Growth is good, but not enough to improve nutrition.
Cross-country analyses have been conducted to explore the general relationship between growth and malnutrition in the process of development. Complementary case studies of an agriculture-based economy (Malawi) and an oil-based economy (Yemen) assess the impacts of alternative policies on growth and nutrition outcomes under a range of scenarios.
Results and associated policy implications
Agricultural or non-agricultural growth can be better for improving nutrition depending on the country's economic structure and the characteristics of its malnourished people. In Malawi, agriculture has a strong potential to contribute to the reduction of malnutrition. This outcome holds for most agriculture-based economies, and particularly those in which poor people are disproportionately found in the agricultural sector. Nutrition outcomes improve not only among rural households, but also among urban ones, mainly through reduced food prices and economic linkage effects that increase real incomes. In Yemen, growth led by the industry and service sectors is more beneficial for improving nutrition outcomes than agriculture growth as the majority of the population draws its income from non-agricultural activities. In addition, most foods--especially staples--are imported, so the net consumer benefit accruing from the local price effect of agricultural productivity growth is low.
The role of growth in improving nutrition shifts during the development process. Comparisons between a bread-based agricultural growth and a baseline scenario (in which agricultural growth is concentrated in the large maize sector) in the Malawian study reveal that calorie and micronutrient deficiencies become less responsive to growth as prevalence rates decline. Further reductions require economic diversification; thus, the structure of growth across the whole economy and within the sectors is important for determining nutritional outcomes.
Neither agricultural growth nor nonagricultural growth is sufficient to improve child nutrition and reduce micronutrient malnutrition as a whole. Cross-country differences are more pronounced for the relationships between growth and child malnutrition than they are for the relationships between growth and undernourishment. Non-income related factors (such as information and knowledge) and individual health and healthcare seem to matter more in reducing child malnutrition than in reducing undernourishment. Even with decisive policy reform in Yemen, resulting in rapid growth acceleration, child malnutrition remains at unacceptably high levels. In addition, despite reduced deficiencies in calories, iron, zinc and folate, vitamin A deficiency in Malawi remains largely unresponsive to economic growth. Although the proportion of people with a vitamin A deficiency declined due to Malawi's rapidly growing population, the actual number of deficient people increased.
Policy reform supporting both agricultural and non-agricultural growth needs to be accompanied by strategic investments and targeted programmes to tackle child malnutrition. Persistent, widespread child malnutrition globally and the low responsiveness of child nutrition to economic development are alarming. Necessary actions include: (1) investments in infrastructure (drinking-water networks), health and education; (2) programmes to improve child and maternal nutrition and health (for example, through birthing assistance and pre- and postnatal care); (3) education campaigns on child feeding practices, appropriate diets, proper hygiene, and disease and illness prevention and treatment; (4) child growth monitoring; (5) immunization campaigns; and (6) nutrient-supplementation programmes. Actions to promote gender equality, women's empowerment and family planning are required. Interventions require political will and financial resources, reinforcing the importance of increased revenues from growth.
Specific investments and programmes are also needed to effectively reduce micronutrient malnutrition. Possible avenues for directly reducing deficiencies are programmes that distribute nutrient supplements to the most deficient people, mass fortification of commonly consumed foods and condiments, and biofortification. Dietary diversification can be encouraged by providing education on nutritious, well-balanced diets. Without this understanding, the nutritional impact of interventions will be limited. Enhancing people's direct access to fruits, vegetables and animal products includes programmes promoting home and school gardens, small-scale livestock husbandry and aquaculture. Investments in programmes that improve people's health and hygiene help reduce secondary malnutrition, which causes nutritional deficiencies through infection, illness and disease.
This brief is extracted from the authors 2020 conference paper Growth is Good. but Is Not Enough to Improve Nutrition (Washington. DC; International Food Policy Research Institute)
For more information visit www.ifpri.org/sites/default/files/ publications/2020anhconfbr07.pdf
OLIVIER ECKER, CLEMENS BREISINGER, AND KARL PAUW
Development Strategy and Governance Division
International Food Policy Research Institute