Emanuela Galasso | The World Bank (original) (raw)

Papers by Emanuela Galasso

ABSTRACTBackgroundMeta-analyses have demonstrated that small-quantity lipid-based nutrient supple... more ABSTRACTBackgroundMeta-analyses have demonstrated that small-quantity lipid-based nutrient supplements (SQ-LNS) reduce stunting and wasting prevalence among infants and young children. Identification of subgroups who benefit most from SQ-LNS may facilitate program design.ObjectiveOur objective was to identify study-level and individual-level modifiers of the effect of SQ-LNS on child growth outcomes.MethodsWe conducted a two-stage meta-analysis of individual participant data from 14 randomized controlled trials of SQ-LNS provided to children 6 to 24 months of age in low- and middle-income countries (n=37,066). We generated study-specific and subgroup estimates of SQ-LNS vs. control and pooled the estimates using fixed-effects models, with random-effects models as sensitivity analyses. We used random effects meta-regression to examine study-level effect modifiers. Heterogeneity was assessed using I2 and Tau2 statistics. Sensitivity analyses were conducted to examine whether results d...

Policy Research Working Papers

The Policy Research Working Paper Series disseminates the findings of work in progress to encoura... more The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

Economics & Human Biology

Maternal & Child Nutrition

Scaling up integrated nutrition programmes from small, targeted interventions or pilot studies to... more Scaling up integrated nutrition programmes from small, targeted interventions or pilot studies to large-scale government-run programmes can be challenging, with risks of changing the nature and quality of the interventions such that effectiveness is not sustained. In 1999, the Government of Madagascar introduced a nationwide, community-based, growth-monitoring and nutrition education programme, which was gradually scaled up throughout the country until 2011. Data from three nationally representative surveys, administered pre-and post-programme implementation, in participating and non-participating communities, were used to evaluate the effectiveness of the programme to reduce malnutrition in children under 5 after two phases of expansion (1999-2004 and 2004-2011). In our analyses, we compared "original" communities, who had initiated the programme during the first phase, and "new" communities, who initiated the programme during the second phase. "Original" communities demonstrated a significant effect on mean weight-forage and on the prevalence of underweight by 2004; this effect was sustained at a reduced level through 2011. In contrast, "new" communities showed no benefits for any childhood nutritional outcomes. An explanation for these findings may be that community health workers in the "new" communities reported lower motivation and less use of key messages and materials than those in the "original" communities. Frontline workers reported increased workload and irregular pay across the board during the second phase of programme expansion. Our findings underscore the risk of losing effectiveness if programme quality is not maintained during scale-up. Key factors, such as training and motivation of frontline workers, are important to address when bringing a programme to scale. KEYWORDS community-based programme, difference in differences, impact evaluation, integrated nutrition programme, scale-up 1 | INTRODUCTION Nutrition programmes must be brought to scale in low-and middleincome countries in order to achieve the global commitment to ending all forms of malnutrition (Richter et al., 2017; Ruel & Alderman, 2013). In spite of an existing knowledge base about what nutrition interventions are most effective to improve health outcomes (Bhutta et al., 2014; Black et al., 2008), there is an urgent need for cost-effective, scalable approaches that can address the entire population of children who are at risk of malnutrition and poor development. In addition to the challenge of bringing programmes and policies to scale (Bhutta,

BMC public health, Jun 3, 2016

Over half of the world's children suffer from poor nutrition, and as a consequence they exper... more Over half of the world's children suffer from poor nutrition, and as a consequence they experience delays in physical and mental health, and cognitive development. There is little data evaluating the effects of delivery of lipid-based, nutrition supplementation on growth and development during pregnancy and early childhood within the context of a scaled-up program. Furthermore, there is limited evidence on effects of scaled-up, home-visiting programs that focus on the promotion of child development within the context of an existing, national nutrition program. The MAHAY ("smart" in Malagasy) study uses a multi-arm randomized-controlled trial (RCT) to test the effects and cost-effectiveness of combined interventions to address chronic malnutrition and poor child development. The arms of the trial are: (T0) existing program with monthly growth monitoring and nutritional/hygiene education; (T1) is T0 + home visits for intensive nutrition counseling within a behavior chang...

The Center for Retirement Research at Boston College, part of a consortium that includes a parall... more The Center for Retirement Research at Boston College, part of a consortium that includes a parallel centers at the University of Michigan and the National Bureau of Economic Research, was established in 1998 through a grant from the Social Security Administration. The goals of the Center are to promote research on retirement issues, to transmit new findings to the policy community and the public, to help train new scholars, and to broaden access to valuable data sources. Through these initiatives, the Center hopes to forge a strong link between the academic and policy communities around an issue of critical importance to the nation's future.

Randomly sampled workfare participants in a welfare-dependent region of Argentina were each given... more Randomly sampled workfare participants in a welfare-dependent region of Argentina were each given a voucher that entitled an employer to receive a sizable wage subsidy. Another sample also received voluntary skill training, while a third randomizedout sample was retained as the control group. Double-difference and instrumentalvariables methods are used to deal with potential experimental biases, including selective compliance. Compared to the control group, voucher recipients had a significantly higher probability of employment after 18 months, though their current incomes were no higher. The impact was largely confined to women and younger workers. The experiment proved to be cost effective, given low voucher take-up by employers.

Este programa de trabajo ha sido financiado por subvenciones del Fondo Fiduciario para el Desarro... more Este programa de trabajo ha sido financiado por subvenciones del Fondo Fiduciario para el Desarrollo Ecológicamente y Socialmente Sostenible apoyado por Finlandia y Noruega y el Programa de Sociedad de los Países Bajos y el Banco, financiado por los Países Bajos. El gerente de tarea para esta nota fue Markus Goldstein.

It is now common for central governments to delegate authority over the targeting of antipoverty ... more It is now common for central governments to delegate authority over the targeting of antipoverty programs to better informed-but potentially less accountable-community organizations, while the center retains control over how much goes to each locality. We model the interconnected behavior of the various actors in such a setting. The model's information structure provides scope for econometric identification. Results for Bangladesh's Food-for-Education Program indicate that withinvillage targeting improved with program size, and with lower land inequality, less remoteness, fewer shocks, and less private redistribution. Power in community decision making clearly mattered to the outcomes. However, there is little sign that the center's program placement took account of village attributes conducive to reaching the poor.

BMC public health, Jun 3, 2016

It is common for central governments, to delegate authority over the targeting of welfare program... more It is common for central governments, to delegate authority over the targeting of welfare programs to local community organizations - which may be better informed about who is poor, though possibly less accountable for getting the money to the local poor - while the center retains control over how much goes to each local region. The authors outline a theoretical model of the interconnected behavior of the various actors in such a setting. The model's information structure provides scope for econometric identification. Applying data for a specific program in Bangladesh, they find that overall targeting was mildly pro-poor, mostly because of successful targeting within villages. But this varied across villages. Although some village characteristics promoted better targeting, these were generally not the same characteristics that attracted resources from the center. The authors observe that the center's desire for broad geographic coverage, appears to have severely constrained ...

It is now common for central governments to delegate authority over the targeting of anti- povert... more It is now common for central governments to delegate authority over the targeting of anti- poverty programs to better informed—but potentially less accountable—community organizations, while the center retains control over how much goes to each locality. We model the inter-connected behavior of the various actors in such a setting. The model's information structure provides scope for econometric identification. Results for Bangladesh's Food-for-Education Program indicate that within- village targeting improved with program size, lower land inequality, less remoteness, fewer shocks, and less private redistribution. Power in community decision making clearly mattered to the outcomes. However, there is little sign that the center's program placement took account of village attributes conducive to reaching the poor.

Monitoring data is generally collected as a by-product of the process of monitoring program imple... more Monitoring data is generally collected as a by-product of the process of monitoring program implementation. Yet this rich source of data has not been exploited to assess the effectiveness of the program. In this paper we use detailed administered data from a large-scale, community-based nutrition program in Madagascar, to argue that this data can be used to estimate the differential effect of increased exposure to the program and study how these returns to exposure evolve over time. We find that the returns to exposure are positive: communities exposed for additional one (or two) years display on average lower malnutrition rates of around 7-9 percentage points. Moreover, we find that the returns are decreasing as time and duration increase, though they do not dissipate to zero. These results are consistent with the hypothesis that the returns to the program reflect learning effects from the intervention. Finally, the results show higher differential returns to the program in poorer areas and areas more vulnerable to diseases. These findings have important implications for how such programs should be scaled-up within a country.

One important concern of governments in developing countries is on how to phase-out large safety ... more One important concern of governments in developing countries is on how to phase-out large safety nets programs. This paper evaluates the short run effects of one possible exit strategy, programs that promote self-employment, in Argentina. We provide evidence that a small fraction of beneficiaries were attracted by this program. Overall, potential participants to self-employment are more likely to be female household heads and more educated beneficiaries relative to the average Jefes beneficiaries. Using nonexperimental methods, we show that participation in the program does affect labor supply of participants, by reducing the probability of having an outside job especially for males and increasing the total number of hours worked. However, the intervention fails to produce on average income gains to participating individuals and households in the short run. The fact that a very small subset of former welfare beneficiaries are attracted to the program, coupled with the fact that only a subset of participants (younger and more educated beneficiaries, and with previous self-employment experience) has important implications for this intervention to represent a viable exit strategy from welfare.

Resumen: En este trabajo se analiza el impacto y la incidencia de la principal respuesta de polít... more Resumen: En este trabajo se analiza el impacto y la incidencia de la principal respuesta de política social Argentina a la severa crisis económica de 2002. El programa estaba destinado a brindar un apoyo directo al ingreso de las familias con dependientes cuyo jefe o jefa estuviera desempleado debido a la crisis. Las comparaciones contrafácticas se basan en un subconjunto apareado ("matching") de solicitantes que no eran aún beneficiarios del programa. Adicionalmente, se utilizaron datos de panel del transcurso de la crisis. Se ha encontrado que el programa redujo el desempleo agregado si bien atrajo un número similar de personas inactivas y desempleadas. Aun cuando se prodjujo una sustancial filtración de familias formalmente no elegibles y no se logro una completa cobertura de aquellos elegibles, el programa compenso parcialmente a muchos de los afectados por la crisis y redujo la pobreza extrema. Palabras clave: Crisis; red de seguridad; programas de subsidio al empleo;...

Policy Research Working Papers

Economics & Human Biology

Maternal & Child Nutrition

BMC public health, Jun 3, 2016