N Saville
Biographic Data
| ID | 78335 |
|---|---|
| NAME | N Saville |
| GIVEN NAMES | N |
| FAMILY NAME | Saville |
| SIGNATURE | SAVILLE N |
| AFFILIATIONS | University College London |
| ORCID | 0000-0002-1735-3684 |
| VERIFIED | Yes |
| TOTAL WORKS | 41 |
| TOTAL CITATIONS | 29 |
| AUTHOR COUNT | 41 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2013 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
The association between paternal labour migration and the growth of the left-behind children—evidence from a birth cohort in Dhanusha district, Nepal
INTRODUCTION: We aimed to determine the association between paternal labour migration and the growth of the left-behind children in Dhanusha district, Nepal, where child stunting and international labour migration are highly prevalent. METHODS: -score (HAZ). Children's body circumferences, skinfold thicknesses, body composition, tibia length and grip strength were secondary outcomes measured at 6 years. We tested (i) the overall association betwe…
MANTRA game analytics
Mobile technology can deliver public health interventions to reach remote populations such as unique mHealth interventions aimed at low-literacy audiences in low resource settings. This research study assessed a mobile phone-based serious game that teaches geohazard, maternal, and neonatal health messages. This study is part of the Maternal and Neonatal Technologies in Rural Areas (MANTRA) project: Increasing maternal and child health resilience …
Determinants of Infant Growth in a Birth Cohort in the Nepal Plains
This study aimed to identify the determinants of infant growth in terms of length-for-age z-score (LAZ) in a birth cohort (n = 602) in the plains of Nepal. Children were enrolled within 72 h of birth and followed-up every 28 days until they were 2 years. We fitted mixed-effects linear regression models controlling for multiple measurements within individuals to examine the impact of household and maternal factors, feeding practices and infection …
Dietary Diversity, Haemoglobin and Anaemia in Nepali Adolescent Girls
Adolescent girls and young women in Nepal are vulnerable to poor diets and anaemia, yet the extent of these risks remains overlooked. We assessed changes in dietary diversity, haemoglobin, and anaemia, and identified associated factors among adolescent girls and young women in Nepal. We analysed data from a longitudinal panel study including never-married and not-pregnant participants, enroled at 10-19 years in 2017 (n = 770) and followed up in 2…
Pathways to leadership
OBJECTIVES: We aimed to capture evidence on enablers and barriers to improving equal opportunity and effective organisational interventions that can advance women's leadership in India and Kenya's health sectors. METHODS: We systematically searched JSTOR, PubMed, SCOPUS and Web of Science databases, reference lists of selected articles and Google Scholar using string searches. We included studies that were published in English from 2000 to 2022 i…
Factors influencing the implementation of integrated screening for HIV, syphilis, and hepatitis B for pregnant women in Nepal
In Nepal, national guidelines recommend free HIV and syphilis screening for pregnant women at their first antenatal visit, using an opt-out approach. However, screening uptake is low and the guidelines do not include hepatitis B screening. It is essential to understand the factors influencing the implementation of integrated screening for HIV, syphilis, and hepatitis B, as recommended by WHO, to improve uptake and prevent vertical transmission. T…
Generational trends in the transition to womanhood in lowland rural Nepal
OBJECTIVE: In South Asia, studies show secular trends toward slightly later women's marriage and first reproduction. However, data on related biological and social events, such as menarche and age of coresidence with husband, are often missing from these analyses. We assessed generational trends in key life events marking the transition to womanhood in rural lowland Nepal. METHODS: We used data on 110 co-resident mother-in-law (MIL) and daughter-…
“Can’t live willingly”
In South Asia, early marriage has been associated with a range of adverse outcomes during pregnancy and infancy. This may partly be explained by early marriage leading to a younger maternal age, however it remains unclear which other factors are involved. This review aimed to synthesise the qualitative evidence on experiences of pregnancy following early marriage or early pregnancy in South Asia, to inform our understanding of the mechanisms betw…
Exploring the feasibility of integrating health, nutrition and stimulation interventions for children under three years in Nepal’s health system
Community-based primary care settings are a potential entry point for delivering Early Childhood Development (ECD) interventions in Nepal. Past studies have suggested that integrating stimulation with nutrition interventions is an effective way to deliver multiple benefits for children, but there is limited knowledge of how to do this in Nepal. We conducted a qualitative study in Nepal’s Dhanusha district to explore how stimulation interventions …
Contextual factors affecting the implementation of an anemia focused virtual counseling intervention for pregnant women in plains Nepal
It is important to understand gender norms, mobile access, and mobile literacy before implementing an mHealth intervention. The contextual barriers to implementation meant that we were not able to engage family members as much as we had hoped, and we were not able to minimize in-person contact with families. We recommend a flexible approach to mHealth interventions which can be responsive to local context and the situation of participants. Home v…
Strengthening causal inference from randomised controlled trials of complex interventions
Researchers conducting randomised controlled trials (RCTs) of complex interventions face design and analytical challenges that are not fully addressed in existing guidelines. Further guidance is needed to help ensure that these trials of complex interventions are conducted to the highest scientific standards while maximising the evidence that can be extracted from each trial. The key challenge is how to manage the multiplicity of outcomes require…
A network approach for managing ecosystem services and improving food and nutrition security on smallholder farms
Smallholder farmers are some of the poorest and most food insecure people on Earth. Their high nutritional and economic reliance on home‐grown produce makes them particularly vulnerable to environmental stressors such as pollinator loss or climate change which threaten agricultural productivity. Improving smallholder agriculture in a way that is environmentally sustainable and resilient to climate change is a key challenge of the 21st century. Ec…
Associations between early marriage and preterm delivery
OBJECTIVES: Preterm delivery (<37 weeks gestation) is the largest cause of child mortality worldwide. Marriage and pregnancy during adolescence have been associated with an increased risk of preterm delivery. We investigate independent associations of age at marriage and age at first pregnancy with preterm delivery in a cohort of women from rural lowland Nepal. METHODS: We analyzed data from 17 974 women in the Low Birth Weight South Asia Trial. …
Differences in maternal and early child nutritional status by offspring sex in lowland Nepal
OBJECTIVE: On average, boys grow faster than girls in early life but appear more susceptible to undernutrition. We investigated sex differences in early child growth, and whether maternal nutritional status and diet differed by offspring sex during and after pregnancy in an undernourished population. METHODS: We analyzed longitudinal data from a cluster-randomized trial from plains Nepal, stratifying results by child or gestational age. Children'…
Feeding, caregiving practices, and developmental delay among children under five in lowland Nepal
Suboptimal caregiving practices, inappropriate early breastfeeding practices, delayed introduction of complementary foods, inadequate dietary diversity and low animal-source food consumption are challenges in lowland Nepal. We call for urgent integrated nutrition and caregiving interventions, especially as interventions for child development are lacking in Nepal
Comprehensive analysis of the association of seasonal variability with maternal and neonatal nutrition in lowland Nepal
Objective: To provide a comprehensive seasonal analysis of pregnant mothers’ eating behaviour and maternal/newborn nutritional status in an undernourished population from lowland rural Nepal, where weather patterns, agricultural labour, food availability and disease prevalence vary seasonally. Design: Secondary analysis of cluster-randomised Low Birth Weight South Asia Trial data, applying cosinor analysis to predict seasonal patterns. Outcomes: …
Coming together
This paper investigates how educational and geographic capital are assorted among households in rural Nepal, and how women's marital age may shape this distribution. Our focus on the timing of marriage adds a new dimension to studies of geographies of youth and marital assortment, while our emphasis on the physical and spatial attributes of households leads us to propose the concept of geographic capital, operationalised here as agrarian landhold…
Do Women in Nepal Like Playing a Mobile Game? MANTRA
In Low and Middle Income Countries (LMIC), one of the causes of maternal and child mortality is a lack of medical knowledge and consequently the inability to seek timely healthcare. Mobile health (mHealth) technology is gradually becoming a universal intervention platform across the globe due to ubiquity of mobile phones and network coverage. MANTRA is a novel mHealth intervention developed to tackle maternal and child health issues through a ser…
A feminist vision for transformative change to disaster risk reduction policies and practices
Maternal physical, socioeconomic, and demographic characteristics and childbirth complications in rural lowland Nepal
OBJECTIVES: Evolutionary perspectives on human childbirth have primarily focused on characteristics of our species in general, rather than variability within and between contemporary populations. We use an evolutionary framework to explore how physical and demographic characteristics of mothers shape the risks of childbirth complications in rural lowland Nepal, where childbearing typically commences in adolescence and chronic undernutrition is wi…
Addressing anaemia in pregnancy in rural plains Nepal
Maternal anaemia prevalence in low-income countries is unacceptably high. Our research explored the individual-, family- and community-level factors affecting antenatal care uptake, iron folic acid (IFA) intake and consumption of micronutrient-rich diets among pregnant women in the plains of Nepal. We discuss how these findings informed the development of a home visit and community mobilisation intervention to reduce anaemia in pregnancy. We used…
Relative power
We estimate the effects of antenatal food and cash transfers with women's groups on household allocative behaviour and explore whether these effects are explained by intergenerational bargaining among women. Interventions were tested in randomised-controlled trial in rural Nepal, in a food-insecure context where pregnant women are allocated the least adequate diets. We show households enrolled in a cash transfer intervention allocated pregnant wo…
Independent associations of women's age at marriage and first pregnancy with their height in rural lowland Nepal
OBJECTIVES: In many South Asian communities, the majority of women are married during adolescence and reproduce before 20 years. Early reproduction may adversely affect maternal nutrition and linear growth, however whether early marriage has similar effects is unknown. Shorter women might also be preferentially chosen for earlier marriage. We hypothesized that early marriage and early pregnancy may each be associated with women's shorter height, …
Mantra
Serious games, conveying educational knowledge rather than merely entertainment, are a rapidly expanding research domain for cutting-edge educational technology. Digital interventions like serious games are great opportunities to overcome challenges in low-and-middle-income countries that limit access to health information, such as social barriers like low-literacy and gender. MANTRA: Increasing maternal and child health resilience before, during…
How Much Education Is Needed to Delay Women's Age at Marriage and First Pregnancy
Background: Early childbirth is associated with adverse maternal and child health outcomes. In South Asia, where women generally marry before having children, public health efforts need to focus on delaying marriage. Female education is widely considered the primary means to achieve this. However, it remains unclear how much education is required to delay marriage to the universal minimum age of 18 years, or what predicts marriage age in women la…
Revisiting the patriarchal bargain
Although power struggles between daughters-in-law and mothers-in-law in the South Asian household remain an enduring theme of feminist scholarship, current policy discourse on 'women's economic empowerment' in the Global South tends to focus on married women's power over their husband; this neglects intergenerational power dynamics. The aim of this study was to describe and analyze the processes involved in young, married women's negotiations of …
Relative power
We estimate the effects of antenatal food and cash transfers with women's groups on household allocative behaviour and explore whether these effects are explained by intergenerational bargaining among women. Interventions were tested in randomised-controlled trial in rural Nepal, in a food-insecure context where pregnant women are allocated the least adequate diets. We show households enrolled in a cash transfer intervention allocated pregnant wo…
Coming together
This paper investigates how educational and geographic capital are assorted among households in rural Nepal, and how women's marital age may shape this distribution. Our focus on the timing of marriage adds a new dimension to studies of geographies of youth and marital assortment, while our emphasis on the physical and spatial attributes of households leads us to propose the concept of geographic capital, operationalised here as agrarian landhold…
Independent associations of women's age at marriage and first pregnancy with their height in rural lowland Nepal
OBJECTIVES: In many South Asian communities, the majority of women are married during adolescence and reproduce before 20 years. Early reproduction may adversely affect maternal nutrition and linear growth, however whether early marriage has similar effects is unknown. Shorter women might also be preferentially chosen for earlier marriage. We hypothesized that early marriage and early pregnancy may each be associated with women's shorter height, …
Reaching the poor with health interventions
BACKGROUND: Efforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa. METHODS: We conducted a secondary analysis of seven randomised trials of participatory women's groups to reduce newborn mortality in …
Women's groups practising participatory learning and action to improve maternal and newborn health in low-resource settings
Participatory women’s groups and counselling through home visits to improve child growth in rural eastern India
ISRCTN register 51505201 ; Clinical Trials Registry of India number 2014/06/004664
Maternal phenotype, independent of family economic capital, predicts educational attainment in lowland nepalese children
OBJECTIVES: Factors acting before children are born or reach school-going age may explain why some do not complete primary education. Many relevant factors relate to maternal phenotype, but few studies have tested for independent associations of maternal factors relative to those characterizing the family in general. METHODS: Using data from a longitudinal study of 838 children in Dhanusha, Nepal, we used logistic regression models to test whethe…
Development and validation of a photographic food atlas for portion size assessment in the southern plains of Nepal
Objective To develop and validate a photographic food atlas of common foods for dietary assessment in southern Nepal. Design We created a life-sized photographic atlas of forty locally prepared foods. Between March and June 2014, data collectors weighed portion sizes that respondents consumed during one mealtime and then a different data collector revisited the household the next day to record respondents’ estimations of their previous day’s inta…
Reaching the poor with health interventions
BACKGROUND: Efforts to end preventable newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based newborn health intervention across social strata in Asia and Africa. METHODS: We conducted a secondary analysis of seven randomised trials of participatory women's groups to reduce newborn mortality in …
Experiences in running a complex electronic data capture system using mobile phones in a large-scale population trial in southern Nepal
The increasing availability and capabilities of mobile phones make them a feasible means of data collection. Electronic Data Capture (EDC) systems have been used widely for public health monitoring and surveillance activities, but documentation of their use in complicated research studies requiring multiple systems is limited. This paper shares our experiences of designing and implementing a complex multi-component EDC system for a community-base…
Socioeconomic determinants of growth in a longitudinal study in Nepal
Socioeconomic status (SES) is associated with childhood anthropometry, but little is known about how it is associated with tissue growth and body composition. To investigate this, we looked at components of SES at birth with growth in early and mid-childhood, and body composition in a longitudinal study in Nepal. The exposure variables (material assets, land ownership, and maternal education) were quantified from questionnaire data before birth. …
Women’s Ideas about the Health Effects of Household Air Pollution, Developed through Focus Group Discussions and Artwork in Southern Nepal
Household air pollution is a major cause of ill health, but few solutions have been effective to date. While many quantitative studies have been conducted, few have explored the lived experiences and perceptions of women who do the cooking, and as a result are those most exposed to household air pollution. In this study, we worked with groups of home cooks, and sought to use art as a means of engaging them in discussions of how household air poll…
Socioeconomic inequalities in newborn care during facility and home deliveries
Socioeconomic inequalities in facility care greatly contribute to inequalities in newborn care. Improving newborn care during home deliveries and improving access to facility care are a priority for addressing inequalities in newborn care and newborn mortality
Formative qualitative research to develop community-based interventions addressing low birth weight in the plains of Nepal
Objective To explore the factors affecting intra-household food allocation practices to inform the development of interventions to prevent low birth weight in rural plains of Nepal. Design Qualitative methodology using purposive sampling to explore the barriers and facilitating factors to improved maternal nutrition. Setting Rural Dhanusha District, Nepal. Subjects We purposively sampled twenty-five young daughters-in-law from marginalised groups…
Smartphone tool to collect repeated 24 h dietary recall data in Nepal
Objective To outline the development of a smartphone-based tool to collect thrice-repeated 24 h dietary recall data in rural Nepal, and to describe energy intakes, common errors and researchers’ experiences using the tool. Design We designed a novel tool to collect multi-pass 24 h dietary recalls in rural Nepal by combining the use of a CommCare questionnaire on smartphones, a paper form, a QR (quick response)-coded list of foods and a photograph…
Revisiting the patriarchal bargain
Although power struggles between daughters-in-law and mothers-in-law in the South Asian household remain an enduring theme of feminist scholarship, current policy discourse on 'women's economic empowerment' in the Global South tends to focus on married women's power over their husband; this neglects intergenerational power dynamics. The aim of this study was to describe and analyze the processes involved in young, married women's negotiations of …
Do Participatory Learning and Action Women’s Groups Alone or Combined with Cash or Food Transfers Expand Women’s Agency in Rural Nepal
Participatory learning and action women's groups (PLA) have proven effective in reducing neonatal mortality in rural, high-mortality settings, but their impacts on women's agency in the household remain unknown. Cash transfer programmes have also long targeted female beneficiaries in the belief that this empowers women. Drawing on data from 1309 pregnant women in a four-arm cluster-randomised controlled trial in Nepal, we found little evidence fo…
Mantra
Serious games, conveying educational knowledge rather than merely entertainment, are a rapidly expanding research domain for cutting-edge educational technology. Digital interventions like serious games are great opportunities to overcome challenges in low-and-middle-income countries that limit access to health information, such as social barriers like low-literacy and gender. MANTRA: Increasing maternal and child health resilience before, during…
How Much Education Is Needed to Delay Women's Age at Marriage and First Pregnancy
Background: Early childbirth is associated with adverse maternal and child health outcomes. In South Asia, where women generally marry before having children, public health efforts need to focus on delaying marriage. Female education is widely considered the primary means to achieve this. However, it remains unclear how much education is required to delay marriage to the universal minimum age of 18 years, or what predicts marriage age in women la…
The association of maternal nutrition and children’s pre-primary experience with over-age attendance in secondary school
Over-age attendance is increasing but remains under-studied in South Asia.•Children fall behind by entering pre-primary or primary late, and by repeating a grade during/after primary school.•Rural location, thin and uneducated mothers predicted late pre-primary entry.•Educational research and interventions need to focus on the earlier time-point of pre-primary.•Improving maternal nutrition and education may ensure timely progression of children i…
Mantra
This project was approved by the University College London Ethics Committee in London, United Kingdom [10547/001], and the Nepal Health Research Council in Kathmandu, Nepal [Reg. No. 105/2017]. All participants provided informed written consent
Equity implications of rice fortification
Objective: To model the potential impact and equity impact of fortifying rice on nutritional adequacy of different subpopulations in Nepal. Design: Using 24-h dietary recall data and a household consumption survey, we estimated: rice intakes; probability of adequacy (PA) of eight micronutrients commonly fortified in rice (vitamin A, niacin (B 3 ), pyridoxine (B 6 ), cobalamin (B 12 ), thiamin (B 1 ), folate (B 9 ), Fe and Zn) plus riboflavin (B 2…
Do Women in Nepal Like Playing a Mobile Game? MANTRA
In Low and Middle Income Countries (LMIC), one of the causes of maternal and child mortality is a lack of medical knowledge and consequently the inability to seek timely healthcare. Mobile health (mHealth) technology is gradually becoming a universal intervention platform across the globe due to ubiquity of mobile phones and network coverage. MANTRA is a novel mHealth intervention developed to tackle maternal and child health issues through a ser…
A feminist vision for transformative change to disaster risk reduction policies and practices
Maternal physical, socioeconomic, and demographic characteristics and childbirth complications in rural lowland Nepal
OBJECTIVES: Evolutionary perspectives on human childbirth have primarily focused on characteristics of our species in general, rather than variability within and between contemporary populations. We use an evolutionary framework to explore how physical and demographic characteristics of mothers shape the risks of childbirth complications in rural lowland Nepal, where childbearing typically commences in adolescence and chronic undernutrition is wi…
Addressing anaemia in pregnancy in rural plains Nepal
Maternal anaemia prevalence in low-income countries is unacceptably high. Our research explored the individual-, family- and community-level factors affecting antenatal care uptake, iron folic acid (IFA) intake and consumption of micronutrient-rich diets among pregnant women in the plains of Nepal. We discuss how these findings informed the development of a home visit and community mobilisation intervention to reduce anaemia in pregnancy. We used…
Relative power
We estimate the effects of antenatal food and cash transfers with women's groups on household allocative behaviour and explore whether these effects are explained by intergenerational bargaining among women. Interventions were tested in randomised-controlled trial in rural Nepal, in a food-insecure context where pregnant women are allocated the least adequate diets. We show households enrolled in a cash transfer intervention allocated pregnant wo…
Independent associations of women's age at marriage and first pregnancy with their height in rural lowland Nepal
OBJECTIVES: In many South Asian communities, the majority of women are married during adolescence and reproduce before 20 years. Early reproduction may adversely affect maternal nutrition and linear growth, however whether early marriage has similar effects is unknown. Shorter women might also be preferentially chosen for earlier marriage. We hypothesized that early marriage and early pregnancy may each be associated with women's shorter height, …
Strengthening causal inference from randomised controlled trials of complex interventions
Researchers conducting randomised controlled trials (RCTs) of complex interventions face design and analytical challenges that are not fully addressed in existing guidelines. Further guidance is needed to help ensure that these trials of complex interventions are conducted to the highest scientific standards while maximising the evidence that can be extracted from each trial. The key challenge is how to manage the multiplicity of outcomes require…
Medicine (32 works) · Child Nutrition and Water Access (19 works) · Environmental health (19 works) · Psychological intervention (17 works) · Nursing (16 works) · Demography (14 works) · Global Maternal and Child Health (14 works) · Economic growth (13 works) · Population (13 works) · Sociology (13 works)