Economic Research Forum (ERF)

Food security and child malnutrition in Africa

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There is a complex relationship between climate change, food security and children’s nutritional status. This column outlines the research evidence, focusing in particular on the experience of African countries and poorer communities within them.

In a nutshell

Children’s nutritional status is likely to be negatively affected by global climate change given their relative vulnerability to food insecurity shocks; developing countries in Africa are particularly vulnerable to these effects.

Several studies show that lower precipitation and higher temperatures –which often come with climate change – are associated with increased stunting, wasting and other adverse health outcomes for children.

Social policies and public health interventions aimed at reducing the burden of childhood stunting should take account of geographical heterogeneity and adaptability to climate risk factors.

The impact of climate change on food security is one of the most pressing global challenges. Continuous increases in surface temperature, together with more intense and frequent heatwaves and precipitation events, are expected to have a global impact by reducing water availability, food security, infrastructure and agricultural incomes.

The impact on low and middle-income countries is expected to be stronger since these countries are more vulnerable to slower economic growth and food shortages. This will make poverty reduction more difficult and may increase the risk of violent conflicts (Louis and Hess, 2008).

Climate change results in losses in aggregate crop production, but this impact is stronger in tropical and temperate regions that rely on rainfed agriculture to meet their food and nutrition needs (Brown et al, 2015; Challinor et al, 2014). Developing countries in Africa are one of the most vulnerable regions in which agricultural production is negatively highly affected by inconsistent rainfall and extremely high temperatures (Davenport et al, 2017).

The frequent flooding and drought events in addition to extremely high temperatures make it more difficult for families that rely on subsistence agriculture to meet their nutritional and caloric demand. The fact that children in the developing world, and more specifically in poor communities, are more vulnerable to food and nutritional food insecurity provokes research into how climate change may affect the nutritional status of children living in these regions.

Understanding the impact of climate change on children’s nutritional status is becoming more pressing due to the short- and long-term negative impacts of malnutrition. Malnutrition before conception and during early pregnancy has adverse effects on maternal, neonatal and child health outcomes (Ramakrishnan et al, 2012). Malnutrition in-utero also increases the incidence of disability and lower years of schooling (Almond and Mazumder, 2011; Meng and Qian, 2009).

Studies also show that malnutrition during early childhood has a negative impact on adult stature and years of schooling, adult health and mortality rates (Alderman et al, 2006; Hoddinott and Kinsey, 2001; Currie and Vogl, 2013; Van den Berg et al, 2009). The rates of stunting in children in addition to higher risks of maternal and child malnutrition are relatively higher in low- and middle-income populations (Black et al, 2020). This makes focusing on the investigation of the effects of climate change on children’s malnutrition in developing countries of significance importance.

Even though it may seem clear that climate change must have an impact on children’s nutritional status; yet the relationship involves several complex pathways and direct and indirect mechanisms between both variables. Changing climate disrupts the food system by affecting agricultural production, health and the socio-economic status of agricultural labourers and consumers. Extreme weather events, such as heatwaves, droughts and floods, are expected to affect food availability by reducing agricultural production and increasing the likelihood of crop and pest diseases.

The adverse impact on agricultural production does not only directly increase the risk of famines and malnourishment, but it also affects nutrition indirectly by reducing the incomes of food producers and labour in the agricultural sector (Maccini and Yang, 2009). It also increases the price of food, which in turn reduces access to food and increases the likelihood of child malnourishment.

These extreme weather events also increase the spread of vector-borne diseases such as diarrhoea and malaria among children, which reduce their biological ability to digest food, lower the capability of exclusive breast-feeding, and make parents less capable of working and taking care of their children, and hence adversely affect their nutritional status (Louis and Hess, 2008; Randell et al, 2021).

Some research in this area attempts to capture the relationship between exposure to climate change on in-utero and children under the age of five, and their short- and long-term health status measured by their height-for-age and weight-for-age. Some studies have examined the effects of climate variability during pregnancy on child health outcomes and found that pregnancies conceived in months with the lowest precipitation have shorter gestation periods and increased risk of having pre-term babies (Rayco-Solon et al, 2005; Davenport et al, 2020).

Grace et al (2021) show that high temperatures and low levels of agricultural production in Mali are associated with lower birth weights and that living in malarial conditions may increase the likelihood of non-live birth outcomes. McMahon and Gray (2021) find that precipitation extremes in South Asia in the first year of life reduce children’s height-for-age, with the highest impact concentrated in under-resourced households, such as those lacking access to proper sanitation and households with women with lower education.

Thiede and Strube (2020) examine the impact of temperature and precipitation anomalies on the weight and wasting of children below the age of five in sub-Saharan Africa. They conclude that high temperatures are associated with lower weights and increased risk of wasting, whereas low precipitation is associated with reductions in weight.

Hoddinott and Kinsey (2001) reach similar results by investigating the impact of rainfall shocks on children growth and finding that children aged 12-24 months are the most vulnerable as they lose 1.5-2cm of growth in the aftermath of a drought. Grace et al (2012) show that the drying and warming conditions in Kenya are associated with increasing stunting levels for children aged one to five.

Another study tests the relationship between temperature, precipitation and stunting in Ethiopia and concludes that increasing rainfall during rainy seasons is associated with increasing height-for-age, while exposure to higher temperature during the first and third trimester is positively associated with severe stunting (Randell et al, 2020).

In brief, several studies have shown that lower precipitation and higher temperature are associated with increased stunting, wasting, and other adverse health outcomes.

Conversely, Cooper et al (2019) find that higher rainfall is associated with poorer child nutrition in Ghana due to its increasing threat to food security and nutrition.

Some research indicates contradictory results when examining the relationship between climate change and children’s nutritional status. One possible justification for this contradiction is that the relationship between precipitation and height and weight in children is non-linear. This is because too little rainfall negatively affects child health by affecting agricultural incomes and food availability, but also too much rainfall results in more disease transmission, which in turn increases child malnourishment.

Elayouty et al (2022) examine the geographical distribution of stunting and the non-linear relationship between temperature and precipitation anomalies and stunting among children aged from birth to five years old, sub-nationally in Egypt, Ethiopia and Uganda. They control for spatial confounders more rigorously by accounting for the within-country spatial variations while elucidating the complex relationship between climate change and children’s nutritional status, which encompasses several direct and indirect pathways.

This highlights the fact that social policies and public health interventions targeted at reducing the burden of childhood stunting should consider geographical heterogeneity and adaptable risk factors.

Further reading

Alderman, H, J Hoddinott and B Kinsey (2006) ‘Long-term consequences of early childhood malnutrition’, Oxford Economic Papers 58(3): 450-74.

Almond, D, and B Mazumder (2011) ‘Health Capital and the Prenatal Environment: The Effect of Ramadan Observance During Pregnancy’, American Economic Journal: Applied Economics 3(4): 56-85.

Black, RE, CG Victora, SP Walker, ZA Bhutta, P Christian, MD Onis… and R Uauy (2020) ‘Maternal and child undernutrition and overweight in low-income and middle-income countries’, The Lancet 382(9890): 427-51.

Brown, M, J Antle, P Backlund, E Carr, B Easterling, M Walsh… and C Tebaldi (2015) Climate Change, Global Food Security and the US Food System, University Library of Munich.

Challinor, AJ, J Watson, DB Lobell, SM Howden, DR Smith and N Chhetri (2014) ‘A meta-analysis of crop yield under climate change and adaptation’, Nature Climate Change, 4(4): 287-91.

Cooper, M, ME Brown, C Azzarri and R Meinzen-Dick (2019) ‘Hunger, nutrition, and precipitation: Evidence from Ghana and Bangladesh’, Population and Environment 41(2): 151-208.

Currie, J, and T Vogl (2013) ‘Early-life health and adult circumstance in developing countries’, Annual Review of Economics 5(1): 1-36.

Davenport, F, A Dorélien and K Grace (2020) ‘Investigating the linkages between pregnancy outcomes and climate in sub-Saharan Africa’, Population and Environment 41(4): 397-421.

Davenport, F, K Grace, C Funk and S Shukla (2017) ‘Child health outcomes in sub-Saharan Africa: A comparison of changes in climate and socioeconomic factors’, Global Environmental Change 46: 72-87.

Elayouty A, H Abou-Ali and R Hawash (2022) ‘Does climate change affect child malnutrition in the Nile Basin?’, ERF Working Paper No. 1613.

Grace, K, F Davenport, C Funk and AM Lerner (2012) ‘Child malnutrition and climate in Sub-Saharan Africa: An analysis of recent trends in Kenya’, Applied Geography 35(1-2): 405-13.

Grace, K, A Verdin, A Dorélien, F Davenport, C Funk and G Husak (2021) ‘Exploring Strategies for Investigating the Mechanisms Linking Climate and Individual-Level Child Health Outcomes: An Analysis of Birth Weight in Mali’, Demography 58(2): 499-526.

Hoddinott, J, and B Kinsey (2001) ‘Child Growth in the Time of Drought’, Oxford Bulletin of Economics and Statistics 63(4): 409-36.

Louis, MES, and JJ Hess (2008) ‘Climate change: impacts on and implications for global health’, American Journal of Preventive Medicine 35(5): 527-38.

McMahon, K, and C Gray (2021) ‘Climate change, social vulnerability and child nutrition in South Asia’, Global Environmental Change 71: 102414.

Maccini, S, and D Yang (2009) ‘Under the weather: Health, schooling, and economic consequences of early-life rainfall’, American Economic Review 99(3): 1006-26.

Meng, X, and N Qian (2009) ‘The Long Term Consequences of Famine on Survivors: Evidence from a Unique Natural Experiment using China’s Great Famine, NBER Work Paper No. 14917.

Ramakrishnan, U, F Grant, T Goldenberg, A Zongrone and R Martorell (2012) ‘Effect of Women Nutrition before and during Early Pregnancy on Maternal and Infant Outcomes: A Systematic Review’, Pediatric and Perinatal Epidemiology 26: 285-301.

Randell, H, C Gray and K Grace (2020) ‘Stunted from the start: Early life weather conditions and child undernutrition in Ethiopia’, Social Science and Medicine 261: 113234.

Randell, H, K Grace and M Bakhtsiyarava (2021) ‘Climatic conditions and infant care: Implications for child nutrition in rural Ethiopia’, Population and Environment.

Rayco-Solon, P, AJ Fulford and AM Prentice (2005) ‘Maternal preconceptional weight and gestational length’, American Journal of Obstetrics and Gynecology 192(4): 1133-36.

Thiede, BC, and J Strube (2020) ‘Climate variability and child nutrition: Findings from sub-Saharan Africa’, Global Environmental Change 65: 1-10.

Van den Berg, GJ, G Doblhammer and K Christensen (2009) ‘Exogenous determinants of early-life conditions, and mortality later in life’, Social Science and Medicine 68(9): 1591-98.

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