Dissertation/Thesis Abstract

Three Essays on the Economics of Maternal and Early Childhood Undernutrition: Evidence from a Randomized Controlled Nutrition Trial in Ghana
by Adams, Katherine Pittenger, Ph.D., University of California, Davis, 2012, 218; 3555245
Abstract (Summary)

The first 1,000 days in a child's life, beginning at conception and extending through his/her second birthday, have been identified as the critical window for preventing undernutrition. This dissertation brings an economic perspective to a randomized controlled nutrition trial in Ghana testing the efficacy of a lipid-based nutrient supplement formulated for maternal consumption during pregnancy and lactation (LNS-P&L) for the prevention of maternal and early childhood undernutrition. In this collection of essays, I explore (1) household valuation of LNS-P&L, including potential barriers to adoption and policy actions that may help stimulate demand outside the context of the randomized trials, and (2) intrahousehold spillover effects generated by maternal consumption of LNS-P&L.

In the first essay, I use three rounds of contingent valuation survey data from a sample of households participating in the randomized controlled trial to estimate willingness-to-pay (WTP) for LNS-P&L and, as a comparator, soybean flour, which is a locally-available product commonly sold to women at prenatal clinics. I also evaluate how experience using LNS-P&L influences WTP for both products. I find WTP for LNS-P&L is, in general, positive, and respondents are willing to pay a price premium for LNS-P&L over soybean flour at each round. However, neither personal experience using LNS-P&L nor contact with others consuming LNS-P&L has a systematic effect on WTP.

In the second essay, I use experimental auction bids on LNS-P&L from a sample of women who did not participate in the randomized trial to characterize WTP for LNS-P&L and to explore the effect of providing information on the potential long-term benefits of preventing maternal and early childhood undernutrition on WTP. Although the literature has identified a lack of information as a potential barrier to adoption of preventative health and nutritional products, I find that while the information treatment increases average WTP and shifts the distribution of WTP slightly to the right, these effects are not statistically significant.

In the third essay, I explore intrahousehold spillover effects of maternal consumption of LNS-P&L Using anthropometric data on the youngest, non-targeted sibling under five years of age in the household, I find an increase in siblings' changes in height-for-age z-scores over the course of maternal supplementation with LNS-P&L I then use supplementary data to explore mechanisms that may be generating the sibling spillover effects and find maternal consumption of LNS-P&L is associated with an increase in the percentage of total household expenditures allocated to food, resulting in higher expenditures on some nutrient-rich foods such as fish, milk, fruit, and vegetables.

The results presented in these essays suggest that the effectiveness of LNS-P&L outside the context of the randomized controlled trials may hinge on innovative policy action to encourage demand for LNS-P&L and to reduce barriers to its adoption. Nonetheless, households indicate a willingness to invest in LNS-P&L, a product that may improve the likelihood a baby is born healthy and thrives through his/her first two years of life. Moreover, consuming LNS-P&L may have beneficial spillover effects on the nutritional status of other young children in the household.

Indexing (document details)
Advisor: Lybbert, Travis J.
Commitee: Boucher, Stephen R., Vosti, Stephen A.
School: University of California, Davis
Department: Agricultural and Resource Economics
School Location: United States -- California
Source: DAI-A 74/07(E), Dissertation Abstracts International
Subjects: Agricultural economics, Nutrition
Keywords: Ghana, Spillovers, Undernutrition, Willingness-to-pay
Publication Number: 3555245
ISBN: 978-1-267-96731-2
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