The Effects of Nutrition and Health on Fertility: Hypotheses, Evidence, and Interventions

Abstract

The relationship between nutrition socioeconomic development and fertility is logically examined a model describing the interaction between the variables is presented and policy implications flowing from this model are discussed. From a biological standpoint improvements in health and nutrition would be expected to have a positive affect on reproductive capacity; however improved standards of living are negatively related to fertility. Therefore behavioral factors and not biological factors must account for the observed negative relationship. The behavior of poor people is rational and oriented toward maintaining an equilibrium between resource allocation and production. They retain this balance by adhering to principles developed over time and found to be effective under existing environmental conditions. For example the allocation of food resources is based on the time-tested principle that those family members most involved in production should receive the largest share of the food supply in times of scarity. Given the conditions under which these individuals live this allocation decision makes sense. Similarly the number of children in a family is considered to be more important than the quality of life for these children. Having many children even if these children suffer from malnutrition and lack an education contributes more toward the productive capacity of the family than having 1 or 2 healthy educated children under existing economic conditions. To expect parents living in these situations to allocate resources for the improvement of the nutritional status of infants is to expect them to act irrationally. Changing the environment in which these individuals live is the only way to induce them to change. If new conditions create a need for healthy educated children parents will alter the way they allocate resources. For example if new jobs requiring intellectual skills and improved agricultural technology requiring capital investment are made available the existing allocation system will be thrown out of balance; parents will respond by reallocating resources so as to take advantage of the new opportunities and reestablish the balance between resources and production by applying new principles more in tune with the environmental changes. This model based on the assumption that the peasant farmer is rational has policy implications which differ radically from the policy implications flowing from the backward peasant model.