Harold Alderman

Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?

Acceleration of progress in nutrition will require effective, large-scale nutrition-sensitive programmes that address key underlying determinants of nutrition and enhance the coverage and effectiveness of nutrition-specific interventions. We reviewed evidence of nutritional effects of programmes in four sectors--agriculture, social safety nets, early child development, and schooling. The need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable; targeted agricultural programmes can complement these investments by supporting livelihoods, enhancing access to diverse diets in poor populations, and fostering womens empowerment. However, evidence of the nutritional effect of agricultural programmes is inconclusive--except for vitamin A from biofortification of orange sweet potatoes--largely because of poor quality evaluations. Social safety nets currently provide cash or food transfers to a billion poor people and victims of shocks (eg, natural disasters). Individual studies show some effects on younger children exposed for longer durations, but weaknesses in nutrition goals and actions, and poor service quality probably explain the scarcity of overall nutritional benefits. Combined early child development and nutrition interventions show promising additive or synergistic effects on child development--and in some cases nutrition--and could lead to substantial gains in cost, efficiency, and effectiveness, but these programmes have yet to be tested at scale. Parental schooling is strongly associated with child nutrition, and the effectiveness of emerging school nutrition education programmes needs to be tested. Many of the programmes reviewed were not originally designed to improve nutrition yet have great potential to do so. Ways to enhance programme nutrition-sensitivity include: improve targeting; use conditions to stimulate participation; strengthen nutrition goals and actions; and optimise womens nutrition, time, physical and mental health, and empowerment. Nutrition-sensitive programmes can help scale up nutrition-specific interventions and create a stimulating environment in which young children can grow and develop to their full potential.

Attrition in Longitudinal Household Survey Data: Some Tests for Three Developing-Country Samples

For capturing dynamic demographic relationships, longitudinal household data can have considerable advantages over more widely used cross-sectional data. But because the collection of longitudinal data may be difficult and expensive, analysts must assess the magnitudes of the problems, specific to longitudinal, but not to cross-sectional data. One problem that concerns many analysts is that sample attrition may make the interpretation of estimates problematic. Such attrition may be especially severe where there is considerable migration between rural, and urban areas. And attrition is likely to be selective on such characteristics as schooling, so high attrition is likely to bias estimates. The authors consider the extent, and implications of attrition for three longitudinal household surveys from Bolivia, Kenya, and South Africa that report very high annual attrition rates between survey rounds. Their estimates indicate that: 1) the means for a number of critical outcome, and family background variables differ significantly between those who are lost to follow-up, and those who are re-interviewed. 2) A number of family background variables are significant predictors of attrition. 3) Nevertheless, the coefficient estimates for standard family background variables in regressions, and probit equations for the majority of outcome variables in all three data sets, are not significantly affected by attrition. So attrition is apparently not a general problem for obtaining consistent estimates of the coefficients of interest for most of these outcomes. These results, which are very similar to those for industrial countries, suggest that multivariate estimates of behavioral relations may not be biased because of attrition. This wold support the collection of longitudinal data.

Gender differentials in farm productivity: Implications for household efficiency and agricultural policy

Abstract Within many African households, agricultural production is simultaneously carried out on many plots controlled by different members of the household. Detailed plot-level agronomic data from Burkina Faso provides striking evidence of substantial inefficiencies in the allocation of factors of production across the plots controlled by different members of the household. Production function estimates imply that the value of household output could be increased by 10–15% by reallocating currently used factors of production across plots. This finding contradicts standard models of agricultural households. A richer model of behaviour, which recognizes that the individuals who comprise a household compete as well as co-operate, has important implications for the structure of agricultural production and for the design of agricultural policy.

Strategies for reducing inequalities and improving developmental outcomes for young children in low-income and middle-income countries

This report is the second in a Series on early child development in low-income and middle-income countries and assesses the effectiveness of early child development interventions, such as parenting support and preschool enrolment. The evidence reviewed suggests that early child development can be improved through these interventions, with effects greater for programmes of higher quality and for the most vulnerable children. Other promising interventions for the promotion of early child development include childrens educational media, interventions with children at high risk, and combining the promotion of early child development with conditional cash transfer programmes. Effective investments in early child development have the potential to reduce inequalities perpetuated by poverty, poor nutrition, and restricted learning opportunities. A simulation model of the potential long-term economic effects of increasing preschool enrolment to 25% or 50% in every low-income and middle-income country showed a benefit-to-cost ratio ranging from 6·4 to 17·6, depending on preschool enrolment rate and discount rate.

Child Malnutrition in Ethiopia: Can Maternal Knowledge Augment the Role of Income?*

Over the past decades, child malnutrition in Ethiopia has persisted at alarmingly high rates. By applying the conditional nutrition demand approach to household data from three consecutive welfare monitoring surveys over the period 1996-1998, this study identifies household resources, parental education, food prices, and maternal nutritional knowledge as key determinants of growth faltering in Ethiopia. Income growth is important for alleviating child stunting, though on its own it will not suffice to reach the international goal of halving each countrys level of child malnutrition by 2020. Universalizing access to primary schooling for girls has slightly more promise. However, to reduce child growth faltering in Ethiopia in a significant - and timely - manner, our empirical results indicate that targeted child growth monitoring and maternal nutrition education programs will be needed in conjunction with efforts to promote private income growth and formal schooling.

Child Growth, Shocks, and Food Aid in Rural Ethiopia

Over the past decades child stunting in Ethiopia has persisted at alarming rates. While the country experienced several droughts during this period, it also received enormous amounts of food aid, leading some to question the effectiveness of food aid in reducing child malnutrition. Using nationally representative household surveys from 1995-96 and controlling for program placement, we find that children between 6 and 24 months experienced about 0.9 cm less growth over a six-month period in communities where half the crop area was damaged compared to those without crop damage. Food aid was also found to have a substantial effect on growth of children in this age group. Moreover, on average the total amount of food aid appeared to be sufficient to protect children against plot damage, an encouraging sign that food aid can act as an effective insurance mechanism, though its cost effectiveness needs further investigation.

Do local officials know something we don’t? Decentralization of targeted transfers in Albania

Abstract Albania provides a small amount of social assistance to nearly 20% of its population through a system which allows a degree of community discretion in determining distribution. This study indicates that relative to other safety net programs in low-income countries, social assistance in Albania is fairly well targeted to the poor. Moreover, the poverty targeting exceeds that which could be expected on the basis of proxy indicators of targeting alone; communes appear to be using local information unlikely to be obtained on the basis of a questionnaire or formula. This remains the case conditional on the level of funding allocated from the central government.

Saving and economic shocks in rural Pakistan

Abstract This paper adapts the recent methodology of Paxson to study saving rates in rural Pakistan. Particular attention is paid to differences in marginal rates of financial and physical saving and how these vary across income groups and by direction of income shocks. Households exhibit more difficulty in smoothing consumption after successive shocks than with a single shock. The study also observes marginal rates of saving out of international remittances, and lump sum pensions. Unlike domestic remittances, international remittances appear to be treated much as transitory income shocks.

Decomposing the Gender Gap in Cognitive Skills in a Poor Rural Economy

Girls lag markedly behind boys in education in many developing countries, which may slow economic growth and increase inequity. This paper uses indicators of the output of the education production process, cognitive skills, to characterize and to investigate the determinants of the large educational gender gap in rural Pakistan. Local school availability accounts for about a third of the total cognitive achievement gender gap and over two-fifths of that in numeracy, which implies that policies that increased local school availability for girls could reduce substantially the gender gaps in cognitive skills. To further reduce these gender gaps will require policies that focus on the demand side of the market, where, our results suggest, the response to modest changes in incentives may be high.

Gender differences in parental investment in education

Abstract The gender gap in schooling is puzzling given that the expected returns to an individual for increased schooling — as measured by proportional wage increments — does not differ by gender. This paper explores possible explanations for the disparity using a model of parental investment in children. The model allows for differences in investments due to differences in costs — including the opportunity cost of the childs labor as well as school fees and availability. Moreover, it indicates that disparities in investment could come through differences in returns realized by parents, for example, in the probability of transfers from children to parents or in the degree of sympathy or altruism, even when market returns to the children themselves do not differ. While it is difficult to distinguish these different explanations empirically, the paper reviews available evidence and indicates interventions that governments can make to reduce the gender gap in education.