Unintended effects of a targeted maternal and child nutrition intervention on household expenditures, labor income, and the nutritional status of non-targeted siblings in Ghana
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Date
2018-03
Journal Title
Journal ISSN
Volume Title
Publisher
ScienceDirect
Abstract
It is common for health and nutrition interventions to target specific household members and for evaluations
of their effects to focus exclusively on those members. However, if a targeted intervention
changes a household’s utility maximization problem or influences decision-making, households might
respond to the intervention in unintended ways with the potential to affect the wellbeing of nontargeted
members. Using panel data from a randomized controlled nutrition trial in Ghana, we evaluate
household behavioral responses to the provision of small-quantity lipid-based nutrient supplements (SQLNS)
to mothers and their infants to prevent undernutrition. We find that targeted supplementation with
SQ-LNS had a positive effect on household expenditures on food, including some nutrient-rich food
groups, as well as on non-food goods and services. We also find a positive impact on labor income, particularly
among fathers. We then explore intrahousehold spillover effects on the nutritional status of nontargeted
young children in the household. We find evidence that the targeted provision of SQ-LNS led to
higher height-for-age z-scores among non-targeted children in the LNS group compared to the non-LNS
group, though only among those with relatively taller mothers, which is an indicator of a child’s growth
potential. These findings support existing evidence and suggest that unintended behavioral responses
and spillover are a real possibility in the context of nutrition interventions targeting nutritionallyvulnerable
household members. Thoughtfully considering this possibility in the design, analyses, and
evaluation of targeted nutrition interventions may provide a more complete picture of overall effects.
2018 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license
Description
Keywords
Intrahousehold spillovers, Randomized trial, trial Expenditures, Income, Child nutrition
Citation
K.P. Adams et al. / World Development 107 (2018) 138–150