Implementation and effects of India's national school-based iron supplementation program

James Berry, Saurabh Mehta, Priya Mukherjee, Hannah Ruebeck and Gauri Shastry

Journal of Development Economics, 2020, vol. 144, issue C

Abstract: Reducing the rate of anemia is a primary public health concern in many developing countries. This paper studies the Indian government's school-based Iron and Folic Acid (IFA) supplementation program. We provide a descriptive analysis of program implementation patterns across 377 schools in the state of Odisha. We document that the more advantaged blocks had more consistent tablet distribution, and that distribution within the less advantaged blocks was less predictable, and plausibly random. We use this quasi-random variation to estimate the causal effect of the policy using a difference-in-differences strategy. The IFA program had no effect on hemoglobin levels at the mean, but there is a significantly larger effect for moderately anemic students in schools that were more recently distributing tablets, relative to schools that had run out of tablets. These results suggest that school-based supplementation has the potential to improve hemoglobin levels, but that breaks in supplementation – either due to inconsistent tablet distribution or the constraints of a school calendar – limit the long-term efficacy of school-based supplementation programs.

Keywords: School nutrition programs; Micronutrient supplementation; Anemia (search for similar items in EconPapers)
JEL-codes: H40 I18 O15 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:deveco:v:144:y:2020:i:c:s0304387818314317

DOI: 10.1016/j.jdeveco.2019.102428

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