Browsing by Author "Alderman, H."

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Food for Thought?
(The Journal of Human Resources, 2020) Aurino, E.; Gelli, A.; Adamba, C.; Osei-Akoto, I.; Alderman, H.
There is limited experimental evidence on the effects of large-scale, government-led interventions on human capital in resource-constrained settings. We report results from a randomized trial of the government of Ghana’s school feeding. After two years, the program led to moderate average increases in math and literacy standardized scores among pupils in treatment communities and to larger achievement gains for girls and disadvantaged children and regions. Improvements in child schooling, cognition, and nutrition constituted suggestive impact mechanisms, especially for educationally disadvantaged groups. The program combined equitable human capital accumulation with social protection, contributing to the “learning for all” sustainable development agenda.
Maternal and child nutrition: Building momentum for impact
(The Lancet, 2013-06) Black, R.E.; Alderman, H.; Bhutta, Z.A.; Gillespie, S.; Haddad, L.; Horton, S.; Lartey, A.; Mannar, V.; Ruel, M.; Victora, C.G.; Walker, S.P.; Webb, P.
support for the interventions that can be quickly scaled up or linked to nutrition programmes—such as early child development initiatives. It is equally important to take note of the message of Marie Ruel and colleagues 4 — that in certain sectors, such as agriculture, the evidence of the eff ect of targeted programmes on maternal and child nutrition is largely inconclusive and requires new approaches to fi eld evaluation. Since 2008, there have been only limited increases in donor aid for nutrition. It is true that nutrition is not so readily attractive to politicians as an international development priority. Undernutrition has a complex set of political, social, and economic causes, none of which are amenable to easy solutions that fi t within the timeframe of a single political cycle. For this reason, the outlook today for nutrition is not wholly good. The target endorsed only a year ago at the World Health Assembly—to reduce by 40% the number of children stunted by 2025—is already on course to be missed. As the endpoint of the Millennium Development Goals approaches, countries and the international community may agree that nutrition was one of the great missed opportunities of the past 15 years. But this neglect can be turned around quickly. As sustainable development becomes the dominant idea post-2015, nutrition emerges as the quintessential example of a sustainable development objective. If maternal and child nutrition is optimised, the benefi ts will accrue and extend over several generations. This remarkable opportunity is why Stuart Gillespie and colleagues 5 take a very diff erent approach to implementation than in any previous Lancet Series. Instead of exhorting politicians and policy makers to do something—or worse, simply hoping that political commitment will appear like a rabbit out of a hat—they set out a practical guide about how to seize the agenda for nutrition, how to create political momentum, and how to turn that momentum into results. This is the prize we have to grasp in the next 18 months.
A School Meals Program Implemented at Scale in Ghana Increases Height-for-Age during Midchildhood in Girls and in Children from Poor Households: A Cluster Randomized Trial
(The Journal of Nutrition Nutritional Epidemiology, 2019-04-01) Folson, G.; Gelli, A.; Aurino, E.; Arhinful, D.; Adamba, C.; Osei-Akoto, I.; Masset, E.; Watkins, K.; Fernandes, M.; Drake, L.; Alderman, H.
Background: Attention to nutrition during all phases of child and adolescent development is necessary to ensure healthy physical growth and to protect investments made earlier in life. Leveraging school meals programs as platforms to scale-up nutrition interventions is relevant as programs function in nearly every country in the world. Objective: The aim of this study was to evaluate the impact of a large-scale school meals program in Ghana on school age children’s anthropometry indicators. Methods: A longitudinal cluster randomized control trial was implemented across the 10 regions of Ghana, covering 2869 school-age children (aged 5–15 y). Communities were randomly assigned to 1) control group without intervention or 2) treatment group providing the reformed national school feeding program, providing 1 hot meal/d in public primary schools. Primary outcomes included height-for-age (HAZ) and BMI-for-age (BAZ) z scores. The analysis followed an intention-to-treat approach as per the published protocol for the study population and subgroup analysis by age (i.e., mid childhood for children 5–8 y and early adolescence for children 9–15 y), gender, poverty, and region of residence. We used single-difference ANCOVA with mixed-effect regression models to assess program impacts. Results: School meals had no effect on HAZ and BAZ in children aged 5–15 y. However, in per-protocol subgroup analysis, the school feeding intervention improved HAZ in 5- to 8-y-old children (effect size: 0.12 SDs), in girls (effect size: 0.12 SDs)—particularly girls aged 5–8 y living in the northern regions, and in children aged 5–8 y in households living below the poverty line (effect size: 0.22 SDs). There was also evidence that the intervention influenced food allocation and sharing at the household level. Conclusion: School meals can provide a platform to scale-up nutrition interventions in the early primary school years, with important benefits accruing for more disadvantaged children. This trial was registered at www.isrctn.com as ISRCTN66918874. J Nutr 2019;149:1434–1442