Economic development and child nutrition in Nepal
Child malnutrition rates in Nepal are among the highest in the world. Government and non-governmental agencies are actively seeking various pathways that might be useful to improve child nutrition outcomes in Nepal, fill gaps in understanding surrounding nutrition drivers, and shorten the time required to attain the Millennium Development Goals. This dissertation includes three essays that use a range of data, including nationally representative data on the growth of children nutrition below five years of age, to identify potential pathways for improving child nutrition in Nepal. Essay 1 focuses on food prices. The analysis seeks to explain price movements and price variances in local markets. Since a majority of Nepalese households are net-buyers of food, food prices can be expected to influence nutrition outcomes among Nepalese children. A panel GARCH approach is used. Results suggest that rice prices in regional markets and wheat prices in border markets tend to strongly influence rice and wheat prices in local markets, respectively. The density of roads and bridges, and agricultural production, not unexpectedly, are negatively correlated with local food prices and price variances. Higher fuel prices are associated with higher local rice prices. Essay 2 uses a series of multilevel (hierarchical) regression models to identify the factors correlated with child height-for-age and weight-for-height z-scores. The essay also assesses what factors account for the observed improvements in average outcomes between 2011 and 2006. Various factors observed at the child, mother, household, cluster, and district levels are found to be associated with child nutrition outcomes. The observed improvement in average height-for-age Z-score between 2011 and 2006 is explained largely by mother and district level variables while the observed improvement in average weight-for-height Z-scores between 2011 and 2006 seems more closely tracked by variables observed at the cluster and district levels. Essay 3 studies the association between district-level infrastructure and district-average child nutrition outcomes in Nepal. A dose response function, and instrumental variable and spatial econometric techniques are used. Results suggest that roads and road quality matter for short- and long-term nutrition outcomes for children below five years. Significant spatial spillover effects of roads on long-term child nutrition outcomes is found. Based on findings of these three essays, several policies that are likely to reduce food prices and variances, and improve short- and long-term nutrition outcomes in Nepal are proposed. These include improving the connections between local and regional markets by improving road quality, extending the road network and constructing bridges, and formulating and implementing policies to increase cereal production. Policies targeted towards improving nutrition outcomes of twins, increasing mother’s education level, discouraging mother’s smoking, promoting family planning, encouraging mothers to deliver babies in health facilities, avoiding smoke-producing fuels will help to improve the nutrition outcomes of children below five years of age.
Shively, Purdue University.
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