From subsidies to nutrition: Investigating effects among cohort children from the Subsidy Reinvestment programme in Nigeria

Abstract

This study investigates the effect of a nationwide maternal health programme that targets both demand- and supply-side factors on the nutritional status of children under five years old whose mothers were potentially exposed to the programme. We employed a difference-in-differences approach by matching programme beneficiary facilities to the districts and communities where households reside. The data are drawn from the 2008, 2013, and 2018 rounds of Nigeria's Demographic and Health Surveys (DHS), comprising responses for approximately 120,000 children. Our findings reveal a significant increase in child dietary diversity, particularly in districts with two beneficiary facilities, suggesting stronger effects with expansive programme implementation. Additionally, we observed positive effects on children's consumption of various nutritious foods for those children in districts with two beneficiary facilities. This study investigates a potential mechanism by which expanding access to healthcare facilities, through funding two clinics per district, may contribute to improved child dietary diversity. Our findings suggest that, unlike districts with one beneficiary facility, those with two funded clinics have a higher likelihood of women engaging in work outside the home and earning cash for it. As shown in the analysis, this mechanism is likely due to easier access to health facilities and better contact with health officers, which facilitate quicker reintegration into the labour market for mothers after childbirth and, in turn, could lead to better maternal earnings and potentially enable a more diverse diet for children. The findings suggest that SURE-P's expansive implementation strengthens child nutrition outcomes and supports maternal economic empowerment. In areas with multiple SURE-P facilities, increased access to healthcare enables mothers to reintegrate into the labor market more quickly, facilitating cash income and fostering a reinforcing cycle of improved child dietary diversity and economic benefits for families. This highlights the potential of scaling such programs to maximize both health and economic outcomes in similar contexts.