April 2, Lec9, Pt3: Nutri Interventions: Who Does What and How?

Question 1

Gov’s role in combating hunger and malnutrition?

Answer 1

1. Moral leadership/guarantor of a human right (religious institution also can serve the moral leadership role)
2. Gov can conduct policies and interventions at a scale (no other actor can mobilize the scale of resources like the gov)
3. Coordination of efforts (Gov more effective at leading and coordination efforts)
4. Regulatory interventions (only the gov has the authority to regulate)
   - industry can create voluntary regulations (voluntary labeling/fortification) but less comprehensive
5. Info interventions: Gov’s more likely to be able to provide trusted info
   - Private companies also give lots of nutri info, but not 100% trustworthy
6. Cost effectiveness of gov interventions: sometimes gov do things at lower costs
7. Public good nature of benefits (Many nutri issues have widespread benefits for society, but only small benefits for indivs. Positive externalities to better nutri

Question 2

Econ cost-benefit of GOV in nutri interventions: YAYS and NAYS

Answer 2

YAYS:
- well financed
- long-term view
- can mobilize big resources

NAYS:
- slow and bureaucratic
- politicized decision making

Question 3

Econ cost-benefit of NON-GOV ORGS in nutri interventions: YAYS and NAYS

Answer 3

YAYS
- fast moving
- connections to the community

NAYS
- coordination issues
- indiv decision making
- low sustainability

Question 4

Econ cost-benefit of PHILANTHROPHIES in nutri interventions: YAYS and NAYS

Answer 4

YAYS
- can access financing
- can move fast

NAYS
- coordination issues
- donor driven agenda, less accountable to community
- low sustainability

Question 5

Econ cost-benefit of OTHER COUNTRIES in nutri interventions: YAYS and NAYS

Answer 5

YAYS
- well financed
- long-term view
- can mobilize big resources

NAYS
- donor driven agenda
- coordination issues with host gov

Question 6

who should be prioritized/helped by nutri interventions?

Answer 6

• kids
• mothers
• the poor
• ppl of certain region

Why not everyone?

Question 7

Why would we prioritize some people and not others with nutri interventions?

Answer 7

1. Better “return on investment” for some types of people (cost-benefit calcs)
2. Morality
3. Vulnerability

Question 8

Regarding ‘Why Should wE Prioritize some Ppl not Others?’:

-> Describe [Better “return on investment” for some types of ppl/cost-benefit calcs]

Answer 8

• Healthy kids have long lives to live = largest potential benefit
• Well nourished kids learn more = increased benefit

Question 9

Regarding ‘Why Should wE Prioritize some Ppl not Others?’:

-> Describe [Morality]

Answer 9

• Kids aren’t responsible for their own poverty
• Are adults responsible for their poverty and not worthy?

Question 10

Regarding ‘Why Should wE Prioritize some Ppl not Others?’:

-> Describe [vulnerability]

Answer 10

• Choose ppl most vulnerable to nutri harms
• Is the goal to reduce potential long-term harms?

Question 11

Define: targeting “leakage”

Answer 11

Errors of inclusion

to nontargeted indivs, households, regions

Question 12

Define targeting “Exclusion”

Answer 12

Errors of exclusion

missing intended beneficiaries

Question 13

Consequences for targeting errors

Answer 13

Over inclusion
- added costs
- disincentives to work

Exclusion
- lower impact
- humanitarian/moral consequences

Question 14

Draw graph ‘Targeting: Inclusion and Exclusion of Groups’

Answer 14

TARGETED, FOOD INSECURE -> 1. Successful targeting

TARGETED, FOOD SECURE -> 2. Inclusion error (Leakage)

NOT TARGETED, FOOD INSECURE -> 3. Exlucsion error (Under-coverage)

NOT TARGETED, FOOD SECURE -> 4. Successful targeting

Question 15

Define: ‘mean tested’

Answer 15

having income thresholds determined by one’s income (from tax forms), wages (weekly paychecks), and assets (bank accounts, real estate).

Question 16

Move poverty programs in the US are __________

Answer 16

means tested

Question 17

Advantages of means tested ppoverty programs

Answer 17

Improves targeting: only people who meet criteria receives program

• No program leakage

Question 18

Disadvantages of means testing poverty program

Answer 18

• Administrative burden, harder to sign up, time consuming
• Exclusion of those who don’t meet burden

Question 19

Poverty is better at doin what than food insecurity?

Answer 19

Poverty has clearer lines for determining who is eligible than food insecurity

Question 20

How to decide what is the right poverty line?

Answer 20

Draw the “Level of Poverty” versus “Targeted by the Intervention?” graph

Poor+Targeted: Correct Targeting
NotPoor+Targeted: Inclusion error (leakage)
Poor+NotTargeted: Exclusion error (Under coverage)
NotPoor+NotTargeted: Correct Targeting

Question 21

Draw the “Level of Poverty” versus “Targeted by the Intervention?” graph

Answer 21

Poor+Targeted: Correct Targeting
NotPoor+Targeted: Inclusion error (leakage)
Poor+NotTargeted: Exclusion error (Under coverage)
NotPoor+NotTargeted: Correct Targeting

Question 22

What was the one exception to the “we hate leakage” mantra?

Answer 22

Short term COVID efforts

Question 23

How was Covid being an exception to “we hate leakage” mantra look like?

Answer 23

• Everyone was eligible for free vaccines/testing kits/masks
• Child tax credit given to everyone irrespective of their income
• Businesses got Covid money without filing out forms

Question 24

Equitable Access includes:

Answer 24

• Online accessibility
• Mobile accessibility
• Call Center accessibility
• Local Office accessibility
• Application burden
• Customer satisfaction

Question 25

Effective Delivery includes:

Answer 25

- Application outcomes - Procedural denials - Timeliness - Expedited Service (SNAP) - Interview completion - Notifications - Verifications - renewals - Churn

Question 26

Compassionate Integrity includes:

Answer 26

- Participation Rate - Accuracy - Appeals/Hearings

Question 27

Examples of Nutrition policies/programs in the US

Answer 27

- Food labeling iwth calories, protein, nutrients, ... on side of box - USDA food pyramid - WIC: women and infant children supplemental nutrition program - School lunch/breakfast programs - Fortification programs: Niacin in wheat, Iodine in salt, VitD in milk - USDA food distribution programs

Question 28

Examples of nutrition targeting in Africa

Answer 28

- Food Aid programs, esp for humanitarian needs - School feeding programs: funded by home country budgets - Promotion of micro-nutri dense foods - Increase productivity/agriculture: more crops, lower prices - Promoting breastfeeding - Cash transfers to households facing food security shortages

Question 29

Types of interventions to address Macro Nutri Gaps:

Answer 29

- Income based interventions - Price based interventions - Access based interventions - Production based interventions - Information based intervations

Question 30

Types of interventions to address Micro Nutri Gap policies:

Answer 30

- Fortification - Information - Rules and regulations - Diversification of production

Question 31

Most nutri interventions should be done when? Why?

Answer 31

Done in advance of an acute problem - By the time a malnourished child shows up in a hospital, it may be too late to save them - Early life interventions can have later life benefits, requires paying attention to the timing - Many interventions seek to reduce the vulnerability to food security shocks, these are best done in advance: (famine early warning system is an example of trying to place interventions before famine hits)

Question 32

Many interventions, particularly with farm communities may be _____

Answer 32

seasonal

Question 33

Why would many interventions, particularly with farm communities may be seasonal?

Answer 33

- During harvest time, there plenty of food, but 6 months later ma be lack of food - Suggests interventions at specific times of year (hungry season) and not others

Question 34

Getting the timing wrong with nutri interventions may lead to what?

Answer 34

Leakage or Exclusion

Question 35

Why would getting the timing wrong with nutri interventions may lead leakage or exclusion?

Answer 35

- Handling out food aid (free food) after good rains come and the drought is over hurts farmers by creating low prices - An intervention that doesn't show up in time will exclude intended beneficiaries