Nutrition
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Promotion of smallholder irrigation is cited as a strategy for enhancing income generation and food security for sub-Saharan Africa’s poor farmers, but what makes this technology a successful poverty alleviation tool? In the short run, the technology should pave the way for increased consumption, asset accumulation, and reduced persistent poverty among users. Over the longer run, it should lead to institutional feedbacks that support sustained economic development and nutritional improvements. Our conceptual model and review of case studies reveal the importance of three sub-components of irrigation technology—access, distribution, and use—and the ways in which the design of the technology itself can either bridge, or succumb to, institutional gaps. These critical features are illustrated in an experimental evaluation of a solar-powered drip irrigation project in rural northern Benin, which provides a controlled study of technology impacts in the Sudano-Sahel. The combined evidence highlights the technical and institutional requirements for project success and points to two important areas of research in the scale-up of any small-scale irrigation strategy: the risk behavior of water users, and the evolution of institutions that either support or obstruct project replication over space and time.

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World Development
Authors
Jennifer Burney
Jennifer Burney
Rosamond L. Naylor
Rosamond Naylor
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Although the past few decades have seen incomes rise and increased government commitment to helping the poor, there is concern that a large fraction of children in rural China still lack regular access to micronutrient-rich regular diets. Insufficient diets and poor knowledge of nutrition among low income populations can result in nutritional problems, including iron deficiency anemia, which adversely affect attention and learning in school. Surprisingly, there has been little research in China trying to document the prevalence of nutritional problems among certain vulnerable populations, such as school-aged children in rural areas. The absence of programs to combat iron deficiency anemia among students might be interpreted as a sign that the government does not recognize the severity of this problem. The goal of this paper is to increase our understanding of the extent of anemia among school-aged children in poor regions of Qinghai and Ningxia, and to identify structural correlates of anemia in this region. We report on the results of a cross-sectional survey involving over 4000 fourth grade students, from 76 randomly selected elementary schools in 10 poor counties in Qinghai Province and Ningxia Hui Autonomous Region, in China’s poor northwest region. Data were collected through structured questionnaires and standardized tests. Trained professional nurses administered hemoglobin (Hb) tests (using Hemocue finger prick kits) and anthropomorphic measurements using high quality equipment. Our baseline data shows that the overall anemia rate is 34.5% (23.0%) using the World Health Organization’s blood Hb cutoff of 120g/L (115g/L). We find that students who live and eat at school have higher rates of anemia. Children with less-educated parents are more likely to be anemic. Higher anemia rates are associated with students with parents working on farms and away from home. Anemia rates are correlated with adverse physical (lower body mass index (BMI) z-scores and higher incidences of stunting), cognitive and psychological impacts among students. Such findings are consistent with recent findings of other studies in other poor areas in China’s Northwest.

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Journal of Health, Population and Nutrition
Authors
Renfu Luo
Linxiu Zhang
Chengfang Liu
Qiran Zhao
Yaojiang Shi
Grant Miller
Grant Miller
Elaine Yu
Brian Sharbono
Scott Rozelle
Scott Rozelle
Reynaldo Martorell
Alexis Medina
Alexis Medina

Encina Commons Room 210,
615 Crothers Way,
Stanford, CA 94305-6006

(650) 723-1919
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Professor, Pediatrics
Professor, Health Policy
Professor, Epidemiology & Population Health (by courtesy)
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MD, MPH

Dr. Lee Sanders is a general pediatrician and Professor of Pediatrics at the Stanford University School of Medicine, where he is Chief of the Division of General Pediatrics. He holds a joint appointment in the Center for Health Policy in the Freeman Spogli Institute for International Studies, where he is a co-director of the Center for Policy, Outcomes and Prevention (CPOP).

An author of numerous peer-reviewed articles addressing child health disparities, Dr. Sanders is a nationally recognized scholar in the fields of health literacy and child chronic-illness care.  Dr. Sanders was named a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar for his leadership on the role of maternal health literacy and English-language proficiency in addressing child health disparities.  Aiming to make the US health system more navigable for the one in 4 families with limited health literacy, he has served as an advisor to the Institute of Medicine, the Centers for Disease Control and Prevention, the Food and Drug Administration, the American Academy of Pediatrics, the Academic Pediatric Association, and the American Cancer Society.  Dr. Sanders leads a multi-disciplinary CPOP research team that provides analytic guidance to national and state policies affecting children with complex chronic illness – with a focus on the special health-system requirements that arise from the unique epidemiology, care-use patterns, and health-care costs for this population.  He leads another CPOP/PCOR-based research team that applies family-centered approaches to new technologies that aim to improve care coordination for children with medical complexity.    Dr. Sanders is also principal investigator on two NIH-funded studies that address health literacy in the pediatric context: one aims to assess the efficacy of a low-literacy, early-childhood intervention designed to prevent early childhood obesity; the other aims to provide the FDA with guidance on improved labeling of pediatric liquid medication.  Research settings for this work include state and regional health departments, primary-care and subspecialty-care clinics, community-health centers, WIC offices, federally subsidized child-care centers, and family advocacy centers.

Dr. Sanders received a BA in History and Science from Harvard University, an MD from Stanford University, and a MPH from the University of California, Berkeley.  Between 2006 and 2011, Dr. Sanders served as Medical Director of Children’s Medical Services South Florida, a Florida state agency that coordinates care for more than 10,000 low-income children with special health care needs.  He was also Medical Director for Reach Out and Read Florida, a pediatric-clinic-based program that provides books and early-literacy promotion to more than 200,000 underserved children.  At the University of Miami, Dr. Sanders directed the Jay Weiss Center for Social Medicine and Health Equity, which fosters a scholarly community committed to addressing global health inequities through community-based participatory research.  At Stanford University, Dr. Sanders served as co-medical director of the Family Advocacy Program, which provides free legal assistance to help address social determinants of child health.

Fluent in Spanish, Dr. Sanders is co-director of the Complex Primary Care Clinic at Stanford Children’s Health, which provides multi-disciplinary team care for children with complex chronic conditions.  Dr. Sanders is also the father of two daughters, aged 11 and 14 years, who make sure he practices talking less and listening more.

Co-Director, Center for Policy, Outcomes & Prevention (CPOP)
Chief, Division of General Pediatrics, School of Medicine
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Studies show high levels of anemia, nearsightedness, intestinal worms, and poor health and sanitation among children in China’s rural boarding schools. This project is first measuring initial health and nutrition levels of students in a randomized control setting, then deploying a toolkit of affordable and sustainable interventions in a set of treatment schools that includes multivitamins, eyeglasses, deworming medication, and nutrition and sanitation training for parents and educators. Finally, the project will assess what works and what does not by comparing improvements in academic performance in treatment and control groups. The results of this experiment are intended to inform education and nutrition policy in China at the central and provincial levels.

Walter P. Falcon Lounge

Encina Hall East, E404
Stanford, CA 94305-6055

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Faculty Co-director of the Stanford Center on China's Economy and Institutions
Helen F. Farnsworth Endowed Professorship
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Stanford Institute for Economic Policy Research
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PhD

Scott Rozelle is the Helen F. Farnsworth Senior Fellow and the co-director of Stanford Center on China's Economy and Institutions in the Freeman Spogli Institute for International Studies and Stanford Institute for Economic Policy Research at Stanford University. He received his BS from the University of California, Berkeley, and his MS and PhD from Cornell University. Previously, Rozelle was a professor at the University of California, Davis and an assistant professor in Stanford’s Food Research Institute and department of economics. He currently is a member of several organizations, including the American Economics Association, the International Association for Agricultural Economists, and the Association for Asian Studies. Rozelle also serves on the editorial boards of Economic Development and Cultural Change, Agricultural Economics, the Australian Journal of Agricultural and Resource Economics, and the China Economic Review.

His research focuses almost exclusively on China and is concerned with: agricultural policy, including the supply, demand, and trade in agricultural projects; the emergence and evolution of markets and other economic institutions in the transition process and their implications for equity and efficiency; and the economics of poverty and inequality, with an emphasis on rural education, health and nutrition.

Rozelle's papers have been published in top academic journals, including Science, Nature, American Economic Review, and the Journal of Economic Literature. He is fluent in Chinese and has established a research program in which he has close working ties with several Chinese collaborators and policymakers. For the past 20 years, Rozelle has been the chair of the International Advisory Board of the Center for Chinese Agricultural Policy; a co-director of the University of California's Agricultural Issues Center; and a member of Stanford's Walter H. Shorenstein Asia-Pacific Research Center and the Center on Food Security and the Environment.

In recognition of his outstanding achievements, Rozelle has received numerous honors and awards, including the Friendship Award in 2008, the highest award given to a non-Chinese by the Premier; and the National Science and Technology Collaboration Award in 2009 for scientific achievement in collaborative research.

Faculty affiliate at the Center on Democracy, Development, and the Rule of Law
Faculty Affiliate at the Walter H. Shorenstein Asia-Pacific Research Center
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Scott Rozelle FSI senior fellow; director, FSI/Rural Education Action Program Speaker
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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
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MD, MPH

Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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Paul H. Wise professor of pediatrics; FSI senior fellow Speaker
Patricia Foo MD/PhD student in economics Speaker
Seminars
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Objective To investigate educational disparities in the care process and health outcomes among patients with diabetes in the context of South Korea's universal health insurance system.

Design Bivariate and multiple regression analyses of data from a cross-sectional health survey.

Setting A nationally representative and population-based survey, the 2005 Korea National Health and Nutrition Examination Survey.

Participants Respondents aged 40 or older who self-reported prior diagnosis with diabetes (n= 1418).

Main Outcome Measures Seven measures of the care process and health outcomes, namely (i) receiving medical treatment for diabetes, (ii) ever received diabetes education, (iii) received dilated eye examination in the past year, (iv) received microalbuminuria test in the past year, (v) having activity limitation due to diabetes, (vi) poor self-rated health and (vii) self-rated health on a visual analog scale.

Results Except for receiving medical care for diabetes, overall process quality was low, with only 25% having ever received diabetes education, 39% having received a dilated eye examination in the past year and 51% having received a microalbuminuria test in the past year. Lower education level was associated with both poorer care processes and poorer health outcomes, whereas lower income level was only associated with poorer health outcomes.

Conclusion While South Korea's universal health insurance system may have succeeded in substantially reducing financial barriers related to diabetes care, the quality of diabetes care is low overall and varies by education level. System-level quality improvement efforts are required to address the weaknesses of the health system, thereby mitigating educational disparities in diabetes care quality.

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International Journal for Quality in Health Care
Authors
Young Kyung Do
Young Kyung Do
Karen Eggleston
Karen Eggleston
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Policies promoting ethanol and biodiesel production and use in the U.S., Europe, and other parts of the world since the mid-2000s have had profound—and largely unintended—consequences on global food prices, agricultural land values, land acquisition, and food security in developing countries. They have also created regional opportunities in the form of agricultural investments, crop yield growth, and booming farm economies. Rising incomes in emerging economies are generating increased demand for transportation fuels, thus stimulating further growth of the global biofuel industry. This seminar will explore the politics, economics, and global food security implications of the expanding biofuel sector. Several policy questions will be raised, including the role of biofuel mandates on food prices, the role of trade policies for stabilizing food prices in an era of increasingly tight demand, and the role of land policies and institutions for feedstock production and income distribution in the developing world.

Siwa Msangi, Senior Research Fellow in the Environment and Production Technology Division at the International Food Policy Research Institute (IFPRI) will provide commentary. Msangi's work focuses on the major socio-economic and bio-physical drivers affecting agricultural production and trade, and their impacts on nutrition, poverty and the environment. Dr. Msangi manages a research portfolio that includes the economic and environmental implications of biofuels, and has coordinated the project Biofuels and the Poor in partnership with FSE.  

Biofuels videos: Roz Naylor talks food security and energy with Near Zero

Bechtel Conference Center

The Jerry Yang and Akiko Yamazaki
Environment and Energy Building
Stanford University
473 Via Ortega, Office 363
Stanford, CA 94305

(650) 723-5697 (650) 725-1992
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Senior Fellow, Stanford Woods Institute and Freeman Spogli Institute for International Studies
William Wrigley Professor of Earth System Science
Senior Fellow and Founding Director, Center on Food Security and the Environment
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PhD

Rosamond Naylor is the William Wrigley Professor in Earth System Science, a Senior Fellow at Stanford Woods Institute and the Freeman Spogli Institute for International Studies, the founding Director at the Center on Food Security and the Environment, and Professor of Economics (by courtesy) at Stanford University. She received her B.A. in Economics and Environmental Studies from the University of Colorado, her M.Sc. in Economics from the London School of Economics, and her Ph.D. in applied economics from Stanford University. Her research focuses on policies and practices to improve global food security and protect the environment on land and at sea. She works with her students in many locations around the world. She has been involved in many field-level research projects around the world and has published widely on issues related to intensive crop production, aquaculture and livestock systems, biofuels, climate change, food price volatility, and food policy analysis. In addition to her many peer-reviewed papers, Naylor has published two books on her work: The Evolving Sphere of Food Security (Naylor, ed., 2014), and The Tropical Oil Crops Revolution: Food, Farmers, Fuels, and Forests (Byerlee, Falcon, and Naylor, 2017).

She is a Fellow of the Ecological Society of America, a Pew Marine Fellow, a Leopold Leadership Fellow, a Fellow of the Beijer Institute for Ecological Economics, a member of Sigma Xi, and the co-Chair of the Blue Food Assessment. Naylor serves as the President of the Board of Directors for Aspen Global Change Institute, is a member of the Scientific Advisory Committee for Oceana and is a member of the Forest Advisory Panel for Cargill. At Stanford, Naylor teaches courses on the World Food Economy, Human-Environment Interactions, and Food and Security. 

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Rosamond L. Naylor Speaker
Siwa Msangi Senior Research Fellow Commentator International Food Policy Research Institute
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