The aggregate income losses from childhood stunting and the returns to a nutrition intervention aimed at reducing stunting

Emanuela Galasso,Adam Wagstaff

doi:10.1016/j.ehb.2019.01.010

Abstract

We undertake two calculations, one for all developing countries, the other for 34 developing countries that together account for 90% of the world’s stunted children. The first asks how much lower a country’s per capita income is today as a result of having a fraction of its workforce been stunted in childhood. We use a development accounting framework, relying on micro-econometric estimates of the effects of childhood stunting on adult wages through their effects on years of schooling, cognitive skills, and height, parsing out the relative contribution of each set of returns to avoid double counting. We estimate that, on average, the per capita income penalty from stunting is between 5–7%, depending on the assumption. In our second calculation we estimate the economic value and the costs associates with scaling up a package of nutrition interventions using the same methodology and set of assumptions used in the first calculation. We take a package of 10 nutrition interventions that has data on both effects and costs, and we estimate the rate-of-return to gradually introducing this program over a period of 10 years in 34 countries that together account for 90% of the world’s stunted children. We estimate a rate-of-return of 12%, and a benefit-cost ratio of 5:1-6:1.

Highlights

In 2014, 171 million children under the age of five were stunted (UNICEF et al 2015)
This paper presents the econometric analysis undertaken by the authors that was reported in a broader World Bank policy research note, written with Sophie Naudeau and Meera Shekar, on the economic costs of stunting and policies to reduce them
In the second part of our paper, we perform a forward-looking exercise, assessing the economic value and the costs associated with scaling up a package of nutrition interventions using the same methodology and set of assumptions used in the first calculation

Summary

Introduction

In 2014, 171 million children under the age of five were stunted (UNICEF et al 2015). Stunting in childhood matters because it is associated with adverse outcomes throughout the life cycle (Dewey and Begum 2011). Health problems in terms of non-communicable diseases are more likely in later life, leading to increased health care costs. Stunting in childhood leads to reduced stature in adulthood, which, due to the persistence of shortness over the lifetime, and the negative (and independent) effect of height on income, further reduces income in adulthood. Stunting is not a given: it can be avoided if the child (in utero and after birth) has adequate nutrient intake, and is not exposed to bouts of disease that weaken the body. Programs that increase the flow of nutrients and reduce exposure to disease can reduce the risk of stunting, and potentially eliminate it altogether (de Onis et al 2013)

Methods

Results

Conclusion