Does exposure to social and behavior change (SBC) programming mediate the effects of drought on nutrition indicators? A spatial-temporal analysis in Burkina Faso
Summary:
The Sahel region faces increasing food insecurity, linked with high population growth rates, inadequate infrastructure, and recurrent climate shocks such as drought. The result is a vulnerable population at risk of poor maternal and child health outcomes including malnutrition. New, nutrition-sensitive programs with social and behavior change (SBC) components are being deployed, but access and exposure to these can be challenging to measure. This study aims to better understand the geographic patterns of drought, malnutrition, care-seeking, and exposure to SBC programming in Burkina Faso. We created a comprehensive drought indicator using satellite-derived rainfall from the Climate Hazards Group InfraRed Precipitation with Station (CHIRPS) data. Using spatial location, the drought indicator was overlaid with PMA2020 nutrition survey data collected in 2017 and 2018. The survey data captured information regarding: 1) demographics; 2) infant and young child feeding practices including minimum acceptable diet, exclusive breastfeeding rates; 3) access to and uptake of health services (e.g., antenatal care [ANC] attendance and receiving supplements such as Vitamin A); 4) exposure to SBC programming (e.g., counseling regarding nutrition behaviors); and 5) the mid-upper-arm-circumference (MUAC), a measure of nutritional status. The objective is to identify the degree to which exposure to SBC programming mediates the effects of drought on nutritional outcomes. These results may inform future SBC programs, including spatial targeting of communities most vulnerable to the effects of drought. If possible, we may also identify the components of the program that are associated with improved nutritional outcomes.
Background/Objectives:
The objective of this research-oriented analysis is to measure the extent of the association between a comprehensive indicator of drought and under-nutrition. We will explore spatial-temporal variation in access to health services, nutrition-specific interventions, and exposure to SBC programming, as well as whether this exposure mitigates the negative effects of drought on nutritional outcomes for children and their mothers.
Description of Intervention and/or Methods/Design:
To quantify nutrition outcomes, access to health services, and exposure to SBC programming, PMA2020 nutrition surveys conducted in Burkina Faso in 2017 and 2018 will be explored. PMA2020 collected nationally representative data from clusters across Burkina Faso (n=83), sampling from randomly selected households within each cluster. Each cluster has a GPS point that has been displaced for confidentiality; to account for displacement, buffers will be drawn around each point (2km for urban and 5km for rural points). These will be used to extract average rainfall values from the CHIRPS data by location. Multiple dimensions of the rainy season, such as duration, start, and difference from the historical average will be used to create a comprehensive indicator of drought. Maps of rainfall, drought, MUAC, and exposure to different components of healthcare access and SBC programming will be generated. Multi-level models will be fit, accounting for spatial correlation.
Results/Lessons Learned:
We will explore spatial-temporal variation in drought, nutrition outcomes, access to health services, uptake of nutrition-specific interventions, and exposure to SBC programming in Burkina Faso, comparing 2017 and 2018 surveys. The results will aim to measure the protective effects of access to health services and SBC exposure in a drought-prone region. Findings may inform future programming to ensure they are targeted to the most vulnerable regions. In severely drought-prone countries with high rates of malnutrition, SBC programming is critical to improve maternal and child health outcomes. This research will identify regions that are most vulnerable to drought that may require more targeted SBC programming to improve health outcomes. We will also explore the various components of the programming to detect whether any specific component (for example, learning about nutrition during ANC in a group or one-on-one counseling) appears to be more effective.
Discussion/Implications for the Field:
Countries such as Burkina Faso face recurrent droughts and food-security concerns. Malnutrition is prevalent, with adverse consequences for both short- and long-term health, growth, and development. SBC programs are critical to addressing behaviors around infant and young child feeding practices, including breastfeeding, and to encourage uptake of critical health services such as ANC, supplements of Vitamin A, and treatment of diarrhea with oral rehydration solution. Ultimately, SBC programs will need to be developed and deployed to improve health outcomes. These may be more effective and cost-effective if geographically targeted and potentially tailored to the season.
Abstract submitted by:
Jessie Pinchoff - Population Council
Kathryn Grace - University of Minnesota
Leanne Dougherty - Population Council
Kathryn Spielman - Population Council
The Sahel region faces increasing food insecurity, linked with high population growth rates, inadequate infrastructure, and recurrent climate shocks such as drought. The result is a vulnerable population at risk of poor maternal and child health outcomes including malnutrition. New, nutrition-sensitive programs with social and behavior change (SBC) components are being deployed, but access and exposure to these can be challenging to measure. This study aims to better understand the geographic patterns of drought, malnutrition, care-seeking, and exposure to SBC programming in Burkina Faso. We created a comprehensive drought indicator using satellite-derived rainfall from the Climate Hazards Group InfraRed Precipitation with Station (CHIRPS) data. Using spatial location, the drought indicator was overlaid with PMA2020 nutrition survey data collected in 2017 and 2018. The survey data captured information regarding: 1) demographics; 2) infant and young child feeding practices including minimum acceptable diet, exclusive breastfeeding rates; 3) access to and uptake of health services (e.g., antenatal care [ANC] attendance and receiving supplements such as Vitamin A); 4) exposure to SBC programming (e.g., counseling regarding nutrition behaviors); and 5) the mid-upper-arm-circumference (MUAC), a measure of nutritional status. The objective is to identify the degree to which exposure to SBC programming mediates the effects of drought on nutritional outcomes. These results may inform future SBC programs, including spatial targeting of communities most vulnerable to the effects of drought. If possible, we may also identify the components of the program that are associated with improved nutritional outcomes.
Background/Objectives:
The objective of this research-oriented analysis is to measure the extent of the association between a comprehensive indicator of drought and under-nutrition. We will explore spatial-temporal variation in access to health services, nutrition-specific interventions, and exposure to SBC programming, as well as whether this exposure mitigates the negative effects of drought on nutritional outcomes for children and their mothers.
Description of Intervention and/or Methods/Design:
To quantify nutrition outcomes, access to health services, and exposure to SBC programming, PMA2020 nutrition surveys conducted in Burkina Faso in 2017 and 2018 will be explored. PMA2020 collected nationally representative data from clusters across Burkina Faso (n=83), sampling from randomly selected households within each cluster. Each cluster has a GPS point that has been displaced for confidentiality; to account for displacement, buffers will be drawn around each point (2km for urban and 5km for rural points). These will be used to extract average rainfall values from the CHIRPS data by location. Multiple dimensions of the rainy season, such as duration, start, and difference from the historical average will be used to create a comprehensive indicator of drought. Maps of rainfall, drought, MUAC, and exposure to different components of healthcare access and SBC programming will be generated. Multi-level models will be fit, accounting for spatial correlation.
Results/Lessons Learned:
We will explore spatial-temporal variation in drought, nutrition outcomes, access to health services, uptake of nutrition-specific interventions, and exposure to SBC programming in Burkina Faso, comparing 2017 and 2018 surveys. The results will aim to measure the protective effects of access to health services and SBC exposure in a drought-prone region. Findings may inform future programming to ensure they are targeted to the most vulnerable regions. In severely drought-prone countries with high rates of malnutrition, SBC programming is critical to improve maternal and child health outcomes. This research will identify regions that are most vulnerable to drought that may require more targeted SBC programming to improve health outcomes. We will also explore the various components of the programming to detect whether any specific component (for example, learning about nutrition during ANC in a group or one-on-one counseling) appears to be more effective.
Discussion/Implications for the Field:
Countries such as Burkina Faso face recurrent droughts and food-security concerns. Malnutrition is prevalent, with adverse consequences for both short- and long-term health, growth, and development. SBC programs are critical to addressing behaviors around infant and young child feeding practices, including breastfeeding, and to encourage uptake of critical health services such as ANC, supplements of Vitamin A, and treatment of diarrhea with oral rehydration solution. Ultimately, SBC programs will need to be developed and deployed to improve health outcomes. These may be more effective and cost-effective if geographically targeted and potentially tailored to the season.
Abstract submitted by:
Jessie Pinchoff - Population Council
Kathryn Grace - University of Minnesota
Leanne Dougherty - Population Council
Kathryn Spielman - Population Council
Source
Approved abstract for the postponed 2020 SBCC Summit in Marrakech, Morocco. Provided by the International Steering Committee for the Summit. Image credit: © Dominic Chavez/The Global Financing Facility via Flickr (CC BY-NC-ND 2.0)