Beyond a conceptual framework : an applied method to assess the potential impact of multi-sectoral approaches on the reduction of child stunting in Yemen (2013-2014)

  • Patrizia Fracassi

Student thesis: Doctoral ThesisDoctor of Health (DHealth)


BackgroundThis research aims to explore the recommendations of the 2013 Lancet Series on maternal and child nutrition in the case study of Yemen (2013-2014), by answering the question “What mix of public interventions works best in a given context to reduce child stunting prevalence?” Yemen was selected due to its Government commitment to use a multi-sectoral approach in its planning and financing cycle for nutrition.MethodThe research applied a mixed method, starting with a literature review and a cross-country secondary-data analysis to produce evidence for composing a research framework for Yemen. Subsequently, a descriptive analysis, two types of regressions (Probit and Poisson) and an adapted ‘Delphi method’ for discussion with decision-makers from various sectors were carried out. Results Based on the descriptive analysis, Yemen progressed in: maternal and child health care, drinking water supply and sanitation, girls’ education, delayed marriage and pregnancy. However, infant and young child feeding practices remained inadequate. Significant determinants of child stunting identified by the regressions included characteristics of: child (age, gender and diet diversity), mother (undernutrition, birth-spacing and head of family) and household (access to water and sanitation). Children of households that engaged in agriculture, livestock and fishing were the most likely to access diet diversity and animal-protein sources. Other significant determinants of child diet included maternal education, per capita expenditure, income-related shocks and ownership of a cooking stove and fridge. Results from the adapted ‘Delphi-method’ discussion showed that decision-makers were ready to use multi-sectoral approaches to converge their existing interventions in the most vulnerable geographical areas. However, they were less keen to retarget beneficiaries based on age, gender or livelihoods.ConclusionsThe research demonstrates how the applied mixed method can provide a comprehensive way to examine child stunting as a multi-sectoral issue, rather than just considering it as a health problem.
Date of Award27 Jun 2017
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorAlan Buckingham (Supervisor)


  • stunting
  • Yemen
  • multi-sectoral

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