Evidence map›Paper›PMID 34615509›Full record

ArticleBMC pediatrics2021

Effective nutrition governance is correlated with better nutrition outcomes in Nepal.

Grace Namirembe, Robin Shrestha, Julieta Mezzano, Lynne M Ausman, Dale Davis, Kedar Baral, Shibani Ghosh, Gerald Shively, Patrick Webb

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In one paragraph

Article in BMC pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Grace NamirembeFriedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA. Grace.Namirembe@tufts.edu.ORCID 0000-0002-8017-4144
Robin ShresthaFriedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
Julieta MezzanoFriedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
Lynne M AusmanFriedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
Dale DavisHelen Keller International, Patan, Nepal.
Kedar BaralDepartment of Community Health Sciences, Patan Academy of Health Sciences, Lalitpur, Nepal.
Shibani GhoshFriedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
Gerald ShivelyDepartment of Agricultural Economics, Purdue University, West Lafayette, IN, USA.
Patrick WebbFriedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe public health burden of undernutrition remains heavy and widespread, especially in low-income countries like Nepal. While predictors of undernutrition are well documented, few studies have examined the effects of political will and quality of policy or program implementation on child growth.

methodsData were collected from two nationwide studies in Nepal to determine the relationship between a metric of nutrition 'governance' (the Nutrition Governance Index), derived from interviews with 520 government and non-government officials responsible for policy implementation and anthropometry measured for 6815 children in 5556 households. We employed Generalized Estimating Equation (GEE) and multilevel regression models.

resultsA higher NGI (more effective nutrition governance) is positively associated with height-for-age as well as weight-for-height in children over 2 years of age compared to younger children (HAZ; β = 0.02, p < 0.004, WHZ; β = 0.01, p < 0.37). Results from the hierarchical model show that a one-point increase in the NGI is significantly associated with a 12% increase in HAZ and a 4% increase in WHZ in older children (> 24 months old). Mothers' education, child's age, BMI and no fever in the past 30 days were also protective of stunting and wasting. Seven percent and 17% of the overall variance in HAZ and WHZ, respectively, are accounted for by variations across the 21 district locations in which sampled households were located. Mean HAZ differs considerably across districts (intercept = 0.116, p < 0.001).

conclusionsThese results highlight the importance of effective management of policy-based programming and resource use to bring about nutrition gains on the ground. The NGI explained a non-negligible amount of variation in HAZ and WHZ, which underscores the fundamental role that good governance plays in promoting child nutrition and growth, and the value of seeking to measure it to assist governments in moving policies from paper to practice.

Indexed as

MalnutritionNutritional StatusChildChild, PreschoolFamily CharacteristicsGrowth DisordersHumansInfantNepalNepalNutrition governance indexPolicy processesStuntingWasting

Identifiers

PMID34615509
PMCPMC8493744

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.