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印度通过自助小组改善妇女营养状况:营养信息有帮助吗?

Women improving nutrition through self-help groups in India: Does nutrition information help?

作者信息

Kumar Neha, Raghunathan Kalyani, Quisumbing Agnes, Scott Samuel, Menon Purnima, Thai Giang, Gupta Shivani, Nichols Carly

机构信息

Food and Nutrition Policy Department, International Food Policy Research Institute, Washington, DC, USA.

Food and Nutrition Policy Department, International Food Policy Research Institute, New Delhi, India.

出版信息

Food Policy. 2024 Oct;128:102716. doi: 10.1016/j.foodpol.2024.102716.

Abstract

Women's self-help groups (SHGs) are an important platform for reaching poor women in India. Despite SHGs' women-focused programming, evidence of the impact of SHG-based interventions on nutrition outcomes is limited, and most evaluations of nutrition interventions have not examined intermediate outcomes along the impact pathways or outcomes for women themselves. This paper evaluates the effectiveness of an integrated agriculture-nutrition intervention delivered through women's SHGs in five states in central and eastern India. The interventions involved the delivery of nutrition behavior change communication to groups through participatory approaches, community engagement around key issues, and the strengthening of collective organizations. Our analysis is based on three rounds of rich panel data on close to 2700 rural women and their households from eight districts in these five states and qualitative work from an accompanying process evaluation. Using difference-in-difference models with nearest neighbor matching methods, we present results on women's anthropometry and diet-related outcomes. We do not observe any improvements in women's BMI or overall dietary diversity. Although more women in the nutrition intensification arm consumed animal source foods, nuts and seeds, and fruits, this was not enough to increase overall dietary diversity scores or the proportion of women achieving minimum dietary diversity. We measure intermediate outcomes along the program's impact pathways and find improvements in household incomes, cultivation of home gardens, and utilization of government schemes but not in women's empowerment. The lack of improvement in anthropometry and diets despite changes in some intermediate outcomes can be attributed to several factors such as low implementation intensity, poor facilitator capacity and incentives, the lack of relevance of the BCC topics to the average SHG member, and resource and agency constraints to adoption of recommended practices. Although we do not have data to test the parallel trends assumption and so do not interpret our results as causal, these findings do suggest that optimism about using group-based platforms needs to be tempered in resource-poor contexts.

摘要

妇女自助小组(SHGs)是印度接触贫困妇女的重要平台。尽管妇女自助小组的项目以女性为重点,但基于妇女自助小组的干预措施对营养成果影响的证据有限,而且大多数营养干预措施的评估并未考察影响路径上的中间成果或妇女自身的成果。本文评估了通过印度中部和东部五个邦的妇女自助小组实施的综合农业 - 营养干预措施的有效性。这些干预措施包括通过参与式方法向小组提供营养行为改变宣传、围绕关键问题开展社区参与以及加强集体组织。我们的分析基于来自这五个邦八个区近2700名农村妇女及其家庭的三轮丰富面板数据以及伴随过程评估的定性研究。使用具有最近邻匹配方法的差分模型,我们展示了关于妇女人体测量和饮食相关成果的结果。我们没有观察到妇女的体重指数(BMI)或总体饮食多样性有任何改善。尽管营养强化组中有更多妇女食用动物源食品、坚果和种子以及水果,但这不足以提高总体饮食多样性得分或实现最低饮食多样性的妇女比例。我们衡量了该项目影响路径上的中间成果,发现家庭收入、家庭菜园种植和政府计划的利用率有所提高,但妇女赋权方面没有改善。尽管一些中间成果有所变化,但人体测量和饮食方面缺乏改善可归因于几个因素,如实施强度低、促进者能力和激励不足、行为改变宣传(BCC)主题与普通妇女自助小组成员的相关性不足以及采用推荐做法的资源和机构限制。尽管我们没有数据来检验平行趋势假设,因此不将我们的结果解释为因果关系,但这些发现确实表明,在资源匮乏的背景下,对使用基于小组的平台的乐观态度需要有所缓和。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3f3/11535312/1a6457561901/gr1.jpg

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