Effects of nutrition promotion on child growth in El Alto, Bolivia:results from a geographical discontinuity design

Interventions that offer growth monitoring and nutrition counseling services to families with young children are one of the cornerstones of nutrition policy in developing countries. By raising caregivers’ awareness and encouraging recommended feeding, health, and hygiene practices, these programs seek to improve children’s growth, measured in terms of height and weight. We explore the effects of one such intervention that conducted home visits and community meetings with mothers of children under two years old in El Alto, a city of high poverty concentration in Bolivia. Project eligibility was limited to just over 400 households residing within a strictly defined geographical area. We exploit the resulting geographical discontinuity to identify impacts. Three years after the project started, we find that caregivers in the intervention area show substantial gains in health- and nutrition-related knowledge (0.327s) and practices (0.273s) relative to their peers just outside the project boundary. We find no detectable impacts on children’s height, but observe a significant increase in the prevalence of overweight children. For contexts such as El Alto, with high prevalence of stunting and increasing risk of overweight in the same population, these results suggest that nutrition promotion interventions should reassess both content and behavioral change strategies to reduce stunting while concurrently preventing excess weight gain in children.