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Published in: BMC Women's Health 1/2015

Open Access 01-12-2015 | Research article

The economic consequences of selected maternal and early childhood nutrition interventions in low- and middle-income countries: a review of the literature, 2000—2013

Authors: Nafisa Halim, Kathryn Spielman, Bruce Larson

Published in: BMC Women's Health | Issue 1/2015

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Abstract

Background

Globally, 25% of children aged 0 to 4 years and more than 10% of women aged 15 to 49 years suffer from malnutrition. A range of interventions, promising for improving maternal and child nutrition, may also improve physical and intellectual capacity, and, thereby, future productivity and earnings.

Methods

We conducted a systematic literature review and summarized economic impacts of 23 reproductive, maternal, newborn and child health (RMNCH) interventions, published in 29 empirical studies between 2000 and 2013, using data from 13 low- and middle-income countries.

Results

We find that, in low- and middle-income countries, RMNCH interventions were rarely evaluated using rigorous evaluation methods for economic consequences. Nonetheless, based on limited studies, maternal and childhood participation in nutrition interventions was shown to increase individuals’ income as adults by up to 46%, depending on the intervention, demography and country. This effect is sizeable considering that poverty reduction interventions, including microfinance and conditional cash transfer programs, have helped increase income by up to 18%, depending on the context. We also found, compared to females, males appeared to have higher economic returns from childhood participation in RMNCH interventions.

Conclusions

Countries with pervasive malnutrition should prioritize investments in RMNCH interventions for their public health benefits. The existing literature is currently too limited, and restricted to a few selected countries, to warrant any major reforms in RMNCH policies based on expected future income impacts. Longitudinal and intergenerational databases remain needed for countries to be better positioned to evaluate maternal and early childhood nutrition intervention programs for future economic consequences.
Literature
1.
go back to reference Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed
2.
go back to reference Halim N, Larson B, Bryant M, Dorji G, Spielman K. The short- and long-term consequences of maternal and child malnutrition for economic development in low- and middle- income countries: A systematic review of recent literature, 2000–2013. Geneva, Switzerland: The Partnership for Maternal, Newborn & Child Health (PMNCH); 2013. Halim N, Larson B, Bryant M, Dorji G, Spielman K. The short- and long-term consequences of maternal and child malnutrition for economic development in low- and middle- income countries: A systematic review of recent literature, 2000–2013. Geneva, Switzerland: The Partnership for Maternal, Newborn & Child Health (PMNCH); 2013.
3.
go back to reference Chen Yuyu ZL. The long-term health and economic consequences of the 1959–1961 famine in China. J Health Econ. 2007;26(4):659–81.CrossRefPubMed Chen Yuyu ZL. The long-term health and economic consequences of the 1959–1961 famine in China. J Health Econ. 2007;26(4):659–81.CrossRefPubMed
4.
go back to reference Cutler D, Fung W, Kremer M, Singhal M, Vogl T. Early-life malaria exposure and adult outcomes: evidence from malaria eradication in India. Am Econ J: Appl Econ. 2010;2(2):72–94. Cutler D, Fung W, Kremer M, Singhal M, Vogl T. Early-life malaria exposure and adult outcomes: evidence from malaria eradication in India. Am Econ J: Appl Econ. 2010;2(2):72–94.
5.
go back to reference Venkataramani A. Early life exposure to malaria and cognition in adulthood: evidence from Mexico. J Health Econ. 2012;31:767–80.CrossRefPubMed Venkataramani A. Early life exposure to malaria and cognition in adulthood: evidence from Mexico. J Health Econ. 2012;31:767–80.CrossRefPubMed
6.
go back to reference Allen L, Gillespie S. What works? A review of efficacy and effectiveness of nutrition interventions. Manila: Nutrition and Development Series Asian Development Bank; 2001. Allen L, Gillespie S. What works? A review of efficacy and effectiveness of nutrition interventions. Manila: Nutrition and Development Series Asian Development Bank; 2001.
7.
go back to reference Verhoeff FH, Brabin BJ, Van Buuren S, Chimsuku L, Kazembe P, Wit JM, et al. An analysis of intra-uterine growth retardation in rural Malawi. Eur J Clin Nutr. 2001;55(8):682–9.CrossRefPubMed Verhoeff FH, Brabin BJ, Van Buuren S, Chimsuku L, Kazembe P, Wit JM, et al. An analysis of intra-uterine growth retardation in rural Malawi. Eur J Clin Nutr. 2001;55(8):682–9.CrossRefPubMed
8.
go back to reference Alderman H, Behrman JR. Reducing the incidence of Low birth weight in Low-income countries Has substantial economic benefits. World Bank Research Observer. 2006;21(1):25–48.CrossRef Alderman H, Behrman JR. Reducing the incidence of Low birth weight in Low-income countries Has substantial economic benefits. World Bank Research Observer. 2006;21(1):25–48.CrossRef
9.
go back to reference Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60.CrossRefPubMed Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60.CrossRefPubMed
10.
go back to reference Canning D, Schultz TP. The economic consequences of reproductive health and family planning. Lancet. 2012;380(9837):165–71.CrossRefPubMed Canning D, Schultz TP. The economic consequences of reproductive health and family planning. Lancet. 2012;380(9837):165–71.CrossRefPubMed
13.
go back to reference Currie J. Healthy, wealthy, and wise: Is there a causal relationship between child health and human capital development? J Econ Lit. 2009;47(1):87–122.CrossRef Currie J. Healthy, wealthy, and wise: Is there a causal relationship between child health and human capital development? J Econ Lit. 2009;47(1):87–122.CrossRef
15.
go back to reference Miller G. Contraception as development? New evidence from family planning in Colombia. Econ J. 2009;120:709–36.CrossRef Miller G. Contraception as development? New evidence from family planning in Colombia. Econ J. 2009;120:709–36.CrossRef
16.
go back to reference Schultz T. How does family planning promote development? Evidence from a social experiment in Matlab, Bangladesh, 1977–1996. New Haven: Yale University; 2009. Schultz T. How does family planning promote development? Evidence from a social experiment in Matlab, Bangladesh, 1977–1996. New Haven: Yale University; 2009.
17.
go back to reference Joshi S, Schultz T. Family planning and women’s and children’s health: Long-term consequences of an outreach program in Matlab, Bangladesh. Demography. 2013;50:149–80.CrossRefPubMed Joshi S, Schultz T. Family planning and women’s and children’s health: Long-term consequences of an outreach program in Matlab, Bangladesh. Demography. 2013;50:149–80.CrossRefPubMed
18.
go back to reference Hoddinott J, Maluccio JA, Behrman JR, Flores R, Martorell R. Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults. Lancet. 2008;371(9610):411–6.CrossRefPubMed Hoddinott J, Maluccio JA, Behrman JR, Flores R, Martorell R. Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults. Lancet. 2008;371(9610):411–6.CrossRefPubMed
19.
go back to reference Stein A, Wang M, DiGirolamo A, Grajeda R, Ramakrishnan U, Ramirez-Zea M, et al. Nutritional supplementation in early childhood, schooling, and intellectual functioning in adulthood: A prospective study in Guatemala. Arch Pediatr Adolesc Med. 2008;162(7):612–8.CrossRefPubMedPubMedCentral Stein A, Wang M, DiGirolamo A, Grajeda R, Ramakrishnan U, Ramirez-Zea M, et al. Nutritional supplementation in early childhood, schooling, and intellectual functioning in adulthood: A prospective study in Guatemala. Arch Pediatr Adolesc Med. 2008;162(7):612–8.CrossRefPubMedPubMedCentral
20.
go back to reference Li H, Barnhart HX, Stein AD, Martorell R. Effects of early childhood supplementation on the educational achievement of women. Pediatrics. 2003;112(5):1156–62.CrossRefPubMed Li H, Barnhart HX, Stein AD, Martorell R. Effects of early childhood supplementation on the educational achievement of women. Pediatrics. 2003;112(5):1156–62.CrossRefPubMed
21.
go back to reference Stein AD, Wang M, Ramirez-Zea M, Flores R, Grajeda R, Melgar P, et al. Exposure to a nutrition supplementation intervention in early childhood and risk factors for cardiovascular disease in adulthood: evidence from Guatemala. Am J Epidemiol. 2006;164(12):1160–70.CrossRefPubMed Stein AD, Wang M, Ramirez-Zea M, Flores R, Grajeda R, Melgar P, et al. Exposure to a nutrition supplementation intervention in early childhood and risk factors for cardiovascular disease in adulthood: evidence from Guatemala. Am J Epidemiol. 2006;164(12):1160–70.CrossRefPubMed
22.
go back to reference Vermeersch C, Kremer, M. School meals, educational achievement and school competition: Evidence from a randomized evaluation. University of Oxford. 2004. Vermeersch C, Kremer, M. School meals, educational achievement and school competition: Evidence from a randomized evaluation. University of Oxford. 2004.
23.
go back to reference Thomas D, Frankenberg E, Friedman J, Habicht J-P, Hakimi M, Jones N, et al. Iron deficiency and the well-being of older adults: Early results from a randomized nutrition intervention. Mimeo: University of California, Los Angeles; 2003. Thomas D, Frankenberg E, Friedman J, Habicht J-P, Hakimi M, Jones N, et al. Iron deficiency and the well-being of older adults: Early results from a randomized nutrition intervention. Mimeo: University of California, Los Angeles; 2003.
24.
go back to reference Bobonis G, Miguel E, Puri-Sharma C. Anemia and school participation. J Hum Resour. 2006;41(4):692–721.CrossRef Bobonis G, Miguel E, Puri-Sharma C. Anemia and school participation. J Hum Resour. 2006;41(4):692–721.CrossRef
25.
go back to reference Stolzfus R, Kvalsvig J, Chwaya H, Montresor A, Albonico M, Tielsch J, et al. Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: Double-blind, placebo controlled study. Br Med J. 2001;323:1–8.CrossRef Stolzfus R, Kvalsvig J, Chwaya H, Montresor A, Albonico M, Tielsch J, et al. Effects of iron supplementation and anthelmintic treatment on motor and language development of preschool children in Zanzibar: Double-blind, placebo controlled study. Br Med J. 2001;323:1–8.CrossRef
26.
go back to reference Black M, Baqui AH, Zaman K, Ake Persson L, El Arifeen S, Le K, et al. Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants. Am J Clin Nutr. 2004;80(4):903–10.PubMed Black M, Baqui AH, Zaman K, Ake Persson L, El Arifeen S, Le K, et al. Iron and zinc supplementation promote motor development and exploratory behavior among Bangladeshi infants. Am J Clin Nutr. 2004;80(4):903–10.PubMed
27.
go back to reference Field E, Robles O, Torero M. Iodine deficiency and schooling attainment in Tanzania. Am Econ J: Appl Econ. 2009;1(4):140–69. Field E, Robles O, Torero M. Iodine deficiency and schooling attainment in Tanzania. Am Econ J: Appl Econ. 2009;1(4):140–69.
28.
go back to reference O'Donnell KJ, Rakeman MA, Zhi-Hong D, Xue-Yi C, Mei ZY, DeLong N, et al. Effects of iodine supplementation during pregnancy on child growth and development at school age. Dev Med Child Neurol. 2002;44(2):76–81.CrossRefPubMed O'Donnell KJ, Rakeman MA, Zhi-Hong D, Xue-Yi C, Mei ZY, DeLong N, et al. Effects of iodine supplementation during pregnancy on child growth and development at school age. Dev Med Child Neurol. 2002;44(2):76–81.CrossRefPubMed
29.
go back to reference Schmidt M, Muslimatun S, West CE, Schultink W, Hautvast JG. Mental and psychomotor development in Indonesian infants of mothers supplemented with vitamin A in addition to iron during pregnancy. Br J Nutr. 2004;91:279–85.CrossRefPubMed Schmidt M, Muslimatun S, West CE, Schultink W, Hautvast JG. Mental and psychomotor development in Indonesian infants of mothers supplemented with vitamin A in addition to iron during pregnancy. Br J Nutr. 2004;91:279–85.CrossRefPubMed
30.
go back to reference Tofail F, Persson LA, El Arifeen S, Hamadani JD, Mehrin F, Ridout D, et al. Effects of prenatal food and micronutrient supplementation on infant development: a randomized trial from the Maternal and Infant Nutrition Interventions, Matlab (MINIMat) study. Am J Clin Nutr. 2008;87(3):704–11.PubMed Tofail F, Persson LA, El Arifeen S, Hamadani JD, Mehrin F, Ridout D, et al. Effects of prenatal food and micronutrient supplementation on infant development: a randomized trial from the Maternal and Infant Nutrition Interventions, Matlab (MINIMat) study. Am J Clin Nutr. 2008;87(3):704–11.PubMed
31.
go back to reference Prado EL, Alcock KJ, Muadz H, Ullman MT, Shankar AH, Group SS. Maternal multiple micronutrient supplements and child cognition: a randomized trial in Indonesia. Pediatrics. 2012;130(3):e536–46.CrossRefPubMed Prado EL, Alcock KJ, Muadz H, Ullman MT, Shankar AH, Group SS. Maternal multiple micronutrient supplements and child cognition: a randomized trial in Indonesia. Pediatrics. 2012;130(3):e536–46.CrossRefPubMed
32.
go back to reference Pongcharoen T, DiGirolamo AM, Ramakrishnan U, Winichagoon P, Flores R, Martorell R. Long-term effects of iron and zinc supplementation during infancy on cognitive function at 9 y of age in northeast Thai children: a follow-up study. Am J Clin Nutr. 2011;93(3):636–43.CrossRefPubMed Pongcharoen T, DiGirolamo AM, Ramakrishnan U, Winichagoon P, Flores R, Martorell R. Long-term effects of iron and zinc supplementation during infancy on cognitive function at 9 y of age in northeast Thai children: a follow-up study. Am J Clin Nutr. 2011;93(3):636–43.CrossRefPubMed
33.
go back to reference Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics. 2000;105(4), E51.CrossRefPubMed Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics. 2000;105(4), E51.CrossRefPubMed
34.
go back to reference Black M, Sazawal S, Black R, Khosla S, Kumar J, Venugopal M. Cognitive and motor development among small-for-gestational-Age infants: impact of zinc supplementation, birth weight, and caregiving practices. Pediatrics. 2004;113(5):1297–305.CrossRefPubMedPubMedCentral Black M, Sazawal S, Black R, Khosla S, Kumar J, Venugopal M. Cognitive and motor development among small-for-gestational-Age infants: impact of zinc supplementation, birth weight, and caregiving practices. Pediatrics. 2004;113(5):1297–305.CrossRefPubMedPubMedCentral
35.
go back to reference Baird S, Hicks JH, Kremer M, Miguel E. Worms at work: long-run impacts of child health gains. Berkeley: University of California at Berkeley; 2011. Baird S, Hicks JH, Kremer M, Miguel E. Worms at work: long-run impacts of child health gains. Berkeley: University of California at Berkeley; 2011.
36.
go back to reference Miguel E, Kremer M. Worms: identifying impacts on education and health in the presence of treatment externalities. Econometrica. 2004;72(1):159–217.CrossRef Miguel E, Kremer M. Worms: identifying impacts on education and health in the presence of treatment externalities. Econometrica. 2004;72(1):159–217.CrossRef
37.
go back to reference Gilgen DD, Mascie-Taylor CGNCGN, Rosetta LL. Intestinal helminth infections, anaemia and labour productivity of female tea pluckers in Bangladesh. Trop Med Int Health. 2001;6:449–57.CrossRefPubMed Gilgen DD, Mascie-Taylor CGNCGN, Rosetta LL. Intestinal helminth infections, anaemia and labour productivity of female tea pluckers in Bangladesh. Trop Med Int Health. 2001;6:449–57.CrossRefPubMed
38.
go back to reference Joint United Nations Programme on HIV/AIDS (UNAIDS). "Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.". Geneva: UNAIDS; 2013. Joint United Nations Programme on HIV/AIDS (UNAIDS). "Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.". Geneva: UNAIDS; 2013.
39.
go back to reference Thirumurthy H, Zivin JG, Goldstein M. The economic impact of AIDS treatment; labor supply in Western Kenya. J Hum Resour. 2008;43(3):511–52.PubMedPubMedCentral Thirumurthy H, Zivin JG, Goldstein M. The economic impact of AIDS treatment; labor supply in Western Kenya. J Hum Resour. 2008;43(3):511–52.PubMedPubMedCentral
40.
go back to reference Larson BA, Fox MP, Bii M, Rosen S, Rohr J, Shaffer D, et al. Antiretroviral therapy, labor productivity, and sex: a longitudinal cohort study of tea pluckers in Kenya. AIDS. 2013;27(1):115–23.CrossRefPubMedPubMedCentral Larson BA, Fox MP, Bii M, Rosen S, Rohr J, Shaffer D, et al. Antiretroviral therapy, labor productivity, and sex: a longitudinal cohort study of tea pluckers in Kenya. AIDS. 2013;27(1):115–23.CrossRefPubMedPubMedCentral
41.
go back to reference Habyarimana J, Mbakile B, Pop-Eleches C. The impact of HIV/AIDS and ARV treatment on worker absenteeism: implications for African firms. J Hum Resour. 2010;45(4):809–39. Habyarimana J, Mbakile B, Pop-Eleches C. The impact of HIV/AIDS and ARV treatment on worker absenteeism: implications for African firms. J Hum Resour. 2010;45(4):809–39.
42.
go back to reference Coetzee C. The impact of Highly Active Antiretroviral Treatment (HAART) on employment in khayelitsha. South Afr J Econ. 2008;76:S75–85.CrossRef Coetzee C. The impact of Highly Active Antiretroviral Treatment (HAART) on employment in khayelitsha. South Afr J Econ. 2008;76:S75–85.CrossRef
43.
go back to reference Behrman JR. The economic rationale for investing in nutrition in developing countries. World Dev. 1993;21(11):1749–71.CrossRef Behrman JR. The economic rationale for investing in nutrition in developing countries. World Dev. 1993;21(11):1749–71.CrossRef
44.
go back to reference Strauss J, Thomas D. Health, nutrition, and economic development. J Econ Lit. 1998;36:766–817. Strauss J, Thomas D. Health, nutrition, and economic development. J Econ Lit. 1998;36:766–817.
45.
go back to reference Stenberg K, Axelson H, Sheehan P, Anderson I, Gulmezoglu AM, Temmerman M, et al. Advancing social and economic development by investing in women's and children's health: a new Global Investment Framework. Lancet. 2014;383(9925):1333–54.CrossRefPubMed Stenberg K, Axelson H, Sheehan P, Anderson I, Gulmezoglu AM, Temmerman M, et al. Advancing social and economic development by investing in women's and children's health: a new Global Investment Framework. Lancet. 2014;383(9925):1333–54.CrossRefPubMed
46.
go back to reference Kabeer N, Mahmud S, Castro JGI. NGOs and the political empowerment of poor people in rural Bangladesh: cultivating the habits of democracy? World Dev. 2012;40(10):2044–62.CrossRef Kabeer N, Mahmud S, Castro JGI. NGOs and the political empowerment of poor people in rural Bangladesh: cultivating the habits of democracy? World Dev. 2012;40(10):2044–62.CrossRef
47.
go back to reference Crépon B, Devoto F, Duflo E, Pariente W. Estimating the impact of microcredit on those Who take It Up: evidence from a randomized experiment in Morocco. NBER working papers No. w20144. Cambridge: National Bureau of Economic Research; 2014. Crépon B, Devoto F, Duflo E, Pariente W. Estimating the impact of microcredit on those Who take It Up: evidence from a randomized experiment in Morocco. NBER working papers No. w20144. Cambridge: National Bureau of Economic Research; 2014.
48.
go back to reference Augsburg B, de Haas R, Harmgart H, Meghir C. Microfinance, poverty and education. NBER working papers No 18538. Cambridge: National Bureau of Economic Research; 2013. Augsburg B, de Haas R, Harmgart H, Meghir C. Microfinance, poverty and education. NBER working papers No 18538. Cambridge: National Bureau of Economic Research; 2013.
49.
go back to reference Angelucci M, Karlan D, Zinman J. Win some lose some? Evidence from a randomized microcredit program placement experiment by Compartamos Banco. NBER Working Papers No w19119. Cambridge: National Bureau of Economic Research; 2013.CrossRef Angelucci M, Karlan D, Zinman J. Win some lose some? Evidence from a randomized microcredit program placement experiment by Compartamos Banco. NBER Working Papers No w19119. Cambridge: National Bureau of Economic Research; 2013.CrossRef
50.
go back to reference Attanasio O, Augsburg B, de Haas R, Fitzsimons E, Harmgart H. Group lending or individual lending? Evidence from a randomized field experiment in Mongolia, WZB Discussion Paper, No. SP II 2014–303. Berlin: WZB Berlin Social Science Center; 2014. Attanasio O, Augsburg B, de Haas R, Fitzsimons E, Harmgart H. Group lending or individual lending? Evidence from a randomized field experiment in Mongolia, WZB Discussion Paper, No. SP II 2014–303. Berlin: WZB Berlin Social Science Center; 2014.
51.
go back to reference Tarozzi A, Desai J, Johnson K. On the impact of microcredit: Evidence from a randomized intervention in rural Ethiopia. Durham: The Bureau for Research and Economic Analysis of Development; 2013. Tarozzi A, Desai J, Johnson K. On the impact of microcredit: Evidence from a randomized intervention in rural Ethiopia. Durham: The Bureau for Research and Economic Analysis of Development; 2013.
52.
go back to reference Pitt M, Khandker SR. The impact of group-based credit on poor households in Bangladesh: does the gender of the participants matter? J Pol Econ. 1998;106(5):958–96.CrossRef Pitt M, Khandker SR. The impact of group-based credit on poor households in Bangladesh: does the gender of the participants matter? J Pol Econ. 1998;106(5):958–96.CrossRef
53.
go back to reference Case A, Fertig A, Paxson C. The lasting impact of childhood health and circumstance. J Health Econ. 2005;24(2005):365–89.CrossRefPubMed Case A, Fertig A, Paxson C. The lasting impact of childhood health and circumstance. J Health Econ. 2005;24(2005):365–89.CrossRefPubMed
54.
go back to reference Behrman JR, Rosenzweig MR. Returns to birthweight. Rev Econ Stat. 2004;86(2):586–601.CrossRef Behrman JR, Rosenzweig MR. Returns to birthweight. Rev Econ Stat. 2004;86(2):586–601.CrossRef
Metadata
Title
The economic consequences of selected maternal and early childhood nutrition interventions in low- and middle-income countries: a review of the literature, 2000—2013
Authors
Nafisa Halim
Kathryn Spielman
Bruce Larson
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2015
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-015-0189-y

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