects growth, development, behaviour and physiologic function in later life. Relatively less is known about the impact of poor diet on the growth of school-age children compared to children <5 years of age, especially in low/middle-income countries. A better understanding of delivery strategies for effective interventions to improve diet and hence growth in school-age children is needed. A 36-month longitudinal controlled impact evaluation in rural Nepal assessed the nutrition and growth of children <5 years of age in families assigned via community clusters to full package intervention (community development, training in nutrition [during pregnancy and for children <5 years] and livestock husbandry), partial package (training only) or control (no inputs). Concurrent data were collected prospectively (baseline plus additional four rounds) on school-age children (5–8 years at baseline) in these households; the present study analysed findings in the cohort of school-age children seen at all five study visits (n = 341). Diet quality improved more in the full package school-age children compared to those in partial package or control households. full package children consumed more ASF (β +0.40 [CI 0.07,0.73], p < 0.05), more diverse diets (β +0.93 [CI 0.55,1.31], p < 0.001) and had better head circumference z-scores (β +0.21 [CI 0.07,0.35], p < 0.01) than control children. In conclusion, a multi-sectoral community development intervention was associated with improvements in diet and growth of school-age children in rural Nepal even though the intervention focused on the diet of children <5 years of age. The diet and growth of school-age children can be favourably influenced by community-level interventions, even indirectly.

Bioaccessibility and bioavailability of biofortified food and food products: Current evidence

Biofortification increases micronutrient content in staple crops through conventional breeding, agronomic methods, or genetic engineering. Bioaccessibility is a prerequisite for a nutrient to fulfill a biological function, e.g., to be bioavailable. The objective of this systematic review is to examine the bioavailability (and bioaccessibility as a proxy via in vitro and animal models) of the target micronutrients enriched in conventionally biofortified crops that have undergone post-harvest storage and/or processing, which has not been systematically reviewed previously, to our knowledge. We searched for articles indexed in MEDLINE, Agricola, AgEcon, and Center for Agriculture and Biosciences International databases, organizational websites, and hand-searched studies’ reference lists to identify 18 studies reporting on bioaccessibility and 58 studies on bioavailability. Conventionally bred biofortified crops overall had higher bioaccessibility and bioavailability than their conventional counterparts, which generally provide more absorbed micronutrient on a fixed ration basis. However, these estimates depended on exact cultivar, processing method, context (crop measured alone or as part of a composite meal), and experimental method used. Measuring bioaccessibility and bioavailability of target micronutrients in biofortified and conventional foods is critical to optimize nutrient availability and absorption, ultimately to improve programs targeting micronutrient deficiency.

Progress in Water, Sanitation and Hygiene (WASH) coverage and potential contribution to the decline in diarrhea and stunting in Ethiopia

Inadequate safe water supply and poor sanitation and hygiene continue to be important risk factors for diarrhoea and stunting globally. We used data from the four rounds of the Ethiopian Demographic and Health Survey and applied the new World Health Organization (WHO)/UNICEF Joint Monitoring Program (JMP) service standards to assess progress in water, sanitation and hygiene (WASH) coverage between 2000 and 2016. We also performed an age-disaggregated pooled linear probability regression analysis followed by a decomposition analysis to determine whether changes in WASH practices have contributed to the changing prevalence of diarrhoea and stunting in children under 5 years of age. We observed a significant increase in the coverage of safe drinking water and adequate sanitation facilities over the period. At the national level, the use of a basic water source increased from 18% in 2000 to 50% in 2016. Open defecation declined from 82% to 32% over the same period. However, in 2016, only 6% of households had access to a basic sanitation facility, and 40% of households had no handwashing facilities. The reduction in surface water use between 2000 and 2016 explained 6% of the decline in diarrhoea observed among children aged 0–5 months. In children aged 6–59 months, between 7% and 9% of the reduction in stunting were attributable to the reduction in open defecation over this period. Despite progress, improvements are still needed to increase basic WASH coverage in Ethiopia. Our findings showed that improvements in water and sanitation only modestly explained reductions in diarrhoea and stunting.

Utilization of Integrated Child Development Services (ICDS) and its linkages with undernutrition in India

The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6-59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS-4 [2015-2016] and NFHS-5 [2019-2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference-in-differences (DID) approach. Utilization of ICDS increased from 58% in 2015-2016 to 71% in 2019-2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%-12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6-59 months in this period.

The impact of excluding adverse neonatal outcomes on the creation of gestational weight gain charts among women from low- and middle-income countries with normal and overweight BMI

We need to know the economic impacts of Sudan’s ongoing conflict

Food systems interventions for nutrition: Lessons from 6 program evaluations in Africa and South Asia

Although there is growing global momentum behind food systems strategies to improve planetary and human health—including nutrition—there is limited evidence of what types of food systems interventions work. Evaluating these types of interventions is challenging due to their complex and dynamic nature and lack of fit with standard evaluation methods. In this article, we draw on a portfolio of 6 evaluations of food systems interventions in Africa and South Asia that were intended to improve nutrition. We identify key methodological challenges and formulate recommendations to improve the quality of such studies. We highlight 5 challenges: a lack of evidence base to justify the intervention, the dynamic and multifaceted nature of the interventions, addressing attribution, collecting or accessing accurate and timely data, and defining and measuring appropriate outcomes. In addition to more specific guidance, we identify 6 cross-cutting recommendations, including a need to use multiple and diverse methods and flexible designs. We also note that these evaluation challenges present opportunities to develop new methods and highlight several specific needs in this space.

Feed handling practices, aflatoxin awareness and children’s milk consumption in the Sidama region of southern Ethiopia

Consumption of milk is linked to improved nutrient intake and reduced risk of child malnutrition in low and middle-income countries. However, these benefits are contingent on the safety and quality of the milk. Milk consumption may alleviate the widespread risk of malnutrition in rural Ethiopia, but milk-borne contaminants may also compromise child health. We aimed to: i) identify the types of dairy feeds used, their storage conditions, and potential risk of aflatoxin contamination; ii) assess stakeholders’ knowledge about aflatoxin contamination along the value chain; and iii) assess parental practices on feeding milk to infants and young children. This qualitative study was conducted in the Sidama region, southern Ethiopia. In-depth interviews (n = 12) and key-informant interviews (n = 18) were conducted with actors along the dairy value chain. Focus-group discussions were conducted with farmers (9FGD/n = 129) and child caregivers (9FGD/n = 122). Study participants were selected to represent a rural-urban gradient, as well as low- and high- dairy cow holdings. We found that while animal-feed processors and their distribution agents had relatively good knowledge about aflatoxin, farmers and retailers did not. Feed storage conditions were poor. Many respondents linked moldy feeds to animal health but not to human health. Farmers’ feed choice was influenced by cost, seasonality, and herd size. Small-holding farmers had limited access to commercial feed. Children’s consumption of milk was limited to skim milk, as butter was extracted and sold for income. The high cost of dairy products also led some parents to dilute skim milk with water before feeding children, compromising the nutritional value and safety of the milk. Our findings underscore the need to address the gaps in aflatoxin and food safety knowledge, improve storage conditions, and ensure the availability of quality feed to increase the sector’s productivity, but most importantly to protect consumers’ health and well-being, especially infants and young children.

Feasibility of using an artificial intelligence-based telephone application for dietary assessment and nudging to improve the quality of food choices of female adolescents in Vietnam: Evidence from a randomized pilot study

Background Adolescent nutrition has faced a policy neglect, partly owing to the gaps in dietary intake data for this age group. The Food Recognition Assistance and Nudging Insights (FRANI) is a smartphone application validated for dietary assessment and to influence users toward healthy food choices. Objectives This study aimed to assess the feasibility (adherence, acceptability, and usability) of FRANI and its effects on food choices and diet quality in female adolescents in Vietnam. Methods Adolescents (N = 36) were randomly selected from a public school and allocated into 2 groups. The control group received smartphones with a version of FRANI limited to dietary assessment, whereas the intervention received smartphones with gamified FRANI. After the first 4 wk, both groups used gamified FRANI for further 2 wk. The primary outcome was the feasibility of using FRANI as measured by adherence (the proportion of completed food records), acceptability and usability (the proportion of participants who considered FRANI acceptable and usable according to answers of a Likert questionnaire). Secondary outcomes included the percentage of meals recorded, the Minimum Dietary Diversity for Women (MDDW) and the Eat-Lancet Diet Score (ELDS). Dietary diversity is important for dietary quality, and sustainable healthy diets are important to reduce carbon emissions. Poisson regression models were used to estimate the effect of gamified FRANI on the MDDW and ELDS. Results Adherence to the application was 82% and the percentage of meals recorded was 97%. Acceptability and usability were 97%. MDDW in the intervention group was 1.07 points (95% CI: 0.98, 1.18; P = 0.13) greater than that in the control (constant = 4.68); however, the difference was not statistically significant. Moreover, ELDS in the intervention was 1.09 (95% CI: 1.01, 1.18; P = 0.03) points greater than in the control (constant = 3.67). Conclusions FRANI was feasible and may be effective to influence users toward healthy food choices. Research is needed for FRANI in different contexts and at scale.

Women’s leadership in climate-resilient agrifood systems: Defining a future research agenda

Women’s leadership is increasingly considered critical for achieving climate-resilient agrifood systems. Numerous initiatives and policies highlight the business case for women’s leadership to deliver a range of positive social, economic and environmental outcomes. In this Perspective, we examine the business case, finding uneven evidence linking women’s leadership to increased resilience to climate change. We problematize the ways women’s leadership is typically understood in this area and argue that, despite the value and utility of understanding the pathways through which women’s leadership can strengthen climate-resilient agrifood systems, support for increasing women’s leadership should not be contingent on proving the business case or its instrumental value. Rather, increasing the leadership of women in all their diversity in climate action is a moral imperative and non-negotiable due to women’s human right to have meaningful influence in the decisions that affect their lives. Finally, we propose ways to reframe the debate on women’s leadership in climate and agrifood systems and suggest priorities for future research in this area.

Harnessing the job creation capacity of young rural agripreneurs: A quasi-experimental study of the ENABLE program in Africa

With evidence of increasing investment in youth agribusiness empowerment programs across Africa, employment discussions and strategies are increasingly focusing on how youth-owned agribusinesses can facilitate long-term job creation and contribute to revitalizing rural economies in the coming years. In light of these changing employment dynamics, we assessed the evolving role of youth and small agribusinesses in employment creation in rural areas. Further, we assessed the impact of agribusiness empowerment programs in unlocking the job creation capacity of young agribusiness owners, taking evidence from the youth component of the African Development Bank (AfDB) Technologies for African Agricultural Transformation (TAAT) program, Empowering Novel Agribusiness-Led Employment (ENABLE) implemented in Kenya, Nigeria, and Uganda. A total of 1435 respondents, comprising 737 participants and 698 non-participants were surveyed across the three countries. An Endogenous Switching Regression (ESR) model was used to identify factors that determined program participation, and factors influencing job creation, and assess the program’s impact on job creation. The results validate our assumption of changing employment dynamics in the rural areas where youth-owned small agribusinesses hired an average of 4 employees. The ESR results show the significance of the program on the job creation capacity of participants across the three countries. Also, we found that non-participants could potentially increase their job creation capacity if they had participated in the program. Factors that influence job creation include socio-economic, such as age and marital status, business attributes including agribusiness experience, business level, income, and access to land. These results indicate that continuous concerted efforts on agribusiness empowerment will have a notable impact in generating more jobs and reducing the rates of unemployment, particularly among young people. Thus, more investment should be directed towards empowering young people in agribusiness in the study countries, and elsewhere in Africa.

Food systems interventions for nutrition: Lessons from six program evaluations in Africa and South Asia

While there is growing global momentum behind food systems strategies to improve planetary and human health—including nutrition—there is limited evidence of what types of food systems interventions work. Evaluating these types of interventions is challenging due to their complex and dynamic nature and lack of fit with standard evaluation methods. In this paper, we draw on a portfolio of six evaluations of food systems interventions in Africa and South Asia that were intended to improve nutrition. We identify key methodological challenges and formulate recommendations to improve the quality of such studies. We highlight five challenges: a lack of evidence base to justify the intervention; the dynamic and multifaceted nature of the interventions; addressing attribution; collecting or accessing accurate and timely data; and defining and measuring appropriate outcomes. In addition to more specific guidance, we identify six cross-cutting recommendations, including a need to use multiple and diverse methods and flexible designs. We also note that these evaluation challenges present opportunities to develop new methods and highlight several specific needs in this space.

Navigating One Health in research-for-development: Reflections on the design and implementation of the CGIAR Initiative on One Health

Adopting One Health approaches is key for addressing interconnected health challenges. Yet, how to best put One Health into practice in research-for-development initiatives aiming to ‘deliver impacts’ remains unclear. Drawing on the CGIAR Initiative on One Health – a global initiative to address zoonotic diseases, antimicrobial resistance, and food and water safety – we reflect on challenges during program conception and implementation, prompting us to suggest improvements in multisectoral collaboration, coordination, and communication. Our approach involves conducting a researcher-centered process evaluation, comprising individual interviews that are subsequently thematically analyzed and synthesized. The key takeaway is that limited time for planning processes and short program timelines compared to envisioned development impacts may impede research-for-development efforts. Yet, collaborative work can be successful when adequate time and resources are allocated for planning with minimal disruption throughout implementation. Additionally, due to the multifaceted nature of One Health initiatives, it is important to pay attention to co-benefits and trade-offs, where taking action in one aspect may yield advantages and disadvantages in another, aiding to identify sustainable One Health development pathways. Forming close partnerships with national governments and local stakeholders is essential not only to promote sustainability but also to ensure local relevance, enhancing the potential for meaningful impact. Finally, regularly assessing progress toward development goals is critical as development stands as an overarching objective.

Food and nutrition security under changing climate and socioeconomic conditions

Food and nutrition security have become increasingly critical concerns for policy makers given that the slow progress on eliminating these challenges has reversed in recent years, with an increase in the number of hungry people by 122 million (20 percent) between 2019 and 2022. In addition to rebuilding in the aftermath of the COVID-19 pandemic, the global food system faces inter-related challenges from climate change, trade disruptions, increasing scarcity of water and land, environmental degradation, and evolving food demand patterns, among other factors. This paper assesses prospects to 2050 for food and nutrition security with a focus on low- and middle-income countries around the world in the context of these broader food system changes. Measures of food security presented here include per capita food and kilocalorie availability, the number and prevalence of hungry people, and micronutrient availability. Projected outcomes are assessed using the latest version of the International Model for Policy Analysis of Agricultural Commodities and Trade (IMPACT) framework, a modeling system that combines information from climate models, crop simulation models, and river basin level hydrological and water supply and demand models linked to a global, partial equilibrium, multimarket agriculture sector model.

Harnessing digital innovations for climate action and market access: Opportunities and constraints in the CWANA region

There is growing optimism about the potential of digital innovations to support climate action and transform agricultural markets. We review and characterize the landscape of digital innovations in the Central and West Asia and North Africa (CWANA) region. We highlight major success stories associated with the potential of digital innovations to facilitate rural market transformation and support climate action, including adaptation and mitigation. Our desk and landscape review identifies various digital innovations used in Egypt, Morocco, and Uzbekistan. We then create a typology of digital innovations based on seven broad service categorizations: weather and climate; agricultural finance; energy and early warning systems; data and crowdsourcing; market information and market place; extension and advisory information; and supply chain coordination. Three technical and validation workshops supplement this review. Our review shows that digital innovations have the potential to build resilience to climate change and increase market access, but their adoption remains low and varying across contexts. Significant heterogeneity and differences exist across these countries, possibly due to different institutional and regulatory frameworks that guide demand and capacity. We identify several supply and demand-side constraints facing the digital ecosystem in the region. There is the existence of a significant digital divide fueled by gender, literacy gaps, and related socioeconomic and psychosocial constraints. A seeming disconnect also exists between pilots and scale-ups, as most existing digital applications are unsuccessful in expanding beyond the pilot phase.

Soil fertility in mixed crop-livestock farming systems of Punjab, Pakistan: The role of institutional factors and sustainable land management practices

CONTEXT Soil salinization is a significant environmental challenge prevalent in arid and semi-arid regions, causing adverse effects on crop yields and jeopardizing household food security. Previous research has examined the influence of institutional dynamics and the adoption of sustainable land management practices in bolstering agricultural output, and some have investigated the interplay among socioeconomic determinants, institutional frameworks, and the uptake of climate-resilient and sustainable methodologies, or the association between soil health and agricultural productivity. Yet, there has been a lack of studies that considered this relationship altogether and their role in enhancing soil fertility. OBJECTIVE We investigate the relationship among socioeconomic and institutional factors, adoption of sustainable land management practices, and the resulting changes in soil fertility between 2016 and 2019 within the context of mixed crop-livestock farms in the three irrigated agroecological zones of Punjab, Pakistan. A household survey was conducted in 2019 to complement soil attributes data collected by the Government of Punjab in 2016. Households that implemented sustainable land management practices between 2016 and 2019 were analysed to investigate the effect of various factors on soil fertility, including the adoption of sustainable land management practices and their influence on soil fertility dynamics. METHODS A structural equation model was employed to examine the relationship among exogenous variables, moderating variables, and endogenous variables, to explain their collective influence on soil fertility between the two periods. RESULTS AND CONCLUSIONS The key findings highlight the significant role of institutional factors, including access to formal information channels such as extension services, demonstration trials, and credit facilities, alongside secure land rights, in predicting the adoption of sustainable land management practices such as gypsum application, laser land leveling, farmyard manuring, and agroforestry. Furthermore, specific SLM practices, particularly agroforestry featuring intercropping with Acacia spp. and farmyard manure application, exhibited positive impacts on change in soil organic matter, albeit with agroforestry showing a negative influence on soil phosphorus levels. The adoption of gypsum and LLL displayed positive effects on soil phosphorus levels over time, contrasting with LLL’s adverse impact on soil organic matter. SIGNIFICANCE Our findings suggest that soil fertility benefits from policies enacted through public-private partnerships that lead to improved access to sustainable land management information, reduced credit barriers, establishment of local soil testing facilities, and expedited land entitlement processes. These findings highlight the critical role of collaborative partnerships and institutional arrangements in enhancing agricultural productivity and environmental sustainability.

African domestic supply booms in value chains of fruits, vegetables, and animal products fueled by spontaneous clusters of SMEs

There is an international consensus that Africans consume less fruits and vegetables (FV), and animal products (AP) than they need for adequate nutrition, and that production and supply chains of these products are constrained. Yet, in this paper, we show that despite these problems, there is a lot of dynamism in demand and supply of these nutrient-dense products in Africa: (1) macro evidence of “domestic supply booms”—with supply growing as fast as or faster than in Asia and Latin America; (2) only 2–4% of FV, and 10% of AP consumption in Africa is imported, and only about 1–2% of the output of FV and AP is exported: the supply booms have thus been overwhelming domestically sourced, not imported; (3) micro evidence of substantial shares of consumption of FV and AP in total food consumption, similar to Asia’s; (4) evidence of rapid development of spontaneous clusters of farms and off-farm SMEs (output wholesalers, logistics, processors, and agro-dealers supporting farmers). These clusters are important in fueling the supply booms. Illustrative cases from Ethiopia, Nigeria, Tanzania, and Zambia are presented. We recommend that African governments and international partners: (1) internalize the fact that these spontaneous clusters are forming and already fueling supply booms; (2) note that important drivers of the booms have been government investments in wholesale markets, roads, and other infrastructure like electrification, and agricultural research/extension; (3) leverage and support existing spontaneous clusters and help new ones to form by greatly increasing those three types of public investments. JEL Codes: O20, Q13, Q18

Adapting fiscal strategies to energy and food price shocks in Portugal

Unpacking India’s fiscal responses to COVID-19: A computable general equilibrium modelling analysis

COVID-19 and dynamics of food insecurity in eastern India: Evidence from analysis of a panel survey

The COVID-19 pandemic-induced lockdowns raised concerns about increased food insecurity globally. This paper examines the incidence of food insecurity during the first and second wave of the COVID-19 pandemic in the poorest region of India. The study used panel data from two rounds of a telephone survey of 2,091 rural households. The study found that the incidence of food insecurity increased throughout the pandemic, with about 79 per cent of rural households reporting food insecurity in the second round of the survey, up from 70 per cent in the first round. About 59 per cent of the rural families who were food secure during the first round became food insecure by the second round of the survey. Our findings indicate that food insecurity due to COVID-19 is more likely to be structural than transitory.

Revisiting development strategy under climate uncertainty: Case study of Malawi

This paper analyzes the effectiveness of agriculture-led versus non-agriculture-led development strategies under climate-induced economic uncertainty. Utilizing Malawi as a case study, we introduce the application of Stochastic Dominance (SD) analysis, a tool from decision analysis theory, and compare the two strategies in the context of weather/climate-associated economic uncertainty. Our findings suggest that an agriculture-led development strategy consistently surpasses its non-agriculture-led antagonist in poverty and undernourishment outcomes across almost all possible weather/climate scenarios. This underscores that, despite increasing exposure of the entire economy to weather/climate uncertainty, agriculture-led development remains the optimal strategy for Malawi to reduce poverty and undernourishment. The study also endorses the broader use of SD analysis in policy planning studies, promoting its potential to integrate risk and uncertainty into policymaking.

Combining approaches for systemic behaviour change in groundwater governance

Over-extraction of groundwater is a prominent challenge in India, with profound implication for food security, livelihoods, and economic development. As groundwater is an ‘invisible’ and mobile common pool resource, sustainable governance of groundwater is complex, multifaceted, requiring coordination among various stakeholders at different scales. It remains an open question as to what can be done to strengthen the governance of groundwater, particularly on the scale necessary to address widespread depletion of resources. The growing competition over groundwater resources calls for systemic changes towards sustainable water management. These require understanding the behaviours of actors in the system network, as well as the institutions that shape the direction in which the system moves. In this paper, we offer a behavioural perspective to system transformation and apply it to the example of an Indian NGO working on sustainable natural resource governance. The organisation, Foundation for Ecological Security (FES), has been co-designing and using various institutional tools for groundwater governance with the collaboration of other NGOs and government partners, academic and research organisations towards strengthening governance of water. At the local level, these include groundwater monitoring and crop water budgeting, combined with experiential learning tools such as games for demand management, and supply side interventions to support water harvesting and recharge. These tools are combined with efforts to strengthen multi-actor platforms, building coalitions and capacity of government, civil society and private sector actors to support groundwater governance at scale. By combining local and systemic approaches, the aim is to influence water governance on a larger scale and contribute to the sustainable management of water resources in India. Our reflections illustrate how conceptual thinking can inform multi-methods approaches which consider that sustainably improving groundwater management at large scale requires inter-linked behavioural changes of diverse actors. Our approach constitutes critical reflection and conceptualization, based on situated knowledge which contributes to designing better adapted and more powerful intervention strategies through informed argument.

Burden of disease scenarios for 204 countries and territories, 2022–2050: A forecasting analysis for the Global Burden of Disease Study 2021

BACKGROUND Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. INTERPRETATION Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions.

Farmer perceptions, knowledge, and management of fall armyworm in maize production in Uganda

Spodoptera frugiperda (J.E. Smith), fall armyworm (FAW), a polyphagous Noctuid pest, was first reported in Uganda in 2016. Farmers were trained to identify and manage the pest, but there was a lack of information on farmer knowledge, perceptions and practices deployed to control it. Therefore, we conducted a survey to assess maize farmers’ knowledge, perceptions and management of the pest during the invasion. We interviewed 1,289 maize farmers from 10 maize-growing agro-ecological zones (AEZ) of Uganda using well-structured questionnaires. The data were analyzed using R version 4.2.3. The respondents faced many constraints, including pests, drought, poor soils and labor constraints. Among the pests, FAW was ranked by most (85%) of the respondents as the number one pest problem in maize, and some farmers reported having noticed it way back in 2014. By 2018, more than 90% of the farmers had seen or heard about FAW, and about 80% saw FAW in their fields. The most common FAW symptoms reported by maize farmers were windowing, near tunnel damage, and holes on the cobs. The developmental stages of FAW identified by farmers included eggs (10%), young larvae (78.7%), mature larvae (73.5%) and adult moths (6.7%). Insecticides were the major control tactic, although some farmers used plant extracts, hand-picking, sand, and ash. Farmers sourced information on FAW from various sources, including fellow farmers, radio/TV, extension agents, input dealers, print media, research and NGO extension. There is a need to package clear and uniform information for the farmers and to develop and promote a sustainable solution for FAW management, including harnessing biological control and cultural practices.

Perceptions towards management of acute malnutrition by community health volunteers in northern Kenya

Child undernutrition is a persistent challenge in arid and semi-arid areas due to low and erratic rainfall, recurrent droughts and food insecurity. In these settings, caregivers face several challenges in accessing health services for sick and/or malnourished children, including long distances to health facilities, harsh terrain, and lack of money to pay for transportation costs to the health facilities, leading to low service coverage and sub-optimal treatment outcomes. To address these challenges and optimize treatment outcomes, the World Health Organization recommends utilizing community health volunteers (CHVs) to manage acute malnutrition in the community. This study explored the perceptions of community members regarding acute malnutrition treatment by CHVs in Turkana and Isiolo counties in Kenya. The study utilized a cross-sectional study design and included a purposive sample of caregivers of children, CHVs, officers who trained and supervised CHVs and community leaders in the intervention area. Focus group discussions and key informant interviews were used to explore perceptions towards the management of acute malnutrition by CHVs. Generally, caregivers and CHVs perceived the intervention to be beneficial as it readily addressed acute malnutrition treatment needs in the community. The intervention was perceived to be acceptable, effective, and easily accessible. The community health structure provided a platform for commodity supply and management and CHV support supervision. This was a major enabler in implementing the intervention. The intervention faced operational and systemic challenges that should be considered before scale-up.

Famine in Gaza, questions for research and preventive action

The ongoing humanitarian crisis in Gaza is unprecedented in terms of the share of the population experiencing acute food insecurity and famine and the speed of the onset of the crisis. Research can help understand and anticipate the long-term impacts of the conflict on people and livelihoods, design more effective humanitarian support systems and identify options for creating resilient post-conflict livelihoods.

Evidence of potential impacts of a nutrition-sensitive agroecology program in Andhra Pradesh, India, on dietary diversity, nutritional status, and child development

Introduction While a number of studies have examined the nutritional impacts of agroecological interventions, few have examined impacts on child development, maternal and child anemia, and men’s dietary diversity. Moreover, there have been few such evaluations at scale. We evaluated the impact of a large-scale, multi-component food-based nutrition intervention involving homestead food production, nutrition counselling, cooking demonstrations, and crop planning exercises. Methods A cross-sectional assessment was conducted in 2021–2022 of 50 intervention villages where the nutrition-sensitive agroecology program had been implemented since 2018 and 79 control villages where only the agroecology program had been implemented. Data on self-reported dietary intake, caregiver-reported early child development, anthropometric measurements, and hemoglobin concentrations were collected using standardized procedures by trained Nutrition Farming Fellows, who were also responsible for implementing the program. Results A sample of 3,511 households (1,121 intervention and 2,390 control) participated in the survey. Dietary diversity scores (DDS) among women and men were mean (SD) 6.53 (±1.62) and 6.16 (±1.65), respectively, in intervention villages and 5.81 (±1.58) and 5.39 (±1.61), respectively, in control villages (p<0.01). DDS among children 6–24 months of age in intervention and control villages was 2.99 (±1.52) and 2.73 (±1.62), respectively (p<0.01). Children <2 years of age were less likely to be anemic in intervention versus control villages (59% versus 69%, p<0.01). Children 18–35 months age in intervention villages had higher child development scores than children in control villages (all p<0.05). Conclusion Nutrition-sensitive agroecological programs may be effective in improving diets, nutrition, and child development in rural India.

Impact of India’s Farm Science Centers (Krishi Vigyan Kendras) on farm households’ economic welfare: An evidence from a national farmer survey

This study examines the impact of access to India’s farm science centers (Krishi Vigyan Kendras, or KVKs) on agricultural households’ welfare using household data from the nationally representative Situation Assessment Survey of Agricultural Households conducted by India’s National Sample Survey Office in 2013. Employing different matching techniques and endogenous switching regression models, it was observed that the KVKs have a positive and statistically significant impact on agricultural households’ economic welfare, although, that impact is heterogeneous. Further, the investments made in expansion of India’s network of KVKs have been quite remunerative, as the benefit- to-cost ratio of expenditure on KVKs ranges from 8–12. Moreover, present findings suggest that expanding rural formal credit markets and promoting literacy can maximize the potential impact of KVKs on agricultural households’ economic welfare.

Soil quality evaluation for irrigated agroecological zones of Punjab, Pakistan: The Luenberger indicator approach

This article describes the construction of the Luenberger soil quality indicator (SQI) using data on crop yield, non-soil inputs, and soil profile from three irrigated agroecological zones of Punjab, Pakistan, namely, rice–wheat, maize–wheat–mix, and cotton–mix zones. Plot level data are used to construct a soil quality indicator by estimating directional distance functions within a data envelopment analysis (DEA) framework. We find that the SQI and crop yield relationships exhibit diminishing returns to improving soil quality levels. Using the constructed SQI values, we estimate linear regression models to generate weights that could be used directly to aggregate individual soil attributes into soil quality indicators without the necessity of fitting a frontier to the crop production data. For wheat and rice production, we find that SQI is most sensitive to changes in soil electrical conductivity (EC) and potassium (K). The SQI has direct relevance for site-specific decision-making problems where policymakers need to price land resources and conservation services to achieve agricultural and environmental goals.

What I say depends on how you ask: Experimental evidence of the effect of framing on the measurement of attitudes

We use a survey experiment to document the presence of framing effects in the measurement of attitudes. Next, using standard techniques for generating aggregate indices, we find that statement framing can meaningfully influence the relationship of the index with relevant covariates—in some cases changing the magnitude, statistical significance, and even the sign of the estimated relationship. We conclude by discussing how randomizing statement framing across respondents can help address bias in the measurement of attitudes.

Enhancing agency and empowerment in agricultural development projects: A synthesis of mixed methods impact evaluations from the Gender, Agriculture, and Assets Project, Phase 2 (GAAP2)

Development interventions increasingly include women’s empowerment and gender equality among their objectives, but evaluating their impact has been stymied by the lack of measures that are comparable across interventions. This paper synthesizes the findings of 11 mixed-methods impact evaluations of agricultural development projects from South Asia and sub-Saharan Africa that were part of the Gender, Agriculture, and Assets Project, Phase 2 (GAAP2). As part of GAAP2, qualitative and quantitative data were used to develop and validate the multidimensional project-level Women’s Empowerment in Agriculture Index (pro-WEAI), which was used to assess the impact of GAAP2 projects on women’s empowerment. This paper assesses the extent to which: (1) a two- to three-year agricultural development project can contribute to women’s empowerment; and (2) a suite of methods comprising a standardized quantitative measure of women’s empowerment and a set of qualitative protocols, can evaluate such impacts. Our synthesis finds that the most common positive significant impacts were on the instrumental and collective agency indicators that comprise pro-WEAI, owing to the group-based approaches used. We found few projects significantly improved intrinsic agency, even among those with explicitly stated objectives to change gender norms. Unsurprisingly, we find mixed, and mostly null impacts on aggregate pro-WEAI, with positive impacts more likely in the South Asian, rather than African, cases. Our results highlight the need for projects to design their strategies specifically for empowerment, rather than assume that projects aiming to reach and benefit women automatically empower them. Our study also shows the value of a suite of methods containing a common metric to compare empowerment impacts and qualitative protocols to understand and contextualize these impacts.

Gender bias in customer perceptions: The case of agro-input dealers in Uganda

CONTEXT Faced with incomplete and imperfect information, economic actors rely predominantly on perceptions and often base decisions on heuristics prone to bias. Gender bias in perceptions favoring men has been found in a variety of settings and may be an important reason why some sectors remain dominated by men and gender gaps in terms of benefits persist. In modernizing food supply chains in a patriarchal context such as the maize sub-sector in Uganda, this may result in women facing significant barriers to entry. OBJECTIVE Using a unique dataset of ratings of agro-input dealers provided by smallholder farmers in their vicinity, we test if farmers perceive male-managed agro-input shops differently than agro-input shops managed by women. METHODS We use a dyadic dataset of farmer-dealer links to explicitly control for quality differences between male- and female-managed agro-input shops and use the fact that a farmer has generally rated more than one agro-input to account for farmer-level heterogeneity using fixed-effects regression. RESULTS AND CONCLUSIONS We find that farmers rate male-managed agro-input outlets higher on a range of attributes related to the dealership in general, as well as on the quality of inputs sold by the dealer. After controlling for both dealer and farmer level confounders, we conclude that gender bias in customer perceptions persists. SIGNIFICANCE Our results suggest a comparative disadvantage and an important entry barrier for female agro-input dealers. The gender bias may also affect social outcomes like women’s capabilities, aspirations, and empowerment in seed systems but also impairs development at more aggregate levels: as a considerable share of agro-input shops is managed by women, this finding may impose challenges for varietal turnover, hindering agricultural productivity, food security, and rural transformation. Policies and interventions designed to challenge gender norms and customs are needed to correct this bias.

Increasing production diversity and diet quality: Evidence from Bangladesh

In the context of rural Bangladesh, we assess whether agriculture training alone, nutrition behavior communication change (BCC) alone, combined agriculture training and nutrition BCC, or agriculture training and nutrition BCC combined with gender sensitization improve: (a) production diversity, either on household fields or through crop, livestock, or aquaculture activities carried out near the family homestead; and (b) diet diversity and the quality of household diets. All treatment arms were implemented by government employees. Implementation quality was high. No treatment increased production diversification of crops grown on fields. Treatment arms with agricultural training did increase the number of different crops grown in homestead gardens and the likelihood of any egg, dairy, or fish production but the magnitudes of these effect sizes were small. All agricultural treatment arms had, in percentage terms, large effects on measures of levels of homestead production. However, because baseline levels of production were low, the magnitude of these changes in absolute terms was modest. Nearly all treatment arms improved measures of food consumption and diet with the largest effects found when nutrition and agriculture training were combined. Relative to treatments combining agriculture and nutrition training, we find no significant impact of adding the gender sensitization on our measures of production diversity or diet quality. Interventions that combine agricultural training and nutrition BCC can improve both production diversity and diet quality, but they are not a panacea. They can, however, contribute toward better diets of rural households.

Book review: Matias E. Margulis, Shadow negotiators: How UN organizations shape the rules of world trade for food security Stanford University Press, 2023

Social protection amid a crisis: New evidence from South Africa’s Older Person’s Grant

This study estimates the effects of South Africa’s Older Person’s Grant on well-being amid the COVID-19 pandemic. With household-level data collected before and during the pandemic, it leverages the age-eligibility threshold of the grant to estimate its effects on households in both periods. Prior to the pandemic, this study finds that grant receipt substantially improves economic well-being and decreases adult hunger at the household level. During the first 18 months of the pandemic, this study finds larger effects on both economic well-being and hunger than prior to the pandemic. In particular, recipient households were less likely to report running out of money for food and hunger among either adults or children. These results, which are stronger when pandemic-related lockdown policies are in place and for more vulnerable households, provide critical insight into the effectiveness of one of the world’s most well-known cash-transfer programs during a massive global health crisis.