Improving Nutritional Status through Behavioral Change: Lessons from Madagascar

We provide evidence for effects of a large scale intervention that focuses on quality of nutritional and child-care inputs during the early stages of life. Our empirical strategy uses a combination of double difference and weighting estimators in a longitudinal survey to address the purposive placement of participating communities and estimate the effect of the availability of the program at the community level on nutritional outcomes. We find that the program helped 0-5 years old children, in the participating communities to bridge their gap in weight for age z-score and the incidence of underweight. The program also had significant effects in protecting long term nutritional outcomes (height for age z-scores and incidence of stunting) against an underlying negative trend in the absence of the program. Importantly, the effect of the program exhibits substantial heterogeneity: gains in nutritional outcomes are larger for more educated mothers and for villages with better infrastructure. The results are suggestive of important complementarities between child care, maternal education and community infrastructure. (JEL I12, I18, J13, O15)