Amelia Darrouzet-Nardi

Nutrition Smoothing: Can Proximity to Towns and Cities Protect Rural Children against Seasonal Variation in Agroclimatic Conditions at Birth?

A large literature links early-life environmental shocks to later outcomes. This paper uses seasonal variation across the Democratic Republic of the Congo to test for nutrition smoothing, defined here as attaining similar height, weight and mortality outcomes despite different agroclimatic conditions at birth. We find that gaps between siblings and neighbors born at different times of year are larger in more remote rural areas, farther from the equator where there are greater seasonal differences in rainfall and temperature. For those born at adverse times in places with pronounced seasonality, the gains associated with above-median proximity to nearby towns are similar to rising one quintile in the national distribution of household wealth for mortality, and two quintiles for attained height. Smoothing of outcomes could involve a variety of mechanisms to be addressed in future work, including access to food markets, health services, public assistance and temporary migration to achieve more uniform dietary intake, or less exposure and improved recovery from seasonal diseases.

Urbanization, market development and malnutrition in farm households: evidence from the Demographic and Health Surveys, 1986–2011

A principal effect of agricultural productivity growth is to accelerate urbanization by supplying food, labor and other resources to urban services and industry. Towns and cities may also grow for their own reasons, pulling food and resources out of rural areas. Whether pushed or pulled, the development of markets creates new opportunities for agricultural households. This study tests whether, on balance, proximity to older towns and cities has improved or worsened malnutrition among farm households in 43,850 survey clusters in 46 developing countries between 1986 and 2011, using 83 Demographic and Health Surveys (DHS) combined with other geographic and historical data. Controlling for national income, we find that regions with a longer history of urbanization have children with higher weight-for-height and height-for-age z-scores at a wide range of national income levels. We also find a higher prevalence of overweight among mothers living near older cities. These results suggest that, on average, access to urban markets has reduced rural child stunting and wasting in the surveyed countries, but also increased the risks of overweight for children and adult women. These results motivate the need to guide agricultural market development in ways that promote improved nutrition while limiting the rise of diet-related disease.

Nonviolent civil insecurity is negatively associated with subsequent height-for-age in children aged <5 y born between 1998 and 2014 in rural areas of Africa

BACKGROUND Civil wars and wars between states have occurred less frequently since the start of the 21st century, but civil insecurity outside the contexts of official wars continues to plague many parts of the world. The nutritional consequences of civil insecurity may disproportionately affect children, especially if experienced during sensitive developmental periods. OBJECTIVES This study estimated the associations between localized nonviolent and violent civil insecurity during key child nutritional periods and subsequent height-for-age z scores (HAZs) in 145,948 children born between 1998 and 2014 in Africa and examined the type of place of residence as a mediating factor. DESIGN A collection of 61 geo-referenced Demographic and Health Surveys implemented between 1998 and 2014 were merged with data from the high-resolution Armed Conflict Location and Event Data Project to construct a repeat cross-sectional database, which was analyzed by using a difference-in-differences model with maternal fixed-effects. RESULTS Exposure to 1 nonviolent localized civil insecurity event (mean ± SD: 0.42 ± 1.87 events) during pregnancy for children living in rural areas was associated with a reduction of 0.01 SD in HAZ (P = 0.024). Exposure to 5 localized civil conflict fatalities (mean ± SD: 1.41 ± 10.21 fatalities) for children living in rural areas during the complementary feeding stage was associated with a 0.002-SD decrease in HAZ (P = 0.030). There were no measurable associations between civil insecurity and child heights in urban areas, even though children in urban areas experience more civil insecurity. CONCLUSIONS Exposure to both violent and nonviolent civil insecurity had negative associations with subsequent HAZ, but only in rural areas. The associations found were small in magnitude but still meaningful from a child-development perspective, because these events do not necessarily occur in the context of official wars, they are often nonviolent, and they are endemic to the region.