Child nutrition and farm input subsidies: The complementary role of early healthcare and nutrition programs in Malawi

Abstract

Despite significant efforts to improve under-nutrition, the prevalence of low height-for-age in the world’s population remains high. It is highest in sub-Saharan Africa, where extensive early childhood nutrition programs, and the reintroduction of the farm input subsidy program have not significantly altered under-nutrition. Empirical evidence shows that early-life nutrition interventions have limited effects in the long-term. Even though subsidy programs are aimed at enhancing food security, they only improve nutrition outcomes that are sensitive to intervention typically in the short-run, weight-for-age and weight-for-height, but not height-for-age, which is the outcome of a range of interventions and circumstances that effect nutrition cumulatively over the life cycle. We argue that farm input subsidies only support height-for-age as part of a set of in utero and early life investments in nutrition that are complemented by post-infancy community nutrition programs. We use the 2010–2013 Malawi Integrated Household Panel Survey and the 2010 Malawi Demographic and Health Survey for our analysis. We find a positive impact of farm input subsidy vouchers on height-for-age only when maternal health and child nutrition interventions during the in utero and early-life phases have first taken place. When the results are considered by age group, they show that the subsidy positively relates to height-for-age amongst children younger than three years when complemented by maternal access to a WHO-recommended level of maternal healthcare. We find some support to show that the maternal investment only sustains beyond three years of age conditional on a child also participating in a nutrition enhancement program. Increasing long-run child nutrition demands coordinating agricultural and healthcare policies. The sustained impact of investments made during early-life requires follow-up nutrition interventions in later years and financial liquidity to activate the benefits of health policies. Policy coordination is not a ”nice to have”. Rather, co-ordinating a range of responses that target multiple life stages and policy domains is essential for unlocking the benefits of earlier investments later in children’s lives.