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PR, IFPRI3; CRP4; 2 Promoting Healthy Diets and Nutrition for all; 4 Transforming Agricultural and Rural Economies; G Cross-cutting gender theme; ISI; IFPRIOA, Nutrition, Diets, and Health (NDH); Food and Nutrition Policy; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Development programs often rely on women’s participation. However, there is little evidence of whether development programs that engage women’s unpaid labor – particularly in care work – add to their time burdens. We tested this hypothesis on a nutrition-sensitive agriculture program delivered through community-based preschools in Malawi. The mixed-methods study was conducted over one year using data from 1,168 female caregivers from a cluster-randomized control trial. A longitudinal binomial logistic regression model was used to estimate the proportion of time spent caregiving in a 24-hour period (expressed as minutes) at baseline and then separately for each treatment group at 6-months and 1-year post-randomization. In addition, two rounds of 38 qualitative in-depth interviews (n = 76) were conducted with women, men and adolescent girls to explore their perceptions of program activities, time use and gender attitudes. We found that the program quantitatively increased daily caregiving time for participating women by approximately 30 min. However, this effect occurred only during the lean season when preschool scale-up investments increased. Qualitatively, program-related tasks were not considered burdensome. Moreover, participants saw contributions as important investments in their children’s development. These findings add to limited evidence of the impacts of nutrition-sensitive agricultural programs and early childhood interventions on women’s time use. Measuring women’s participation through mixed-method evaluations can aid interpretation to avoid harm and to better understand the tradeoffs of women’s time.

PR, DCA; IFPRI3; 2 Promoting Healthy Diets and Nutrition for all; Capacity Strengthening; CRP4; ISI, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Bangladesh struggles with undernutrition in women and young children. Nutrition-sensitive agriculture programmes can help address rural undernutrition. However, questions remain on the costs of multisectoral programmes. This study estimates the economic costs of the Targeting and Re-aligning Agriculture to Improve Nutrition (TRAIN) programme, which integrated nutrition behaviour change and agricultural extension with a credit platform to support women's income generation. We used the Strengthening Economic Evaluation for Multisectoral Strategies for Nutrition (SEEMS-Nutrition) approach. The approach aligns costs with a multisectoral nutrition typology, identifying inputs and costs along programme impact pathways. We measure and allocate costs for activities and inputs, combining expenditures and micro-costing. Quantitative and qualitative data were collected retrospectively from implementers and beneficiaries. Expenditure data and economic costs were combined to calculate incremental economic costs. The intervention was designed around a randomised control trial. Incremental costs are presented by treatment arm. The total incremental cost was $795,040.34 for a 3.5-year period. The annual incremental costs per household were US$65.37 (Arm 2), USD$114.15 (Arm 3) and $157.11 (Arm 4). Total costs were led by nutrition counselling (37%), agriculture extension (12%), supervision (12%), training (12%), monitoring and evaluation (9%) and community events (5%). Total input costs were led by personnel (68%), travel (12%) and supplies (7%). This study presents the total incremental costs of an agriculture-nutrition intervention implemented through a microcredit platform. Costs per household compare favourably with similar interventions. Our results illustrate the value of a standardised costing approach for comparison with other multisectoral nutrition interventions.

PR, IFPRI3; CRP4; 2 Promoting Healthy Diets and Nutrition for all; ISI, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Background: Low-quality diets contribute to the burden of malnutrition and increase the risk of children not achieving their developmental potential. Nutrition-sensitive agriculture programs address the underlying determinants of malnutrition, though their contributions to improving diets do not factor into current nutrition impact modeling tools. Objective: To synthesize the evidence on the effectiveness of nutrition-sensitive agriculture programs in improving dietary diversity in young children (6-23.9 months and 6-60 months). Methods: A literature search was conducted for published trials through existing systematic reviews and individual database search of the ISI Web of Science. All dietary diversity measures in the studies selected to be in the analysis were extracted. Estimation of main pooled effects were conducted on outcomes of minimum diet diversity (MDD) and diet diversity score (DDS) using random-effects meta-regression models. We report pooled effect sizes as standardized mean differences (SMDs) or odds ratios (ORs). Results: Nutrition-sensitive agricultural interventions have a significant positive impact on the diet diversity scores of children aged 6-23.9 months (SMD = 0.22, 95% confidence interval (CI) = 0.09-0.36) and on the odds of reaching minimum diet diversity (OR = 1.45, 95% CI = 1.20, 1.76). Similar impacts are found when analyses are expanded to include studies for children aged 6-60 months (DDS SMD = 0.22, 95% CI = 0.12-0.32) (MDD OR = 1.64, 95% CI: = 1.38-1.94). Conclusion: Nutrition-sensitive agriculture interventions consistently have a positive impact on child dietary diversity. Incorporating this evidence in nutrition modeling tools can contribute to decision-making on the relative benefits of nutrition-sensitive interventions as compared with other maternal, newborn, child health and nutrition (MNCHN) interventions.

PR, IFPRI3; ISI; DCA; CRP4; 2 Promoting Healthy Diets and Nutrition for all, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Malnutrition is a leading cause of death and disability among children in low-income countries. Nutrition-sensitive interventions show promise in increasing food access and improving diets. There are possible synergies of integrating these programs with other sectors, improving effectiveness by leveraging resources. However, economic evaluations of these multi-sectoral programs are limited. We aimed to estimate the cost efficiency, cost-effectiveness, benefit-cost ratio, and net benefit of using community-based early childhood development (ECD) centers as platforms for an intervention promoting agricultural production and nutrition among households with young children in Malawi. The intervention was costed using bottom-up micro-costing and top-down expenditure analysis with a societal perspective and a 12-month horizon. Effectiveness estimates were derived from a cluster-randomized control trial. Premature deaths and stunting cases averted were estimated using the Lived Saved Tool. We calculated DALYs averted, and the value of three benefits streams resulting from reductions in premature mortality, increases in lifetime productivity and household agricultural productivity. We transferred the US value of a statistical life (VSL) to Malawi using an income elasticity of 1.5, and a 10% discount rate. Probabilistic sensitivity analysis was conducted using a Monte Carlo model. The intervention cost $197,377, reaching 4,806 beneficiaries at $41 per beneficiary, $595 per case of stunting, $18,310 per death, and $516 per DALY averted. Net benefit estimates ranged from $507,589 to $4,678,258, and benefit-cost ratios from 3.57 to 24.70. Sensitivity analyses confirmed a positive return on investment. Implementing agriculture-nutrition interventions through ECD platforms may be an efficient use of resources in Malawi and similar contexts.

PR, IFPRI3; ISI; CRP4; 2 Promoting Healthy Diets and Nutrition for all, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

PR, IFPRI3; ISI; MaSSP; CRP4; DCA; UNFSS, PHND; A4NH; DSGD, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Governments and development partners looking to accelerate progress in addressing malnutrition have been examining how to use interventions in value-chains to improve diets. However, the links between interventions in value chains and diets involve a range of direct and indirect effects that are not yet well understood. We apply a mixed-method multisectoral diagnostic to examine potential interventions in food systems to improve diets of smallholder farmers in Malawi. We examine entry points for interventions involving public and private-sectors, and explore the methodological requirements for undertaking this type of multisectoral analysis. We find that although food consumption is dominated by maize, a range of nutritious foods are also being consumed; including leafy greens, fruits, chicken, dried fish, dried beans and peas, and groundnuts. Yet important deficits in nutrient intake remain prevalent in low-income households due to inadequate quantity of consumption. While increasing consumption through own-production is one potentially important channel to increase quantity of nutritious foods available (particularly fruits and leafy green vegetables), markets also play a potentially important role. Nutritious foods are available on markets year-round, although strong seasonality impacts the availability and price of perishable products. For beans, peas and groundnuts, supply appears to be available throughout the year, with price fluctuations relatively controlled due to storage capacity and imports. The capacity of markets to supply safe and nutritious food is limited by a number of issues, including poor hygiene; lack of infrastructure for storage and selling; limited information on nutrition, and weak coordination among sellers and producers. Other bottlenecks include: on-farm constraints for expanded production, consumers with limited purchasing capacity, intense competition among sellers and few services for sellers to increase volume of product sold during

PR, IFPRI3; DCA; CRP4; ISI; Capacity Strengthening; 2 Promoting Healthy Diets and Nutrition for all; IFPRIOA, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Background: Young children in Malawi consume low-quality diets lacking micronutrients critical for their development. Objective: To evaluate the impact of an agriculture and nutrition behavior change communication (BCC) intervention implemented through community-based childcare centers on the nutrient adequacy of diets of children living in food-insecure settings in Malawi.

Non-PR, IFPRI1; MaSSP; CRP2; DCA; 2 Promoting Healthy Diets and Nutrition for all, DSGD; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM), Malawi is extremely vulnerable to shocks and recurrent food crises (Barrett & Headey 2014). Malawi also suffers from persistently high levels of undernutrition (DHS 2016). Humanitarian aid has played an important role in alleviating hunger during emergencies, such as those in 2015-16 and 2016-17. However, the Government of Malawi and Development partners recognize that emergency responses are not a sustainable solution. This qualitative study examines the characteristics of resilient households and perceived effects of programs to improve food security and resilience from the perspective of the beneficiaries and communities they serve.

Non-PR, IFPRI1; CRP4; MaSSP, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Some 12,000 community preschools in Malawi serve 45 percent of the county’s preschool population. Yet because of food insecurity and communities’ difficulties in providing preschoolers with a midmorning meal, these schools may not survive. To address this challenge, Save the Children and the University of Malawi’s Chancellor College designed a preschool-based nutrition and agriculture intervention aimed at helping rural communities to produce and prepare more nutritious foods for preschools and for households year-round. An IFPRI-led cluster-randomized controlled trial in 60 preschools in the southeastern district of Zomba found that after just one year of the intervention, agricultural production, the quality and frequency of preschool meals, and household and child dietary diversity had all improved. The intervention also had an impact on the diets and growth of the preschoolers’ younger siblings. These results suggest that preschools can provide an effective platform for scaling-up nutrition and agriculture interventions, benefiting not only the preschools but also communities, households, and children in their first 1,000 days.

Non-PR, IFPRI1; MaSSP; CRP2; DCA; 4 Transforming Agricultural and Rural Economies, DSGD; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM), Improving social assistance programs is imperative to addressing problems of poverty and vulnerability in Malawi. Emergency aid has played an important role in alleviating hunger during humanitarian crises such as those in 2015-16 and 2016-17. However, the Government of Malawi and development partners recognize that emergency responses are not a sustainable solution to address vulnerability. This qualitative study examines the characteristics of resilient households and perceived effects of programs to improve food security and resilience from the perspectives of the beneficiaries and communities they serve. This beneficiary-centered approach explores socially-defined concepts of resilience, associated coping strategies, norms and political dynamics affecting programs. These findings can provide useful insights to improve the effectiveness of social assistance programs in this context.

PR, IFPRI3; DCA; CRP4; ISI; Capacity Strengthening; 2 Promoting Healthy Diets and Nutrition for all; IFPRIOA, PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), Children in Malawi face nutritional risks related to low-quality diets and chronic malnutrition. This study evaluated the impact of a 1-y early childhood development (ECD) center–based agriculture and nutrition intervention aimed at improving household production diversity, maternal knowledge on child nutrition and feeding practices, and children's diets and anthropometric measures.

Non-PR, IFPRI1; DCA; CRP4; 2 Promoting Healthy Diets and Nutrition for all; 5 Strengthening Institutions and Governance; Capacity Strengthening; UNFSS, PHND; DSGD; A4NH, CGIAR Research Programs on Agriculture for Nutrition and Health (A4NH), In this paper, we apply a mixed-method multisectoral diagnostic to examine potential interventions in food systems to improve diets of rural smallholder farmers in Malawi. We examine the entry points for interventions involving public and nonprofit (including both government and development partners) and private-sector perspectives. In addition, we explore the methodological and theoretical requirements for undertaking this type of multisectoral analysis.

PR, IFPRI3; ISI; CRP4, DSGD; PHND; A4NH, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

PR, IFPRI3; CRP4; ISI, A4NH; PHND, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

Non-PR, IFPRI1; CRP2; MaSSP; CRP2, DSGD; PHND; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM), This study presents qualitative findings on the dynamics of household and community resources for food security and nutrition in Southern Malawi. We explore how kinship and social obligations influence the allocation of social support, and focus on the role of village chiefs. We then examine the implications for state- and donor-led social programs in light of the norms that permeate village life.

Non-PR, IFPRI2; CRP2; G Cross-cutting gender theme; 2 Promoting Healthy Diets and Nutrition for all; Transfer Modality Research Initiative (TMRI); CRP4; PRSSP, PHND; PIM; A4NH, CGIAR Research Program on Policies, Institutions, and Markets (PIM); CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), This report presents the results of the TMRI evaluation. It is organized in ten sections. The rest of Section 1 presents the objectives of the study, conceptual issues and empirical evidence of the effects of food and cash transfers. Section 2 describes the salient features of the TMRI. Section 3 discusses the analytical methodology and the data used in the empirical work. Section 4 gives a profile of survey households. Section 5 provides the findings of evaluation of the TMRI implementation process, assesses various aspects of participation in the TMRI, and provides the cost analysis results. Section 6 presents the impact of the TMRI on household consumption. Section 7 shows impact of the TMRI on maternal knowledge and practices related to child nutrition. Section 8 provides the impact of the TMRI on child anthropometric status. Section 9 presents case studies 3 of TMRI participants from qualitative research. Section 10 summarizes the main findings and provides policy conclusions.

PR, IFPRI3; ISI; CRP2, PHND; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM)

PR, IFPRI3; ISI; CRP2; GRP28, PHND; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM)

PR, IFPRI4; CRP2, PHND; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM)

Non-PR, IFPRI1; CRP2; E Building Resilience, PHND; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM), Discussions regarding the merits of cash and food transfers by academics and implementers alike focus on their relative impacts. Much less is known about their relative costs. We apply activity-based costing methods to interventions situated in Ecuador, Niger, Uganda, and Yemen, finding that the per transfer cost of providing cash is always less than that of providing food. Given the budget for these interventions, an additional 44,769 people could have received assistance at no additional cost had cash been provided instead of food. This suggests a significant opportunity cost in terms of reduced coverage when higher-cost transfer modalities are used. Decisions to use cash or food transfers should consider both impacts and costs.

Non-PR, IFPRI2; E Building Resilience, PHND, En este volumen se resumen los hallazgos del informe de investigación titulado Enhancing the Effectiveness of Conditional Cash Transfer Programs for Indigenous Peoples. An Ethnographic Assessment of Programa Juntos (Perú). El estudio fue realizado por un equipo de científicos sociales en el marco de un convenio de cooperación institucional entre el International Food Policy Research Institute (IFPRI) y la Pontificia Universidad Católica del Perú (PUCP). La investigación fue financiada por la Unidad de Género y Diversidad del Banco Interamericano de Desarrollo(BID) como parte del proyecto Enhancing the Effectiveness and Addressing the Sociocultural Impacts of Conditional Cash Transfers in Indigenous Contexts implementado por el IFPRI

Non-PR, IFPRI1; CRP2, PHND; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM), With support from the Government of Spain, and in partnership with the World Food Programme (WFP), researchers from the International Food Policy Research Institute (IFPRI) evaluated four pilot projects to assess the comparative performance of cash transfers, food payments, and vouchers on household food security and other outcomes of interest to WFP. The studies in Ecuador, Uganda, Niger, and Yemen were carried out over the period 2010–2012.

Non-PR, IFPRI5; B Promoting healthy food systems, PHND

Non-PR, IFPRI1; CRP2, PHND; PIM, CGIAR Research Program on Policies, Institutions, and Markets (PIM), This report is the final impact evaluation of the World Food Programme’s Cash and Food transfer program in Yemen. The program operated in Hajjah and Ibb governorates within the larger Emergency Safety Net (ESN), which provides assistance to qualifying households in rural Yemen. The report details the relative effectiveness of each modality at alleviating food security among the targeted population.

Non-PR, IFPRI5, PHND

Non-PR, IFPRI5, PHND

Non-PR, IFPRI1; Theme 1; GRP28, PHND, The debate over whether to provide food assistance and the form that this assistance should take has a long history in economics. Despite the ongoing debate, little rigorous evidence exists that compares food assistance in the form of cash versus in-kind. This paper uses a randomized evaluation to assess the impacts and cost-effectiveness of cash, food vouchers, and food transfers. We find that all three modalities significantly improve the quantity and quality of food consumed. However, differences emerge in the types of food consumed, with food transfers leading to significantly larger increases in calories consumed, and vouchers leading to significantly larger increases in dietary diversity.