F. James Levinson's research while affiliated with Boston University and other places

Publications (27)

Article
After two decades of failed efforts to launch a national nutrition programme and nutrition action largely limited to low coverage interventions, a promising multisectoral nutrition scenario is unfolding in Pakistan led by provincial and regional officials and a well-coordinated group of development partners. The process has emerged from the conflue...
Article
Household food insecurity contributes to poor nutritional health, with negative consequences on growth and development during childhood. Although early childhood nutrition needs have received much attention, another important nutritional phase is adolescence. In a sample of 670 adolescents from Kilosa District, Tanzania, this study used 3 approache...
Conference Paper
Food insecurity is highly prevalent in many developing countries, with negative implications for the health and well-being of affected populations. At the community level, household food security status is affected by inequitable distribution and access to foods. Within households, variation in food allocation influences individual nutritional adeq...
Conference Paper
OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolescents in Sub Saharan Africa. A significant gender difference in adolescent nutritional status has been observed in several developing country studies, with boys appearing to be twice as undernourished as girls. We sought to examine the associations among...
Conference Paper
Household food insecurity contributes to poor nutritional health, with negative consequences on growth and development across childhood. While the nutritional status of children under five years is a priority due to vulnerability and child survival concerns, once beyond that critical age, adolescence is the next important nutritional phase a time w...
Article
Positive deviance is increasingly employed in international development activities to permit the utilization of proven local solutions. Including positive deviance methods in evaluation analysis, particularly in places like Bihar, India, where the rates of child underweight hover at 55%, can help identify project activities and household characteri...
Article
Full-text available
Children participating in the Integrated Child Development Service (ICDS) in India have high rates of iron and vitamin A deficiency. The objective was to assess the efficacy of a premix fortified with iron and vitamin A and added at the community level to prepared khichdi, a rice and dal mixture, in increasing iron and vitamin A stores and decreasi...
Article
Full-text available
The positive deviance approach identifies and promotes existing uncommon healthy behaviours. A positive deviance-informed antenatal project was pilot-tested in Al-Minia Governorate, Upper Egypt, during 2003-2004, after a positive deviance study in 2000 found that successful pregnancies had increased consumption of meat and vegetables, daytime rest,...
Article
India's efforts to address malnutrition have been significant and noteworthy. India's Integrated Child Development Program (ICDS) is the largest child nutrition-related program in the world. The prevalence of malnutrition in India dropped more than 20% since 1960, contributing to significant decreases in infant and child mortality.Despite these adv...
Article
The civil wars in Sudan have resulted in the displacement of roughly 60,000 people in the White Nile State. Internally displaced people (IDP) in Kosti, Sudan face food and nutrition insecurity, as well as poor health and environmental conditions, which are compounded by economic hardships. The data used in this study is from the ADRA/Sudan Kosti Fo...
Article
Full-text available
A follow-up study of malnutrition and its determinants among children 6 to 24 months of age was carried out in rural areas of Punjab State in India 30 years after the original study, and following a period of rapid economic growth. The original 1971 study had found a high prevalence of mortality and malnutrition and the worst gender difference in n...
Article
Full-text available
Monitoring data from the Bangladesh Integrated Nutrition Project and new data collected for this purpose were analyzed to assess the effects of targeted project services, including supplementation of food, on malnourished pregnant women (women with a body mass index [BMI] of < or = 18.5 in early pregnancy). Monitoring data on 456 women--195 receivi...
Article
Two independent cross-sectional studies on early infant feeding behaviors and practices conducted in Bangladesh (1996) and India (1997-98) were unable to find a statistically significant relationship between the time of introduction of complementary foods and the nutritional status of the children. The results of the India data, presented here, ind...
Article
Full-text available
In seeking to improve the micronutrient content of a food supplement used in a major community-based nutrition project in Bangladesh, operations research was conducted to compare the provision of needed micronutrients through additional food sources (fresh or dried fruits or vegetables), a micronutrient multi-mix, or a combination of the two. Using...
Article
Full-text available
Recognizing the increasing reliance being placed on caring practices in large scale nutrition programs, a study was undertaken in the context of one such program, the Bangladesh Integrated Nutrition Project, to examine the effects of women’s time constraints on the successful implementation of such programs. Women who are most seriously time-cons...
Article
How much difference does economic growth make to the nutritional well-being of young children? What effect does it have on traditional child care practices, and specifically on the tendency to favour male children? A follow-up 30 years after a classic study carried out in 1971 in Punjab villages indicates changes that are dramatic, but also that ra...
Article
The common practice of reducing food consumption during pregnancy is recognized as a primary cause of poor pregnancy outcomes and, in turn, malnutrition among young children in many developing countries including Bangladesh. This paper analyzes data from the 1998 Mid-Term Evaluation of the Bangladesh Integrated Nutrition Project (BINP) to identify...
Article
A positive deviance inquiry was conducted in Al-Minia, Upper Egypt, to identify factors associated with achievement of good pregnancy outcomes despite limited resources. As compared with women with poor weight gain (n = 30), low-income women with weight gain greater than 1.5 kg per month in the second trimester of pregnancy (n = 11) were more likel...
Article
Full-text available
Most large-scale nutrition surveys carried out in developing countries have been conducted to compile or update national or regional data that are independent of project activities. At the same time, a growing number of large scale projects are developing monitoring and evaluation systems that also build on periodic baseline and evaluation surveys...
Article
An important measure of good nutrition policy or any public policy is the extent to which that policy is based on solid evidence from the biologic or social sciences. Another measure is the quality of the process and outcomes with regard to the issues of health and well-being for which the policy was initiated. Professionals who work in nutrition p...

Citations

... A study in Tanzanian adolescents has previously associated food insecurity with undernutrition and lower BMI, although mental health was not measured. 27 Alternately, in the North American populations, food insecurity has been associated with an increased risk of obesity and metabolic syndrome in both adults and adolescents. 28,29,30,31 This inconsistency in published results may be because of different lifestyle norms and factors of poverty in each studied population. ...
... Specifically, there is an increase in the prevalence level of Protein-Energy Malnutrition (PEM) and micronutrient deficiencies (Abubakar et al., 2017). Household food insecurity, as Cordeiro et al. (2007) suggest, plays an important role in determining poor nutritional health, which affects the physical growth and development of the child. In other words, the nutrition status of children under-five years is a priority due to vulnerability and child survival concerns. ...
... While the rationale for multisectoral actions is clear, evidence to support this is still limited, and more systematic research needed [20]. From a programmatic perspective, the adage of "planning multisectorally, implementing sectorally and reviewing multisectorally" [21] can guide coordination, reduce efficiencies and mitigate risks and/or harm. [19] Such practice can help support sectoral and geographical convergence (including targeting), clarify roles and responsibilities, and promote a stronger focus on results [22]. ...
... These studies suggest that the root cause of such forms of discrimination is the patriarchal, intra-familial family structure of Punjab where the economic, religious and cultural utility of girls is perceived to be less than that of boys. However, Levinson et al. (2003) presents a more nuanced picture showing a decline in difference in gender mortality in early years. These results are based on two studies conducted across 18 villages in Morinda district of Punjab-one in 1971 and the other in 2001. ...
... A common custom in developing countries is reduction of food intake during pregnancy. This practice, known as "eating down" often stems from a belief that a larger fetus will cause a more difficult delivery, particularly when the woman herself is small 11 . Researchers have found that changes in food-related behaviors take place more often during pregnancy than at any other stage of life 12 . ...
... 3 Interestingly, a comparison of data from interviews and direct observations indicates that women tend to overestimate the amount of time they spend cooking and in cooking-related activities (35% of time compared with an actual 15-22% of time), while underestimating time involved in childcare (3.5% of time compared with an actual 10-26% of time.) 4 Overall in BINP, daytime rest was more likely among higher socio-economic groups. The 1999 BINP Mid-Term Evaluation, carried out two years after the data reported in this study and thus after the project had been functioning for three full years, found that the practice of daytime rest among higher SES groups was 66% as opposed to 56.3% for lower SES groups (Karim, Troy, Patwari & Levinson, 2000). ...
... Micronutrient deficiencies are prevalent across the developing world, affecting 2 billion people (1) and causing cognitive and physical disorders such as anemia, blindness, birth defects, impaired growth in children (2)(3)(4)(5)(6)(7), and around 2 million childhood deaths per year (8)(9)(10). Large-scale human trials have established that micronutrient fortification of foods can effectively treat micronutrient deficiencies (11)(12)(13)(14)(15)(16)(17)(18), but this approach has been limited (19)(20)(21) because of poor implementation in certain countries and unaddressed technical challenges related to micronutrient stability during storage and cooking. ...
... The HDDS is also supported by a growing body of evidence for its external validity. Cordeiro et al. (2012) found a strong correlation between the HDDS and energy intake in a survey of Tanzanian adolescents [74]. The HDDS also demonstrated a strong correlation with the Food Consumption Score across several surveys [8]. ...
... Food packets were distributed for other siblings younger than 5 years to minimize food sharing. Each packet provided about 150 kcal (∼630 kJ) of energy, with 11% of the energy derived from protein, and contained 20 g of roasted rice powder, 10 g of roasted lentil powder, 5 g of molasses and 3 g of soybean oil (Karim et al. 2005). ...