From Program to Plate: Within-Household Insights from Nutrition-Sensitive Social Protection and Agriculture Programs Implemented in Bangladesh
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Social protection and agriculture development programs are considered key strategies for safeguarding and enhancing the nutrition of vulnerable populations. As well described in nutrition literature, they have broad coverage of impoverished and rural households, address root causes of malnutrition such as poverty and food access, and can foster women’s empowerment. These programs can also serve as platforms for more intensive nutrition-specific initiatives, such as nutrition behavior change or delivery of fortified food products (Ruel & Alderman, 2013; Ruel et al., 2018). However, despite their success in improving household food security and access to nutrient-rich foods, these programs exhibit mixed or limited impacts on maternal and child nutrition. This discrepancy suggests that challenges exist along the pathway between program implementation and individuals’ plates, prompting two critical questions: 1) what factors are hindering programs from achieving their intended nutritional impacts, and 2) how can the effectiveness of these programs be enhanced? This dissertation examines two nutrition-sensitive interventions implemented in Bangladesh to unravel the mechanisms of how these programs operate. Given the longstanding concerns of inequitable distribution of resources within households in South Asia, food allocation is a central focus. We examine how households share food, including program benefits, and evaluate whether certain program components influence food-sharing practices. We also identify which program components enhance nutrition impacts across the household. Finally, we delve into a particular program that significantly improved children's nutritional status to understand the process through which it achieved success. The overarching goal of this research is to identify strategies that can enhance the nutritional impact of multi-sectoral programs.