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With research staff from more than 60 countries, and offices across the globe, IFPRI provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition in developing countries.

researcher spotlight

Kalyani Raghunathan

Kalyani Raghunathan is Research Fellow in the Poverty, Gender, and Inclusion Unit, based in New Delhi, India. Her research lies at the intersection of agriculture, gender, social protection, and public health and nutrition, with a specific focus on South Asia and Africa. 

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Publications

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Abstract

Provision and utilization of health and nutrition services during the COVID-19 pandemic in urban Bangladesh

2021Sununtnasuk, Celeste; Nguyen, Phuong Hong; Pant, Anjali; Tran, Lan Mai; Kachwaha, Shivani; Menon, Purnima
Details

Provision and utilization of health and nutrition services during the COVID-19 pandemic in urban Bangladesh

Objectives: The COVID-19 pandemic is expected to have extensive effects on healthcare systems. The Government of Bangladesh has concerns about diminished coverage and quality of maternal and child health services, but little published information exists on service provision, utilization, and adaptations. We examined changes to maternal and child health and nutrition service delivery and utilization in urban Bangladesh during and after the enforcement of COVID-19 restrictions and identified adaptations and potential solutions to strengthen service delivery and uptake. Methods: We conducted longitudinal surveys with health care providers (n = 45), pregnant women (n = 40), and mothers of children < 2 years (n = 387) in February 2020 (in-person) and September 2020 (by phone). We used Wilcoxon matched-pairs signed-rank tests to compare the changes before and during the pandemic. Results: Most services for pregnant women remained available during COVID-19 restrictions, with the provision of antenatal care (ANC) services falling by 6.6 percentage points (pp). Services for women and children which require proximity, however, were more severely affected; weight and height measurements fell by 20–29pp for pregnant women and 37–57pp for children, and child immunizations fell by 38pp. Declines in service utilization were large, including drops in facility visitations (35pp among pregnant women and 67pp among mothers), health and nutrition counseling (up to 73pp), child weight measurements (50pp), and immunizations (61pp). The primary method of adaptation was provision of services over phone (37% for ANC services and 44–49% for counselling of pregnant women or mothers with young children). Conclusions: Despite adaptations to service provisions, continued availability of routine maternal and child health services did not translate into service utilization. Further investments are needed to provide timely and accurate information on COVID-19 to the public, improve COVID-19 training and provide incentives for health care providers, and ensure availability of personal protective equipment for both providers and beneficiaries.

Year published

2021

Authors

Sununtnasuk, Celeste; Nguyen, Phuong Hong; Pant, Anjali; Tran, Lan Mai; Kachwaha, Shivani; Menon, Purnima

Citation

Sununtnasuk, Celeste; Nguyen, Phuong Hong; Pant, Anjali; Tran, Lan Mai; Kachwaha, Shivani; Menon, Purnima; et al. 2021. Provision and utilization of health and nutrition services during the COVID-19 pandemic in urban Bangladesh. Current Developments in Nutrition 5(Supplement 2): 690. https://doi.org/10.1093/cdn/nzab045_072

Country/Region

Bangladesh

Keywords

Southern Asia; Asia; Covid-19; Health; Urban Areas; Nutrition; Health Services; Pandemics

Language

English

Access/Licence

Open AccessCC-BY-NC-ND-4.0

Links

https://doi.org/10.1093/cdn/nzab045_072 Source record

Project

Agriculture for Nutrition and Health

Record type

Abstract

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Journal Article

Dietary diversity predicts the adequacy of micronutrient intake in pregnant adolescent girls and women in Bangladesh, but use of the 5-group cutoff poorly identifies individuals with inadequate intake

2018Nguyen, Phuong Hong; Huybregts, Lieven; Sanghvi, Tina; Tran, Lan Mai; Frongillo, Edward A.; Menon, Purnima; Ruel, Marie T.
Details

Dietary diversity predicts the adequacy of micronutrient intake in pregnant adolescent girls and women in Bangladesh, but use of the 5-group cutoff poorly identifies individuals with inadequate intake

The Minimum Dietary Diversity for Women (MDD-W) indicator based on a 10-food group women dietary diversity score (WDDS-10) has been validated to assess dietary quality in nonpregnant women. Little is known about its applicability in pregnant women, and specifically pregnant adolescent girls with higher nutrient requirements. This study aimed to 1) compare the adequacy of micronutrient intakes between pregnant adolescent girls and women, 2) examine the performance of WDDS-10 in predicting the mean probability of adequacy (MPA) of 11 micronutrients, and 3) assess how well the MDD-W cutoff of 5 groups performed in pregnant adolescent girls and women.We used data from a 2015 household survey in Bangladesh (n = 600). Nutrient intakes were estimated with a multiple-pass 24-h recall and WDDS-10 was assessed through the use of a list-based method. Multiple linear regression models adjusted for geographical clustering assessed the association between WDDS-10 and MPA. Sensitivity and specificity analysis assessed the accuracy of MDD-W in correctly classifying individuals into high (MPA >0.6) or low MPA. Dietary intakes of pregnant adolescent girls and women were similar in energy intake, WDDS-10 (5.1 ± 1.4), MPA (0.40 ± 0.12), and micronutrient intakes. Probabilities of adequacy were ∼0.30 for riboflavin, vitamin B-12, calcium, and zinc; 0.12–0.15 for folate; 0.16–0.19 for vitamin A; and extremely low for iron at 0.01. The WDDS-10 was significantly associated with MPA in both groups and predicted MPA equally well at population level (SD of residuals 0.11 for both). Use of the 5-food groups cutoff for MDD-W to classify individuals’ diets into MPA >0.6, however, resulted in a low correct classification (∼40%). A cutoff of 6 food groups markedly improved correct classification. The WDDS-10 predicted MPA equally well for pregnant adolescent girls and women at population level. The MDD-W indicator performed poorly in classifying individuals with MPA >0.6.

Year published

2018

Authors

Nguyen, Phuong Hong; Huybregts, Lieven; Sanghvi, Tina; Tran, Lan Mai; Frongillo, Edward A.; Menon, Purnima; Ruel, Marie T.

Citation

Nguyen, Phuong Hong; Huybregts, Lieven; Sanghvi, Tina; Tran, Lan Mai; Frongillo, Edward A.; Menon, Purnima; and Ruel, Marie T. 2018. Dietary diversity predicts the adequacy of micronutrient intake in pregnant adolescent girls and women in Bangladesh, but use of the 5-Group cutoff poorly identifies individuals with inadequate intake. Journal of Nutrition 148(5): 790-797. https://doi.org/10.1093/jn/nxy045

Country/Region

Bangladesh

Keywords

Southern Asia; Asia; Adolescents; Pregnancy; Nutrient Intake; Capacity Development; Food; Trace Elements; Diet; Maternal Nutrition; Dietary Diversity

Language

English

Access/Licence

Open AccessCC-BY-4.0

Links

https://doi.org/10.1093/jn/nxy045 Source record

Project

Agriculture for Nutrition and Health

Record type

Journal Article

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Journal Article

Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh

2018Nguyen, Phuong Hong; Frongillo, Edward A.; Sanghvi, Tina; Kim, Sunny S.; Alayon, Silvia; Tran, Lan Mai; Mahmud, Zeba; Aktar, Bachera; Menon, Purnima
Details

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 implementation explained intervention impact.

Year published

2018

Authors

Nguyen, Phuong Hong; Frongillo, Edward A.; Sanghvi, Tina; Kim, Sunny S.; Alayon, Silvia; Tran, Lan Mai; Mahmud, Zeba; Aktar, Bachera; Menon, Purnima

Citation

Nguyen, Phuong Hong; Frongillo, Edward A.; Sanghvi, Tina; Kim, Sunny S.; Alayon, Silvia; Tran, Lan Mai; Mahmud, Zeba; Aktar, Bachera; and Menon, Purnima. 2018. Importance of coverage and quality for impact of nutrition interventions delivered through an existing health programme in Bangladesh. Maternal and Child Nutrition 14(4): e12613. https://doi.org/10.1111/mcn.12613

Country/Region

Bangladesh

Keywords

Southern Asia; Asia; Maternal and Child Health; Implementation; Impact; Nutrition Policies; Capacity Development; Nutrition; Health Services; Maternal Nutrition

Language

English

Access/Licence

Open AccessCC-BY-4.0

Links

https://doi.org/10.1111/mcn.12613 Source record

Project

Agriculture for Nutrition and Health

Record type

Journal Article

Events

CGIAR Platform for Big Data in Agriculture Convention
IFPRI at External Event

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October 3 to 5, 2018

CGIAR Platform for Big Data in Agriculture Convention

IFPRI Staff are participating in the CGIAR Platform for Big Data in Agriculture co-hosted by the International Center for Tropical Agriculture (CIAT) taking place October 3-5, 2018 at the Campus of the World Agroforestry Center (ICRAF) in Nairobi, Kenya. This convention is the second yearly event to bring together the people and organizations that make the […]

Blogs

Can child wasting be prevented in times of crisis? Evidence from Burundi
IFPRI Blog
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Can child wasting be prevented in times of crisis? Evidence from Burundi

By Jef L. Leroy, Deanna K. Olney, Marie Ruel, and Tracy Brown

Positive results from the Tubaramure program suggest lessons for COVID-19 responses and future crises.

The cost of improving nutritional outcomes through food aid programs: Is more and longer better?
IFPRI Blog
 | 
November 20, 2020

The cost of improving nutritional outcomes through food aid programs: Is more and longer better?

By Jef L. Leroy, Jessica Heckert, Deanna K. Olney, Susan Richter, Elyse Iruhiriye, Marie T. Ruel, and Tracy Brown

Evidence shows that these programs can work, but are the costs reasonable?

Optimizing food assistance programs: Improving household food security and diet quality in Burundi
IFPRI Blog
 | 
October 27, 2020

Optimizing food assistance programs: Improving household food security and diet quality in Burundi

By Jef L. Leroy, Deanna K. Olney, Marie Ruel, Lilia Bliznashka, and Tracy Brown

A program combining nutritious rations with behavior change communication yields positive results.

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