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Keeping doors open through investments in adolescent schooling & nutrition: Lessons from IFPRI

Agnes Quisumbing and Crossley Pinkstaff
5 October 2016

As a recent Young Lives blog highlighted, adolescence is a critical window of opportunity for investing in education and nutrition. Yet all too often we seem to be closing these windows, particularly for girls.

Too often, programmes aiming to increase adolescent human capital: 

  1. do not recognize that adolescents are in different  stages of transition to adulthood;
  2. may be  based on outdated assumptions about gender gaps;  
  3. do not always recognize complementarities between schooling and nutrition investments;
  4. often do not build on programmatic platforms that allow services to be delivered at scale; and
  5. often targets only girls,  not realizing that long-run change in gender norms will need to involve boys, future partners, and communities. 

Whereas many doors open to boys as they become men, in many societies, windows of opportunities for girls begin to close as they become women.  Data from the Demographic and Health Surveys in 54 countries shows that a higher proportion of girls age 15-19 are already married, compared to boys of the same age.  Although a higher percentage of girls never attend school, the proportion who have attended some secondary school is not that different between boys and girls on average.   Partly  as a result of successful transfer programs  targeting girls, gender gaps in median years of schooling are closing and have even reversed in some areas (Latin America in particular).   However, large differences between and within regions make it imperative that adolescent programming be sensitive to culture and context.

Lessons from CCTs in Latin America

The  International Food Policy Research Institute’s (IFPRI)  impact evaluations of Conditional Cash Transfers (CCTs) in Latin America found that  CCTs have increased schooling participation rates, had larger impacts on children in poorer households and during years of transition into school or between school levels, and had larger impacts on girls than boys (see review in de Brauw et al. 2015).  However,   even in a “typical” CCT, impacts can be quite different across groups.  An evaluation of the Bolsa Familia (BF) program in Brazil, for example, found that impacts vary by sex, age, and location.  On aggregate, BF increased girls’ school participation by 8.2 percentage points, and did not have a significant impact on boys.  Further disaggregation by location showed that impacts on participation and grade progression were driven by girls in rural areas.  De Brauw and coauthors conclude that BF is widening a gap that already favors girls, suggesting that, in this context, it is important to adopt gender-neutral policies, or to understand better why such programs are more successful at promoting older girls’ education than boys’ education.

Creating platforms can help achieve multiple goals

An impact evaluation in Peru and another in Uganda show that there may be complementarities in schooling and nutrition investments.  A pilot intervention in Cajamarca, Peru, provided iron supplements through a village clinic, with a randomly assigned classroom-based media program encouraging adolescents to take up the supplement.   Students receiving the intervention were more likely to take up the supplement; the reductions in iron deficiency significantly improved school performance and increased anemic students’ aspirations.  A cluster-randomized study in Uganda examined the impacts of implementing food-for-education (FFE) programs in an emergency setting.  The study found that mild anemia prevalence in adolescent girls exposed to FFE program declined 20 percentage points relative to the control group.  Both evaluations show that existing delivery platforms (rural health clinics, food for education programs) can be used to meet the twin goals of increasing investments in adolescent schooling and nutrition.  Building on existing platforms could help other programs targeted to adolescents, such as those aiming to delay marriage, which are typically small community-based programs.   If such programs could be integrated into health or schooling-based programs, they may be able to take advantage of complementarities in program delivery.  

 

Targeting young mothers excluded from adolescent programmes

Married adolescents and adolescent mothers tend to be underserved by programmes targeting unmarried adolescents.  In some countries, such as Bangladesh, this group could account for a substantial proportion of young adults.  Because many girls drop out of school once they get married, they would no longer be reached by school-based nutrition programs.  This large segment of the population could be reached through maternal nutrition and infant and young child feeding (IYCF) programs, designed with young mothers in mind.  In Bangladesh, these young mothers are among the most junior members of their households, with very little bargaining power.   

Nutrition programs targeting young mothers could learn from BRAC’s Alive & Thrive intervention, which combined advocacy, interpersonal communication and community mobilization, media campaigns, and strategic use of data for advocacy, program design, and implementation. Community health and nutrition workers  counseled not only young mothers about nutrition and IYCF practices, but also influential household decisionmakers, like husbands and mothers-in-law, to support the young mother in her caregiving role.  An  ongoing IFPRI-BRAC research project  tests whether adding a nutrition education and behavior change communication component and an explicit gender-sensitization component to an agricultural credit platform targeted to women borrowers can improve maternal and child health nutrition outcomes in Bangladesh.  Recognizing the young ages at first birth, mothers ages 18-25 will be targeted for the intervention.

Key take-aways  

All in all, future programs to invest in adolescents’ human capital should: (1) explore what works in bundled interventions targeting different constraints faced by adolescents, by evaluating the different components of the intervention; (2) develop programming for boys, men, significant family members, and communities to support changes in gender norms; and (3) find out what works best to ensure the delivery of services to adolescents, considering their varied contexts.

 

Agnes Quisumbing is a Senior Research Fellow and Crossley Pinkstaff a Research Analyst in the Poverty, Health, and Nutrition Division of the International Food Policy Research Institute (IFPRI), Washington DC. A longer version of this blog appears on IFPRI'S A4NHs Gender-Nutrition Idea Exchange.