Integration of Nutrition and Economic Development in Sri Lanka: The Graduation Model

Abstract

Objectives: The Graduation Model identifies families where they are on the economic and nutrition scale to tailor interventions enabling graduation from one living standard segment to the next, as well as enabling improved growth failure and anaemia. Methods: Graduation Model has been piloted since 2011.  Families first ranked according to participatory living standard ranking, then a nutrition assessment.  Family Development Plan is prepared with each participating household, which determines their pathway to economic security and improved nutrition.  Positive Deviance/Hearth approach is used to identify existing practices which promote good nutrition and teaches these to caregivers of malnourished children through experiential learning.  Low income families are also supported to establish home gardens.  Economic development activities include skills transfer, savings clubs and small business development.  Progress along the Graduation Pathway is measured by improvements in both economic well-being and child nutritional status. Results:  24% of Poorest of the Poor families who were identified at the baseline survey were reduced to 19.2% within two years. The number Poor families were reduced from 31% to 27.6%. Vulnerable non-poor families were reduced from 23% to 19.5% and small and medium entrepreneur families were increased from 14% to 17%.  Siignificant reductions in the prevalence of anaemia (71% to 33%) and underweight (32% to 26%) among children 6-59 months.  Minimal changes were seen in wasting (17% to 16%) or stunting (26% to 24%).  Conclusions: Optimizes development resources through its integrated pathway to economic self-sufficiency and improved nutrition.  Families are empowered to improve their living conditions and children's nutritional status.