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Baseline Findings
Impact Evaluation of Sunaula Hazar Din- Community action for Nutrition Project
DIME, The World Bank
DOLPA
MUGU
JUMLA
KAILALI
BARDIYA
HUMLA
DOTI
SURKHET
NAWAL
PARASI
KAPIL-
BASTU RUPAN-
DEHI
DANG
BANKE
ACHHAM KALIKOT
JHAPA
MORANG
SIRAHA
SAPTARI
DARCHULA
BAJHANG
BAITADI
DADEL-
DHURA
KANCHAN-
PUR
BAJURA
PARSA
BARA RAUT-
AHAT
DHANUSA
MAHO-
TARI
SUNSARI
SARLAHI
DHADING
MAKAWAN-
PUR
CHITWAN
KASKI
TANAHU
PALPA
SYANGJA
PARBAT
ARGHAK
HACHI
GULMI
UDAYAPUR
SINDHULI
ILAM
BHOJ-
PUR
DHAN-
KUTA
TAPLEJUNG
OKHAL-
DHUNGA
TERHA-
THUM
KHOTANG
LALIT
BHAK
KATHM
SULUK-
HUMBU
DOLAKHA
SANKHUWA-
SABA
NUWAKOT
SINDHU-
PALCHOK
KAVRE
RASUWA
LAMJUNG
GORKHA
PYUT-
HAN
ROLPA
SALYAN
MYAGDI
DAILEKH
JAJARKOT
RUKUM
MUSTANG
MANANG
CHINA
INDIA
N
3
(+) Impact of the program
(+) Impact of other (external) factors
The Value of Control Group
0
2
4
6
8
10
12
14
16
Before After
Treatment Group
Control Group
Impact Evaluation
Rigorous impact evaluation uses a control group of similar individuals who are not exposed to the project
Randomization (usually) ensures that control group is a good proxy for treatment group
4
Three Components
Evaluation of Sunalua Hazar Din has three components: Overall Project Evaluation: Measures the effect of
SHD compared to control groups Expert Suggestions: Tests whether providing
communities with expert suggestions will improve outcomes
Female Leaders: Tests whether requiring female leadership will change goals and outcomes
5
Overall Evaluation Working in 282 out of 292 SHD VDCs
141 early treatment VDCs start project in 2014 141 late treatment VDCs start project in 2016.
The IE is working in the 1-2 most disadvantaged wards in each VDC
Impact of SHD will be determined from comparison of early starters to late starters before late starters begin operations
A number of outcomes will be studied
6
Sample 282 VDCs (out of 290 for SHD) Least developed 1 or 2 wards selected in each
VDC In each ward, household census was taken,
then a random sample of: Group 1: 15 households with a child under 2 Group 2: 10 households with a married woman
aged 15-25 Total sample of 7049 HHs
7
Households in Group 1 were asked the entire questionnaire. Households in Group 2 were asked the Main Household Questionnaire and additional module on family planning.
Indicators on family planning come from Group 2, and are therefore representative of married women aged 15-25.
IE Design
9
282 IE VDCs
141 VDCs Early Starters begin project
in 2014
Standard RRNI Coaching
(70 VDCs)
Female Leadership
Requirement (35 VDCs)
No Leadership Requirement
(35 VDCs)
Coaches suggest
focus areas (71 VDCs)
Female Leadership
Requirement (36 VDCs)
No Leadership Requirement
(35 VDCs)
141 VDCs Late Stasrters begin project
in 2016
IE Activities Household survey of 7049 HHs was taken from
July-October 2013 Survey was undertaken by Full Bright
Consulting, under supervision from DIME, The World Bank
Overall Evaluation: Must be sure that late starter VDCs do not begin
until around 2016 Follow-up survey must be completed before late
starter VDCs begin
10
Balance between Early Starters & Late Starters
11 Note: Standard Errors clustered at VDC-level and District fixed-effects included
Control (Late Starter) Treatment
(Early Starter) Balance
Test
N Mean SD N Mean SD P Value
Female headed Household (yes=1) 3512 0.09 0.29 3526 0.1 0.3 0.45
PDO 1: Unmet Family Planning Needs 820 0.32 0.47 821 0.31 0.46 0.72
PDO 2 : Pregnant Women taking IFA 2053 0.21 0.40 2042 0.21 0.40 0.87
PDO 3: Exclusive Breastfeeding 490 0.71 0.46 534 0.68 0.47 0.55
PDO 4: Minimum Acceptable Diet 1699 0.10 0.30 1685 0.09 0.29 0.34
PDO 5: Keeping Girls at School 3437 0.36 0.48 3446 0.38 0.49 0.31
PDO 6: Reducing Indoor Air Pollution 3439 0.35 0.35 3446 0.29 0.33 0.00***
PDO 7: Pregnant Women's Dietary Needs 2188 0.76 0.43 2192 0.74 0.44 0.16
Sample Breakdown
12
PresenterPresentation Notes90.3% of the household heads are male, while 9.7% of them are female. 71.3% of the households live in the Outer Terai, while 16.3% live in the Hill and 12.4% in the Inner Terai.
13
Household Characteristics
Primary Occupation
14
Household Head Characteristics
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Land and Livestock
16
Child Health and Nutrition
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Malnutrition by Age
18
Malnutrition by Region
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Breastfeeding by Age
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Breastfeeding Practices I
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Breastfeeding Practices II
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Complementary Feeding Practices
23
Maternal Nutrition and Practices
24
Unmet Family Planning Need
25
Type of Contraception
26
Duration of taking IFA Supplements (during last pregnancy)
27
Maternal Nutrition (previous day)
28
Household Food Consumption over last week
29
Water and Sanitation
30
Source of Drinking Water
31
Toilet Facilities
32
Blue portion: Access to Toilet Red portion: No Access to Toilet
Feces Reported around House
33
Hand Washing Behavior
34
Community Attitudes 35
Families in this community send their daughters to school until at least 20 years of age
36
Attitudes towards Reducing Smoke Pollution
37
Should pregnant women eat at least 3 meals a day, including animal products?
38
39
Social Cohesion
Most people in this village can be trusted.
40
In the past year, have you worked with others in your village for the
benefit of the community?
41
What proportion of people in this village contribute time or money toward common development goals?
42
Differences that Most Often Cause Problem
43
To what extent do differences characterize your village?
44
Thank You!
45
Choice of Focus Groups
50% of VDCs were urged to select 3 suggested focus groups: 1. Increase Animal Protein 2. IFA/Deworming for Women 3. Breastfeeding or End Open Defecation
46
Appendix I: Project Development Indicators
47
Appendix II: Definition of PDO
1. PDO 1: Percentage of women who do not want to become pregnant but are not using contraception
2. PDO 2: Percentage of pregnant women (15-49) taking iron and folic acid (IFA) supplements for 180 days
3. PDO 3: Percentage of children 0-6 months of age who are exclusively breastfed
48
Appendix II: Definition of PDO
4. PDO 4: Proportion of children 6-23 months of age who receive a minimum acceptable diet 5. PDO 5: Community attitude towards the importance of keeping girls at school until age 20 6. PDO 6: Community attitudes towards the importance of reducing indoor air pollution 7. PDO 7: Proportion of women with children under 2 years who recognize the importance of eating 3 times a day including at least one animal-sourced food
49
Appendix III: Focus Areas
1. Maintain adequate weight and regular eating among pregnant women and young children
2. Increase consumption of animal protein among pregnant women and young children
3. Practice proper and consistent breastfeeding 4. Use clan and safe water 5. Delay marriage and pregnancy for young girls 6. Regular de-worming and utilization of iron
supplements by young women
50
Appendix III: Focus Areas
7. Extend education of young girls 8. Utilize family planning method to avoid
unwanted pregnancies 9. Practice proper and consistent hand washing 10. Ensure immunization of all children 11. End open defecation
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Appendix III: Focus Areas
12. Ensure prompt medical treatment of chest infection, fever, and diarrhea in young children 13. Improve school sanitation 14. Reduce workload of pregnant women 15. Reduce exposure to indoor smoke for
pregnant women and young children
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Baseline FindingsSlide Number 2The Value of Control GroupImpact EvaluationThree ComponentsOverall EvaluationSampleSlide Number 8IE DesignIE ActivitiesBalance between Early Starters & Late StartersSample BreakdownHousehold CharacteristicsPrimary OccupationHousehold Head CharacteristicsLand and LivestockChild Health and NutritionMalnutrition by AgeMalnutrition by RegionBreastfeeding by AgeBreastfeeding Practices IBreastfeeding Practices IIComplementary Feeding PracticesMaternal Nutrition and PracticesUnmet Family Planning NeedType of ContraceptionDuration of taking IFA Supplements (during last pregnancy)Maternal Nutrition (previous day)Household Food Consumption over last weekWater and SanitationSource of Drinking WaterToilet FacilitiesFeces Reported around HouseHand Washing BehaviorCommunity AttitudesFamilies in this community send their daughters to school until at least 20 years of ageAttitudes towards Reducing Smoke PollutionShould pregnant women eat at least 3 meals a day, including animal products?Slide Number 39Most people in this village can be trusted.In the past year, have you worked with others in your village for the benefit of the community?What proportion of people in this village contribute time or money toward common development goals?Differences that Most Often Cause ProblemTo what extent do differences characterize your village?Thank You!Choice of Focus GroupsAppendix I: Project Development IndicatorsAppendix II: Definition of PDOAppendix II: Definition of PDOAppendix III: Focus AreasAppendix III: Focus AreasAppendix III: Focus Areas