The Impacts of a Multifaceted Pre-natal Intervention on Human Capital Accumulation in Early Life

Abstract

We study a large-scale and long-term randomized control trial to evaluate an intervention targeting early life nutrition and well-being for households in extreme poverty in Northern Nigeria. The intervention provides: (i) information to parents on practices related to pregnancy and infant feeding; (ii) high-valued unconditional cash transfers to mothers, each month from pregnancy until the child turns two. The intervention leads to large and sustained improvements in children’s anthropometric and health outcomes, including an 8% reduction in stunting four years post-intervention. These impacts are partly driven by informationrelated channels (such as improved knowledge, practices and health behaviors of mothers towards new borns). However, the certain and substantial ‡ow of cash transfers is also key. They induce positive labor supply responses among women, and enables them to undertake productive investments in livestock. These provide protein rich diets for children, and generate higher earnings streams for households long after the cash transfers expire. The results show the sustainability and cost-e¤ectiveness of multifaceted pre-natal interventions even in the most challenging and food insecure economic environments. JEL Classi...cation I15, O15. We gratefully acknowledge ...nancial support from DfID and the ESRC CPP at IFS (ES/H021221/1). Carneiro acknowledges the support of the ESRC for CEMMAP (ES/P008909/1) and the ERC (ERC-2015-CoG-682349). We thank Save the Children International and Action Against Hunger International, the OPM Abuja Survey team lead by Femi Adegoke, with special thanks to Ekundayo Arogundade, Eunice Atajiri, Joshua Moriyonu, Okechukwu Ezike, Tayo Ajala, Cynthia Nwodo, Ugochukwu Onuingbo, and Gloria Olisenekwu. Harold Alderman, Oriana Bandiera, Jere Behrman, Sonia Bhalotra, Gabriella Conti, Adeline Delavande, Jessica Goldberg, Emanuela Galasso, Sally Grantham-McGregor, John Hoddinott, Seema Jayachandran, Andrew Kardan, Michael Kremer, Costas Meghir, Ijaz Nabi, Kay Sharp, Alessandro Tarozzi, Marcos Vera Hernandez, Aly Visram and numerous seminar participants provided valuable comments. Human subjects approval was obtained on 2014-06-30 from the IRB at the National Health Research Ethics Committee of Nigeria (NHREC/01/01/2007-30/06/2014c). The study is registered on the AEA registry (AEARCTR-0000454). All errors remain our own. Carneiro: UCL, IFS, CEMMAP and FAIR-NHH, [email protected]; Kraftman: IFS, [email protected]; Mason: Competition and Markets Authority, [email protected]; Moore: OPM, [email protected]; Rasul: UCL and IFS, [email protected]; Scott: OPM, [email protected].