Policy Research Program

1. Policy Research Program Monica Jain Postdoctoral Fellow Oct 18, 2012

2. AIM of HarvestPlus Program Reduce micronutrient malnutrition around the world through direct provision of micronutrients in staple foods - Biofortification

3. Are we making a difference? • Meenakshi, et al. (2010) exante analysis using DALY found that biofortification can make a significant impact on the burden of micronutrient deficiencies in a highlycost-effective manner • Hotz, et al. (2012) found that in Uganda Orange Sweet Potato (OSP) led to 10 percentage point reduction in Vit A deficiency among children 6-35 months • Hotz, et al. (2012) found that in Mozambique OSP intake increased significantly among the 6-66 months children and women, and translated into a doubling of Vit A intakes. The impact did not vary with degree of treatment

4. How much impact can we make? • It depends! • Focus on poor people who do not have income to buy quality food – in economies with stagnant or no income growth • Even if the income grows fast, the evidence indicates weak link between income and nutritional status of children • The increase in income not getting converted into increase in food quantity/quality for children (information, discrimination)?

5. Links between income and energy consumption (calories) Wide range of calorie-income elasticity estimates at the household level: • Behrman and Deolalikar (1987), Bouis and Haddad (1992) – near zero • Subramanian and Deaton (1996) – 0.3 to 0.5 • Deaton and Dreze (2008) - in India calorie intakes are decreasing along with poverty level decreasing (for all income groups)

6. What about relationship between childcalorie consumption and income? • Bouis and Haddad (1990) for Bukidnon (Philippines) found that a large percentage of children 0-4 years from even the richest economic groups were consuming less than 80% of the calorie requirements, whereas the adults were consuming slightly above their recommended levels • Recommended Calorie intakes for children have decreased over time. • Need to re-examine this relationship. Expand the work of Eozenou, et al. (2012) – look at Bangladesh and Philippines also.

7. Relationship between income and diet diversity • Hoddinott and Yohannes (2002) find strong associations recorded between household dietary diversity and per capita expenditures (1% increase in DD associated with 1% increase in pc exp). 0.5% association with staples (significance level varied across countries). 1.4% assocation with non-staples. • In some of the nutrition studies also the asset index is positive and statistically significant correlated with diet diversity. • Hoddinott and Yohannes also find association larger in urban areas than rural areas in Mozambique, but no difference in Egypt.

8. Relationship between diet diversity, micronutrient density & child nutritional status • Child dietary diversity has been shown to be associated with nutrient adequacy of children and adults in developed countries (Kant (2004)). Increasingly the same is being found for developing countries also (Ruel et al. (2003), Kennedy et al. (2007), Moursi et al. (2008)) • Several nutrition papers have found positive significant relationship between dietary diversity and child nutritional status HAZ for 6-23 months old (Arimond and Ruel (2004), Moursi et al. (2008))

9. Research questions related to diet diversity • What is the association between child diet diversity and household diet diversity? • Is the child’s diet diversity more closely associated with mother’s diet diversity than with household diet diversity? • If the association is weak, then is the child’s diet coming mainly from staples? • Is the association different by age of children – 6-24 months children and 25-59 months of children? • Diet diversity and individual micronutrients – Vit A, Zinc and Iron • Diet diversity gap index – measuring the depth of dietary diversity deficiency – how far is the child’s diet diversity from the recommended level

10. Relationship between micronutrients and nutritional status of children • Vitamin A – mixed • Zinc – mixed • Multiple micronutrients – mixed / evolving literature

11. Hh pc calorie consumption Child calorie consumption Child Micronutrient Density Child diet diversity Income Hh diet Diversity Nutritional Status of Children

12. Hh pc calorie consumption Child calorie consumption Child Micronutrient Density Child diet diversity Income Hh diet Diversity Nutritional Status of Children

13. Hh pc calorie consumption Child calorie consumption Child diet diversity Child Micronutrient Density Income Hh diet Diversity Nutritional Status of Children

14. Short term research agenda • Relationship between income and child calorie consumption for ages 6-24 and 6-35 months – Uganda, Mozambique, Bangladesh, Philippines • Relationship between household, mother and child diet diversity by age of child – Food availability and 24 hour recall – Four datasets (panel) • Relationship between individual micronutrient (Vit A, iron and zinc) and diet diversity • Development of Diet diversity Gap Index • Relationship between diet diversity, and specifically effect of H+ interventions on nutritional status of children

15. What about other factors affecting child nutritional status? Long term research agenda • Infant and child feeding practices (function of maternal knowledge, empowerment, time) • Mother’s nutritional status, especially during pregnancy and breastfeeding • Morbidity environment • Access to health services