Complementarities Between Psychological and Technical Policy Interventions: Evidence from Child Health Programs in Rural Tanzania

Child stunting is a public health issue that affects millions of children under five years of age around the world. This condition hinders cognitive development, posing challenges for academic success and future earning potential. Consequently, it perpetuates a cycle of poverty and malnutrition. Over the long term, stunting threatens overall health and economic development. The Empowered World View (EWV) is a faith-based psychological related to beliefs and practices that contribute to poverty, and negative outcomes for children's well-being such as stunting. The program is currently being carried out in rural Tanzania alongside technical interventions in the areas of health, livelihood and child protection. My first objective is to evaluate the complementary impact of combining technical and psychological behavior change interventions compared to implementing technical interventions alone in improving Height-for-Age Z-scores (HAZ) for children under five in two years in rural Tanzania. Our second objective is to identify which components of technical interventions complement (or substitute) the psychological intervention in improving Height-for-Age Z-scores (HAZ) for children under the age of five in two years in rural Tanzania. I employ a longitudinal quasi-experiment design among households with children aged 0-59 months [n=867 at baseline (2020) and n=867 at follow-up (2022)]. The treatment group received technical programs and psychological intervention. The control group received only technical programs. I derive difference-in-difference impact estimates to achieve our first objective and include interaction terms of components of technical intervention and treatment to achieve our second objective. I observe a decrease in Height-for-Age Z-scores (HAZ) and an increase in stunting prevalence in the control group, while these measures remain constant in the treatment group. I find a significant differential improvement in Height-for-Age Z-scores (HAZ) of about 0.36 in the two years among boys and girls under the age of five in the treatment group. I also find complementarity between the psychological intervention and the following components of technical interventions: food security, maternal health, access to health services, and age-appropriate feeding practices for improving Height-for-Age Z-scores (HAZ) for children under the age of five years. I conclude that the delivery of technical and psychological interventions simultaneously is more effective in reducing child stunting than delivering technical interventions alone. I also conclude that technical interventions which are tailored to address components such as food security, access to health services, and good complementary feeding practices will work best with psychological interventions in reducing stunting for children under the age of five years in rural Tanzania.