Key findings
- Young Lives research shows that household perceptions of their food security have improved steadily between 2009 and 2016. However, food insecurity remains a concern among the poorest, in rural sites, and for children with less educated parents. Moreover, between 2013 and 2016 some households moved from being food secure to facing mild food insecurity, probably due to the El Niño-driven drought.
- Food diversity – consumption of four major food groups – increased slightly comparing between the two cohorts at age 15 with a seven year gap. The Younger Cohort in 2016 consumed fewer milk and milk products than the Older Cohort in 2009, but more pulses, legumes and meat. However, children from poorer households, in rural sites or with less educated parents had a less diverse diet.
- Regarding services, there has been considerable improvement in access to sanitation between 2002 and 2016, most notably among the poorest and in rural sites. Likewise, access to clean drinking water has increased substantially over this period in almost all regions.
- Undernutrition declined comparing stunting within cohorts as they grew up and between cohorts between 2009 and 2016. Yet stunting levels, at over a quarter of the Younger Cohort in 2016, remain a cause for concern. Boys in both cohorts are more affected than girls, and stunting is more common among poor families, in rural sites and for children with less educated parents. However, children in poor households and boys showed greater improvement between 2013 and 2016.
- Short term undernutrition, measured as ‘thinness’, increased in comparing the two cohorts at age 12, no doubt owing to drought and food inflation in 2013, whereas by age 15 we found an improvement. However, girls, children in rural sites and those from poor families were much more likely to be thin in both cohorts at both 12 and 15 years of age.
- Regarding the dynamics of nutrition, we documented recovery from stunting of undernourished children and faltering of children who were previously well nourished. In gender terms, a slightly larger proportion of boys were persistently stunted and fewer never stunted and yet the proportion of boys who recovered was much greater, whereas fewer girls were persistently stunted but more faltered. There were also big differences by socioeconomic group in terms of wealth, location, and parental education. However a higher proportion of rural children than urban children recovered.
- Stunting seems to be associated with lower language and maths scores, later school enrolment and slower progression in school. Stunting was also highly associated with poverty, limited or lower levels parental education and rural residence. Children who recovered had better scores than those who faltered or were persistently stunted.
Policy messages
- Despite improvements, continuing high levels of stunting require further investment in nutritional interventions, particularly at times of crisis.
- Interventions to promote dietary diversity are important in order to improve nutritional status, particularly among disadvantaged groups with a less diverse diet.
- As boys were found to be more affected by stunting and thinness but showed greater signs of recovery, while girls were less affected but were more likely to falter, nutrition interventions should be made more gender-sensitive.
- Early investments in nutrition are associated with improved test scores and cognitive achievement. While interventions in the first one thousand days are crucial, later recovery is possible so that nutritional interventions including in day care and school feeding can be important.
- More generally, as poverty plays a key role in children’s nutrition, policy measures directed towards improving households’ livelihoods can have a further impact in improving child health and consequently in their cognitive development and schooling outcomes.