Reducing Child Malnutrition through Community Intervention Programs: Evidence from a Large Scale Randomized Trial in Rural Senegal

This article investigates the impact of the Programme de Renforcement de la Nutrition – Nutrition Enhancement Program (PRN) that aims to improve child nutrition in Senegal based on randomized community intervention. Despite substantial deviation from the original assignment status of villages between the two data waves in 2004 and 2006, we find a significant impact of the PRN on medical inputs and child care measures taken by mothers in villages originally assigned treatment status. We do not detect a strong overall program impact on the outcome measure of weight for age, possibly because the program has not been in place long enough to show a tangible effect. Children with longest exposure to the program, in particular the ones whose mothers benefited from the program during their pregnancy, show a significant improvement in their nutritional status, lending support to this hypothesis. We compare the results of this prospective analysis based on the planned randomization status with those from an ex-post difference-in-difference approach, finding that this treatment-on-the-treated approach leads to larger estimates of the program impact. The findings represent a step into a more complete understanding of the effectiveness of large-scale nutrition interventions. ‡ Harold Alderman, World Bank, Washington DC, USA; email: [email protected]. ♦ Sebastian Linnemayr, Harvard School of Public Health, Harvard University, Cambridge, USA; email: [email protected].