Household food insecurity and early childhood development: Longitudinal evidence from Ghana.

Elisabetta Aurino,Edward Tsinigo,Sharon Wolf,Yacob Zereyesus

doi:10.1371/journal.pone.0230965

Elisabetta Aurino, Edward Tsinigo + Show 2 more

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https://doi.org/10.1371/journal.pone.0230965

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Journal: PloS one	Publication Date: Apr 3, 2020
Citations: 30	License type: CC BY 4.0

Affiliation: Imperial College London, University of Pennsylvania

Abstract

The burden of food insecurity is large in Sub-Saharan Africa, yet the evidence-base on the relation between household food insecurity and early child development is extremely limited. Furthermore, available research mostly relies on cross-sectional data, limiting the quality of existing evidence. We use longitudinal data on preschool-aged children and their households in Ghana to investigate how being in a food insecure household was associated with early child development outcomes across three years. Household food insecurity was measured over three years using the Household Hunger Score. Households were first classified as "ever food insecure" if they were food insecure at any round. We also assessed persistence of household food insecurity by classifying households into three categories: (i) never food insecure; (ii) transitory food insecurity, if the household was food insecure only in one wave; and (iii) persistent food insecurity, if the household was food insecure in two or all waves. Child development was assessed across literacy, numeracy, social-emotional, short-term memory, and self-regulation domains. Controlling for baseline values of each respective outcome and child and household characteristics, children from ever food insecure households had lower literacy, numeracy and short-term memory. When we distinguished between transitory and persistent food insecurity, transitory spells of food insecurity predicted decreased numeracy (β = -0.176, 95% CI: -0.317; -0.035), short-term memory (β = -0.237, 95% CI: -0.382; -0.092), and self-regulation (β = -0.154, 95% CI: -0.326; 0.017) compared with children from never food insecure households. By contrast, children residing in persistently food insecure households had lower literacy scores (β = -0.243, 95% CI: -0.496; 0.009). No gender differences were detected. Results were broadly robust to the inclusion of additional controls. This novel evidence from a Sub-Saharan African country highlights the need for multi-sectoral approaches including social protection and nutrition to support early child development.

Highlights

Household food security, defined as stable access to sufficient and nutritious food, is critical in the early years to meet a child’s developmental needs [1,2,3]
Our results suggest that household food insecurity during the preschool and early primary years is associated with lower child development outcomes, and that the size of the coefficients related to food insecurity, when significant, is rather large
The few studies that have investigated the associations between household food insecurity on outcomes other than nutrition in low- and middle-income countries (LMICs) have focused on schooling among older children in India, China, Venezuela and Ethiopia [23,24,25,26], and on happiness and shame in Venezuela [27]

Summary

Introduction

Household food security, defined as stable access to sufficient and nutritious food, is critical in the early years to meet a child’s developmental needs [1,2,3]. The preschool years are a period of rapid growth in cognitive, social, and emotional skills, and a sensitive period for the promotion or inhibition of children’s developmental potential [4]. The region is characterized by the greatest number and proportion of three- and four-year-olds (29.4 million, equivalent to 44%) failing to meet key cognitive and psycho-social health milestones [8]. Existing studies from LMICs have mostly focused on the linkages between food insecurity and child nutrition and health [9,10,11,12,13,14], neglecting other critical aspects of early childhood development such as early cognitive, behavioural, and social-emotional skills, which are instrumental to children’s transition to school and future learning outcomes [4]. Understanding if food insecurity is associated with child development during preschool and the first years of primary school may have important implications for how early childhood educational services are structured (e.g., providing school feeding or other nutritional services alongside educational inputs)

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