Policies targeting health improvements for particular household members can, as a result of resource allocation adjustments, have repercussions for all household members. Understanding how these spillovers work within the household could enable the design of smarter health policies which take into account households' optimal readjustments. But we cannot fully measure these reallocation responses without data on dietary intake, which is arguably the most important health resource, especially for children in low-income settings. I propose to 1) acquire the knowledge and skills necessary to collect such data, and 2) use it to analyze the effects of nutrition interventions on the intra-household distribution of food and other health resources. To accomplish the first goal, I will engage in three training activities which will enable me to learn about key concepts in nutritional science and measurement issues in dietary intake assessment in low-income settings: 1) coursework, 2) mentoring meetings, and 3) dissemination of my work. To accomplish the second, I will engage in a research program related to understanding the intra-household spillovers of targeted nutrition interventions, focusing on iodine supplementation. Iodine deficiency disorder (IDD) has significant and irreversible effects on cognitive development. One third of the global population has IDD. Low in utero exposure to iodine leads to reduced intelligence quotients, and in severe cases can lead to miscarriage, stillbirth, preterm delivery and growth, hearing and speech problems. Iodine supplementation and fortification programs-both in utero and in early childhood-have been proven to increase child health and cognitive ability, and are thus often used as policy tools in affected areas. Supplementation programs are usually targeted towards pregnant women and young children. However, little is known about how these interventions affect other children in the household who are not targeted. My research program has 3 specific aims: 1) collect novel data which combine socioeconomic and demographic information with dietary intake measurements for every child in the household; 2) document the patterns of intra-household allocation of food and other health resources; and 3) study the effects of fetal and early childhood iodine supplementation interventions on the intra-household distribution of food and other health resources amongst children. I will accomplish the first aim by designing a dietary intake assessment module and integrating it into a large-scale household panel survey in Ghana. I will accomplish Aim 2 by performing preliminary analyses with these new data. I will accomplish the last aim through two studies. In the first, I will study the effects of a large feta iodine supplementation program in Tanzania using an existing, nationally representative dataset. In this study, I will apply econometric techniques developed for intra-household analyses to examine whether children exposed to more iodine while in utero receive more health resources than their untreated siblings during childhood. In the second study, I will implement and analyze data from a pilot field experiment that will distribute iodine supplements to children under 5 in Ghana. The experiment will run concurrently with the panel survey data collection, allowing me to measure the resulting changes in dietary intake and other health resource allocations. Without quantifying the household responses to childhood nutrition interventions, particularly in the context of iodine supplementation policies, it is impossible to know the full impact of these programs. Answering this question-are we helping or hurting other children in the household through targeted interventions?-is essential to the design and improved cost-benefit analysis of childhood nutrition programs around the world.
It is impossible to gauge the full impacts of childhood nutrition interventions without measuring how households redistribute resources among children in response. Answering this question-are we helping or hurting other children in the household through targeted interventions?-is essential to the design and improved cost-benefit analysis of childhood nutrition programs around the world.
