The first years of life mark a critical period for child development. There is a strong consensus that improvements in the nutritional status of infants and young children not only have a direct, short-term impact on their health, but also impact their physical and mental development later in life.

The study provides evidence for effects of a large scale intervention that focuses on quality of nutritional and child-care inputs during the early stages of life.

The 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.

The study finds 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 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.

What are the medium-long term effects of large scale community nutrition interventions on cognitive development and school preparedness, via the improvements in nutritional status?

• The nutrition program reduced the incidence ofunderweight by 5.2-7.5 percentage points.

• The large scale community based nutrition helped the participating communities bridge the gap in weight for age z-score by 0.15-0.22 standard deviations.

• The nutrition program had a protectiveeffect, preventing Seecaline sites from an increasing trend in stunting.

Impact Evaluation Methods:    Difference-in-difference, Propensity score matching

Evaluation Start Date:   1997   Evaluation End Date:  2007

Evaluators:  Emanuela Galasso,  Harold Alderman,  Lia Fernald,  Nithin Umapathi

Impact Evaluation Design

A nationally representative baseline survey was fielded in 1997/98 before the program, and a follow-ip survey of 440 of those communities was conducted in 2004. In the interim, the program was implemented in all districts with a malnutrition rate above the national average. The evaluation uses matching to construct a comparison group of communities, and then difference-in-differences to eliminate time-invariant differences between project and control communities.

  Seecaline

The project intends to improve the nutritional status of children under the age of three, and of pregnant and lactating mothers in targeted project areas.

The focal point of the project is growth monitoring activities, around which a community nutrition agent mobilizes the community to participate in hygiene and nutritional education sessions, counseling, and cooking demonstrations.