Geographic targeting of nutrition programs can substantially affect the severity of stunting in Honduras

The effect of nutrition intervention programs in developing countries is li kely to vary with the degree to which the program can be successfully targe ted at the most vulnerable. In Honduras, the existence of a recent census o f the height of first-grade children makes it possible to assess a priori t he effect of different targeting strategies, holding constant other feature s of a hypothetical program. We simulate a nutrition intervention with 20% national coverage and uniform gains of 0.5 Z-scores for all beneficiaries, with a number of different approaches to targeting. The VIIth National Cens us of First-Graders' Heights provides the baseline scenario and permits ide ntification of priority departments, municipalities, schools and individual s, for a total of six alternative targeting mechanisms. Effect is assessed on the basis of changes in the prevalence of stunting (less than -2 Z-score s) and in two different measures of the severity of stunting adapted from t he economics literature (the malnutrition gap and the quadratic malnutritio n gap). We find that the simulated program has the potential to substantial ly improve the severity, but not the prevalence of stunting in Honduras. Ho usehold targeting with an imperfect indicator of vulnerability could reduce the malnutrition gap by >20% and the quadratic malnutrition gap by >30%, b ut would be very expensive to implement. "Broad stroke" geographic targetin g could reduce the same measures by 15 and 20%, respectively, and would be much less expensive to implement. We conclude that geographic targeting has the potential to substantially enhance the effect of nutrition programs on the severity of stunting in Honduras.