Purnima Menon
Datos Biográficos
| ID | 3933647 |
|---|---|
| NOMBRE | Purnima Menon |
| NOMBRES | Purnima |
| APELLIDO | Menon |
| FIRMA | MENON P |
| AFILIACIONES | International Food Policy Research Institute |
| VERIFICADO | No |
| TOTAL DE OBRAS | 52 |
| TOTAL DE CITAS | 97 |
| TOTAL COMO AUTOR | 52 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1996 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 3 |
Global assessment of childhood growth monitoring
Background: Monitoring children's growth is crucial in paediatric care for early identification of health issues, with the World Health Organization (WHO) advocating for its practice throughout childhood. However, the focus and implementation of growth monitoring vary globally, reflecting different health priorities and practices. Methods: We conducted a global, cross-sectional, questionnaire-based survey, targeted at representatives of the minis…
From promises to action
Assessing progress on the coverage of interventions in the first 1000 days in India
BACKGROUND: High coverage of nutrition-specific interventions is critical to meet global nutrition targets, and it is imperative to understand how to attain it. We examined trends and inequalities in the coverage of interventions in India and the role of the National Nutrition Mission (NNM) in achieving improvements. METHODS: We conducted trends and equity analysis of 30 interventions using two rounds of National Family Health Survey data (2015-2…
Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh
Systematic crises may disrupt well-designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive & Thrive developed an intervention to integrate nutrition services into urban antenatal care services in Dhaka, which started at the onset of COVID-19 and encountered extraordinary disruption of services. We investigated the disruptions and adaptations …
Women improving nutrition through self-help groups in India
Women's self-help groups (SHGs) are an important platform for reaching poor women in India. Despite SHGs' women-focused programming, evidence of the impact of SHG-based interventions on nutrition outcomes is limited, and most evaluations of nutrition interventions have not examined intermediate outcomes along the impact pathways or outcomes for women themselves. This paper evaluates the effectiveness of an integrated agriculture-nutrition interve…
Breastfeeding
In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hou…
Scale and Sustainability
Microfinance groups are a prominent source of small-scale rural credit in many developing countries. In India, evidence of the impact of the now ubiquitous women-only savings and credit self-help groups (SHGs) on household consumption and asset accumulation is inconclusive and based on small-scale interventions. Further, little is known about the sustainability of impacts at scale. We use panel data on close to 2500 households from five states in…
Assessing the hidden burden and costs of Covid-19 pandemic in South Asia
The COVID-19 pandemic has disproportionately affected vulnerable populations. With its intensity expected to be cyclical over the foreseeable future, and much of the impact estimates still modeled, it is imperative that we accurately assess the impact to date, to help with the process of targeted rebuilding of services. We collected data from administrative health information systems in six South Asian countries (Afghanistan, Bangladesh, Nepal, I…
More is not enough
Antenatal care (ANC) is an opportunity to receive interventions that can prevent low birth weight (LBW). We sought to 1) estimate LBW prevalence and burden in South Asia, 2) describe the number of ANC visits (quantity) and interventions received (quality), and 3) explore associations between ANC quantity, quality and LBW. We used Demographic and Health Survey (DHS) data from Afghanistan (2015), Bangladesh (2018), India (2016), Nepal (2016), Pakis…
Comparing delivery channels to promote nutrition-sensitive agriculture
We use a randomized controlled trial in rural Bangladesh to compare two models of delivering nutrition content jointly to husbands and wives: deploying female nutrition workers versus mostly male agriculture extension workers. Both approaches increased nutrition knowledge of men and women, household and individual diet quality, and women's empowerment. Intervention effects on agriculture and nutrition knowledge, agricultural production diversity,…
Learning together
India accounts for a large proportion of the global prevalence of maternal and child undernutrition, and recent trends have renewed the call for large-scale concerted efforts to improve outcomes. With their reach to millions of rural Indian women, self-help groups (SHGs) offer a possible solution. We provide evidence from a cluster-randomized controlled trial in the state of Bihar of the impact of a health and nutrition intervention that provided…
Can digitally enabling community health and nutrition workers improve services delivery to pregnant women and mothers of infants? Quasi-experimental evidence from a national-scale nutrition programme …
BACKGROUND: India's 1.4 million community health and nutrition workers (CHNWs) serve 158 million beneficiaries under the Integrated Child Development Services (ICDS) programme. We assessed the impact of a data capture, decision support, and job-aid mobile app for the CHNWs on two primary outcomes-(1) timeliness of home visits and (2) appropriate counselling specific to the needs of pregnant women and mothers of children <12 months. METHODS: We us…
Using scenario‐based assessments to examine the feasibility of integrating preventive nutrition services through the primary health care system in Bangladesh
The National Nutrition Services of Bangladesh aims to deliver nutrition services through the primary health care system. Little is known about the feasibility of reshaping service delivery to close gaps in nutrition intervention coverage and utilization. We used a scenario-based feasibility testing approach to assess potential implementation improvements to strengthen service delivery. We conducted in-depth interviews with 31 service providers an…
Revisiting maternal and child undernutrition in low-income and middle-income countries
Missed opportunities for delivering nutrition interventions in first 1000 days of life in India
OBJECTIVES: Existing health and community nutrition systems have the potential to deliver many nutrition interventions. However, the coverage of nutrition interventions across the delivery platforms of these systems has not been uniform. We (1) examined the opportunity gaps between delivery platforms and corresponding nutrition interventions through the continuum of care in India between 2006 and 2016 and and (2) assessed inequalities in these op…
Avoiding the Road to Nowhere
Digital health solutions offer tremendous potential to enhance the reach and quality of health services and population‐level outcomes in low‐ and middle‐income countries (LMICs). While the number of programs reaching scale increases yearly, the long‐term sustainability for most remains uncertain. In this article, as researchers and implementors, we draw on experiences of designing, implementing and evaluating digital health solutions at scale in …
Effect of nutrition counselling with a digital job aid on child dietary diversity
Adequate dietary diversity among infants is often suboptimal in developing countries. We assessed the impact of nutrition counselling using a digital job aid on dietary diversity of children aged 6-23 months using data from a cluster randomised controlled trial in Bangladesh. The trial had five arms, each with 25 clusters. The four intervention arms provided counselling using a digital job aid and different prenatal and post-natal combinations of…
Trends and geographic variability in gender inequalities in child mortality and stunting in India, 2006–2016
Gender disparities in child undernutrition and mortality in India have been a topic of interest for a long time, but little is known on trends or geographic variability in recent periods. We examined the degree to which historic patterns in gender disparities in child undernutrition and mortality in India have persisted given recent progress in health and nutrition. Using two nationally representative datasets from India between 2006 and 2016, we…
Using cognitive interviewing to bridge the intent‐interpretation gap for nutrition coverage survey questions in India
Designing survey questions that clearly and precisely communicate the question's intent and elicit responses based on the intended interpretation is critical but often undervalued. We used cognitive interviewing to qualitatively assess respondents' interpretation of and responses to questions pertaining to maternal and child nutrition intervention coverage. We conducted interviews to cognitively test 25 survey questions with mothers (N = 21) with…
The role of the state government, civil society and programmes across sectors in stunting reduction in Chhattisgarh, India, 2006–2016
INTRODUCTION: Childhood stunting has declined in India between 2006 and 2016, but not uniformly across all states. Little is known about what helped some states accelerate progress while others did not. Insights on subnational drivers of progress are useful not just for India but for other decentralised policy contexts. Thus, we aimed to identify the factors that contributed to declines in childhood stunting (from 52.9% to 37.6%) between 2006 and…
Assessing statistical similarity in dietary intakes of women of reproductive age in Bangladesh
Women of reproductive age (WRA) need adequate nutrient intakes to sustain a healthy pregnancy, support fetal growth, and breastfeed after childbirth. However, data on women's dietary intake in low- and middle-income countries (LMICs) are limited, and assessment of differences between dietary intakes of pregnant or lactating women compared with that of nonpregnant, nonlactating (NPNL) women is untested. Using single, multiple-pass 24-h dietary rec…
Intimate partner violence is associated with poorer maternal mental health and breastfeeding practices in Bangladesh
Exposure to intimate partner violence (IPV) can have profound adverse consequences on maternal and child health. This study aimed to: (1) identify factors associated with IPV during pregnancy and postpartum in Bangladesh; and (2) assess the associations between IPV and maternal mental health and breastfeeding practices. We used data from a cross-sectional survey of 2000 mothers with children <6 months in four districts in Bangladesh. We applied m…
Lessons from using cluster-randomized evaluations to build evidence on large-scale nutrition behavior change interventions
Randomized controlled trials of multi-sectoral programs
Development is a multi-faceted process; achieving development goals thus requires a multi-sectoral approach. For over two decades, our research group of economists and nutritionists has designed and implemented randomized trials to assess the effectiveness of multisectoral programs in improving nutrition, food security, and other measures of well-being, largely at the request of developing country governments, development partners, and non-govern…
Progress in reducing child mortality and stunting in India
The Lives Saved Tool (LiST) has been used to estimate the impact of scaling up intervention coverage on undernutrition and mortality. Evidence for the model is largely based on efficacy trials, raising concerns of applicability to large-scale contexts. We modelled the impact of scaling up health programs in India between 2006 and 2016 and compared estimates to observed changes. Demographics, intervention coverage and nutritional status were obtai…
Care and Nutrition
Social networks, mobility, and political participation
Women’s self-help groups (SHGs) have increasingly been used as a vehicle for social, political, and economic empowerment as well as a platform for service delivery. Although a growing body of literature shows evidence of positive impacts of SHGs on various measures of empowerment, our understanding of ways in which SHGs improve awareness and use of public services is limited. To fill this knowledge gap, this paper first examines how SHG membershi…
Child development
Comparing delivery channels to promote nutrition-sensitive agriculture
We use a randomized controlled trial in rural Bangladesh to compare two models of delivering nutrition content jointly to husbands and wives: deploying female nutrition workers versus mostly male agriculture extension workers. Both approaches increased nutrition knowledge of men and women, household and individual diet quality, and women's empowerment. Intervention effects on agriculture and nutrition knowledge, agricultural production diversity,…
Learning together
India accounts for a large proportion of the global prevalence of maternal and child undernutrition, and recent trends have renewed the call for large-scale concerted efforts to improve outcomes. With their reach to millions of rural Indian women, self-help groups (SHGs) offer a possible solution. We provide evidence from a cluster-randomized controlled trial in the state of Bihar of the impact of a health and nutrition intervention that provided…
Urbanization and caregiving
This paper considers the role of caregiving on children's health and development with a special focus on identifying the constraints on effective caregiving in urban areas, and the potential solutions. It uses the extended UNICEF framework for nutrition which suggests that there are six major types of care behaviour: feeding and breast-feeding, food preparation and handling, hygiene behaviour, psycho-social care, care for women and home health pr…
Lessons from using cluster-randomized evaluations to build evidence on large-scale nutrition behavior change interventions
Randomized controlled trials of multi-sectoral programs
Development is a multi-faceted process; achieving development goals thus requires a multi-sectoral approach. For over two decades, our research group of economists and nutritionists has designed and implemented randomized trials to assess the effectiveness of multisectoral programs in improving nutrition, food security, and other measures of well-being, largely at the request of developing country governments, development partners, and non-govern…
Progress in reducing child mortality and stunting in India
The Lives Saved Tool (LiST) has been used to estimate the impact of scaling up intervention coverage on undernutrition and mortality. Evidence for the model is largely based on efficacy trials, raising concerns of applicability to large-scale contexts. We modelled the impact of scaling up health programs in India between 2006 and 2016 and compared estimates to observed changes. Demographics, intervention coverage and nutritional status were obtai…
Incorporating elements of social franchising in government health services improves the quality of infant and young child feeding counselling services at commune health centres in Vietnam
BACKGROUND: Although social franchising has been shown to enhance the quality of reproductive health services in developing countries, its effect on nutrition services remains unexamined. This study assessed the effects of incorporating elements of social franchising on shaping the quality of infant and young child feeding (IYCF) counselling facilities and services in Vietnam. METHODS: Process-related data collected 12 months after the launch of …
Child development
Urbanization and caregiving
This paper considers the role of caregiving on children's health and development with a special focus on identifying the constraints on effective caregiving in urban areas, and the potential solutions. It uses the extended UNICEF framework for nutrition which suggests that there are six major types of care behaviour: feeding and breast-feeding, food preparation and handling, hygiene behaviour, psycho-social care, care for women and home health pr…
Urbanization and caregiving
This paper considers the role of caregiving on children's health and development with a special focus on identifying the constraints on effective caregiving in urban areas, and the potential solutions. It uses the extended UNICEF framework for nutrition which suggests that there are six major types of care behaviour: feeding and breast-feeding, food preparation and handling, hygiene behaviour, psycho-social care, care for women and home health pr…
Care and Nutrition
Using programme theory to assess the feasibility of delivering micronutrient Sprinkles through a food‐assisted maternal and child health and nutrition programme in rural Haiti
This paper uses programme theory to assess, in the context of an effectiveness evaluation, the feasibility and acceptability of distributing micronutrient Sprinkles through a food-assisted maternal and child health and nutrition programme in rural Haiti. We laid out the steps related to programme delivery and household utilization of Sprinkles and used qualitative and quantitative methods to gather data on these steps. Methods included structured…
Biological, Programmatic and Sociopolitical Dimensions of Child Undernutrition in Three States in India
The recently developed India State Hunger Index 2008 highlights the continuing sorry state of hunger in India, and shows that children underweight makes the largest contribution to hunger index scores for most of India. In this article, we apply an assessment framework developed by the Mainstreaming Nutrition Initiative to understand three dimensions of child undernutrition in India: (1) the biological/epidemiological aspects of the nutrition sit…
Infant and young child feeding practices and child undernutrition in Bangladesh
Objective To determine the association between indicators of infant and young child feeding (IYCF) and anthropometric measures of nutritional status among children aged 0–23 months in a nationally representative data set. Design Data from the 2007 Bangladesh Demographic and Health Survey were used. Analyses were conducted using multiple linear regression and logistic regression analyses adjusted for the complex survey design of the survey, contro…
What Policy Changes Will Reverse Persistent Malnutrition in Asia
The politics of reducing malnutrition
Age‐appropriate infant and young child feeding practices are associated with child nutrition in I ndia
Age-appropriate infant and young child feeding (IYCF) practices are critical to child nutrition. The objective of this paper was to examine the associations between age-appropriate IYCF practices and child nutrition outcomes in India using data from ∼18 463 children of 0-23.9 months old from India's National Family Health Survey, 2005-06-3. The outcome measures were child height-for-age z-score (HAZ), weight-for-age z-score (WAZ), weight-for-heig…
W orld H ealth O rganization infant and young child feeding indicators and their associations with child anthropometry
As the W orld H ealth O rganization ( WHO ) infant and young child feeding ( IYCF ) indicators are increasingly adopted, a comparison of country‐specific analyses of the indicators' associations with child growth is needed to examine the consistency of these relationships across contexts and to assess the strengths and potential limitations of the indicators. This study aims to determine cross‐country patterns of associations of each of these ind…
Maternal mental health is associated with child undernutrition and illness in Bangladesh, Vietnam and Ethiopia
Objective We assessed associations of maternal common mental disorders (CMD) with undernutrition and two common illnesses in children aged 0–5 years. Design Cross-sectional survey. Maternal CMD was measured using the WHO Self-Reporting Questionnaire-20. Child undernutrition was defined as stunting, underweight or wasting. Child illnesses included diarrhoea and acute respiratory infections (ARI). Multivariate logistic regression was used to test t…
Incorporating elements of social franchising in government health services improves the quality of infant and young child feeding counselling services at commune health centres in Vietnam
BACKGROUND: Although social franchising has been shown to enhance the quality of reproductive health services in developing countries, its effect on nutrition services remains unexamined. This study assessed the effects of incorporating elements of social franchising on shaping the quality of infant and young child feeding (IYCF) counselling facilities and services in Vietnam. METHODS: Process-related data collected 12 months after the launch of …
Maternal willingness to pay for infant and young child nutrition counseling services in Vietnam
BACKGROUND: Alive & Thrive Vietnam, a 6-year initiative (2009-2014), has developed and incorporated elements of social franchising into government health services to provide high-quality nutrition counseling services to improve infant and young child feeding practices. One element of franchising that has not yet been implemented is fee for service, which is a potential financing mechanism for sustaining services in the long run. OBJECTIVE: This r…
Assessing implementation fidelity of a community-based infant and young child feeding intervention in Ethiopia identifies delivery challenges that limit reach to communities
There is evidence of strong fidelity in training and delivery of program tools and messages at higher FLW levels, but gaps in the reach of these to community volunteers and mothers and variability between regions could limit the potential for impact. Strengthening the linkages between HEWs and volunteers further can help to reach the target households and deliver IYCF results at scale
Women’s empowerment in agriculture and child nutritional status in rural Nepal
Objective To examine the association between women’s empowerment in agriculture and nutritional status among children under 2 years of age in rural Nepal. Design Cross-sectional survey of 4080 households conducted in 2012. Data collected included: child and maternal anthropometric measurements; child age and sex; maternal age, education, occupation and empowerment in agriculture; and household size, number of children, religion, caste and agro-ec…
Exposure to mass media and interpersonal counseling has additive effects on exclusive breastfeeding and its psychosocial determinants among Vietnamese mothers
The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self-efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling …
Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam
Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii…
A community-based cluster randomised controlled trial to evaluate the effectiveness of different bundles of nutrition-specific interventions in improving mean length-for-age z score among children at …
The study was retrospectively registered on May 2, 2016 and is available online at ClinicalTrials.gov (ID: NCT02768181 )
Changes in the policy environment for infant and young child feeding in Vietnam, Bangladesh, and Ethiopia, and the role of targeted advocacy
Targeted policy advocacy can catalyze change in national nutrition and IYCF policy environments, especially actor commitment, policy guidance, and legislation. Implementation constraints - financing, capacity and commitment of systems, and competing priorities and actors - are essential to address to sustain further progress. The lack of pressing political urgency for nutrition and IYCF, and the uncertain role of international networks in nationa…
Understanding the role of intersectoral convergence in the delivery of essential maternal and child nutrition interventions in Odisha, India
Congruent or shared priorities and regularity of actions between sectors across all levels will likely improve the quality of coordination, and clear roles and leadership and accountability are imperative. As convergence is a means to achieving effective coverage and delivery of services for improved maternal and child health and nutrition, focus should be on delivering all the essential services to the mother-child dyads through mechanisms that …
Countdown to 2030
Understanding the geographical burden of stunting in India
India accounts for approximately one third of the world's total population of stunted preschoolers. Addressing global undernutrition, therefore, requires an understanding of the determinants of stunting across India's diverse states and districts. We created a district-level aggregate data set from the recently released 2015-2016 National and Family Health Survey, which covered 601,509 households in 640 districts. We used mapping and descriptive …
Progress and inequalities in infant and young child feeding practices in India between 2006 and 2016
Limited evidence exists on socio-economic status (SES) inequalities in infant and young child feeding (IYCF) in India. We examine trends and changes in inequalities for IYCF practices over 2006-2016 and identify factors that may explain differences in IYCF across SES groups. We use data from the 2015-2016 and 2005-2006 National Family Health Surveys (n = 112,133 children < 24 months). We constructed SES quintiles (Q) and assessed inequalities usi…
Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh
Understanding implementation of interventions is critical to illuminate if, how, and why the interventions achieve impact. Alive & Thrive integrated a nutrition intervention into an existing maternal, neonatal, and child health (MNCH) programme in Bangladesh, documenting improvements in women's micronutrient supplement intake and dietary diversity. Here, we examined how well the nutrition intervention was implemented and which elements of impleme…
Medicine (44 obras) · Child Nutrition and Water Access (42 obras) · Environmental health (34 obras) · Economic growth (26 obras) · Economics (21 obras) · Global Maternal and Child Health (20 obras) · Nursing (19 obras) · Psychological intervention (19 obras) · Food Security and Health in Diverse Populations (18 obras) · Geography (17 obras)