1. September 22 , 2016 The TOPS Program
How data can help us: Analysis of participation in multi-sectoral food security programs that achieve reductions in stunting -- A look at Honduras, Mozambique and Bangladesh.
September 22 , The TOPS Program

2. CARE Honduras Food Security Program FY1996 to FY2000 Statistically significant reduction in stunting: BL 54.9% FE 47.2% Control FE 65.8%

3. CARE Honduras Food Security Program
FY1996 to FY2000
HOGASA: Maternal-child health, nutrition and WASH with preventive ration to <2 and PLW
EXTENSA: Increased agriculture production and diversified production
PODER: Food for Assets

4. Effect of household participation in interventions of the CARE Food Security Program on child stunting, age months
Variable
Coefficient
Participation in any 1 intervention (reference)
1.0000
Participation in 2 interventions
1.1115
Participation in all 3 interventions
0.3441 *
* Regression analysis with controls for SES; significant at 0.01

5. CARE Mozambique Viable Initiatives for the Development of Agriculture (VIDA) FY1997 to FY2001
Started as agriculture production / agribusiness program
At midterm found statistically significant increases in household income but no reduction in stunting
Added nutrition education component through women’s groups, with some linkages with farmer groups
NAMPULA PROVINCE

7. Results: No reduction in stunting?
Z score
Height-for-age
Baseline 1997
Survey 2002 n %
Mild or none (>-2 sd)
352
40.0
341
41.0

8. Results: Trend in reduction of severity of stunting
Z score
Height-for-age
Baseline 1997
Survey 2002 n %
Severe (<-3 sd)
304
34.5
210
25.3
Moderate (<-2 sd and >-3 sd)
224
25.5
282
33.9
Mild or none (>-2 sd)
352
40.0
341
41.0
TOTAL
880
100.0
831
Importance of stratifying results!!

9. Cross-tabulation of chronic malnutrition with participation
Household participation in VIDA Project activities
Height-for-Age
< -2 s.d. N %
Any project activity
181
56.9
No participation
225
64.1
Agriculture only 77
49.3
Nutrition only 86
62.7
Agriculture and nutrition
18*
72.0
* Further investigation showed that fully integrated activities as planned were not prioritized – instead referrals from nutrition groups to agriculture support were made for children in malnourished condition -- a “curative” focus vs. prevention intention. Strategies were reviewed and preventive focus strengthened.

10. CARE Bangladesh SHOUHARDO-I FY1998 to FY2010
In 18 districts, including peri-urban and rural communities in North Char, Mid Char, Haor and Coastal areas.
Reduction in stunting: BL 51.9% FE 36.4%

11. Participation at the household level
Program Group Activities
% of household participation
Core Occupational Group (ag/IGA)
72.2%
Mothers’ Group
94.8%
Additional analysis (regression)
p-value
NUMBER OF INTERVENTIONS households participated in over the previous year and
CHILD STUNTING
0.013 **
IMPORTANCE OF INTEGRATION AT THE HOUSEHOLD LEVEL !

12. Core Occupational Group interventions
COG Intervention
% of household participation
Agriculture
22.5
CHD: Vegetable production
30.9
CHD: Fruit production
8.2
CHD: Livestock
20.2
IGA: Non agriculture
12.9
IGA: Agriculture
11.0
IGA: Livestock
10.6
Fisheries
9.1
ANY COG INTERVENTION
72.2

13. WALA Project: FY2009-FY2014 Reduction in stunting: BL 42. 4% FE 37. 1%
WALA Project: FY2009-FY Reduction in stunting: BL 42.4% FE 37.1%* Statistically significant at p<0.01

14. Positive Results in IPTT Indicators in Multiple Sectors
Nutrition / WASH / Agro-economics BL FE
Minimum adequate diet
12.3%
20.0% *
Improved hygiene (latrine, handwashing, bed nets)
6.1%
26.0% *
Average Household Dietary Diversity Score
4.29
4.50 *
*Statistically significant at p<0.01

15. Percentage of Households Participating in X Number of WALA Project Activities
% HH
at FE
0 ACTIVITIES
13.2
1 to 3 ACTIVITIES
37.4
4 to 6 ACTIVITIES
29.5
7+ ACTIVITIES
19.9

16. The TOPS Program was made possible by the generous support of the American people through the United States Agency for International Development (USAID) Office of Food for Peace. The contents of this presentation do not necessarily reflect the views of USAID or the United States Government.