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Session: Improving Nutrition for the First 1,000 Days (Poster Theater Flash Session 5)

(PTFS05-03-23) Human Capital and Lifetime Income Gains of Scaling-Up Small-Quantity Lipid Nutrient Supplements Among Children <2 Years

Sunday, July 23, 2023
2:13 PM – 2:17 PM ET
Location:  Fairfax

    Presenting Author(s)

  • Nandita Perumal, PhD

    Assistant Professor
    Department of Epidemiology and Biostatistics, University of South Carolina
    Boston, Massachusetts, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • GD

    Goodarz Danaei, MD, ScD

    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

  • GF

    Günther Fink, PhD

    Head, Household Economics and Health System Research Unit
    Swiss Tropical and Public Health Institute & University of Basel
    Basel, Basel-Landschaft, Switzerland

  • ML

    Mark J. Lambiris, PhD

    Swiss Tropical and Public Health Institute
    Basel, Basel-Stadt, Switzerland

  • Christopher R. Sudfeld, ScD

    Assistant Professor of Global Health and Nutrition
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

Disclosure(s):
Nandita Perumal, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Scaling-up nutrition interventions in the ‘first 1000 days’ may provide human capital gains by improving child developmental outcomes. We estimated gains in years of schooling and lifetime income of scaling-up small-quantity lipid nutrient supplements (SQ-LNS) among children 6-24 months of age in five countries with a high burden of child undernutrition.

Methods: We estimated the potential human capital gains of scaling-up SQ-LNS among young children in Bangladesh, Burkina Faso, Ethiopia, Pakistan, and Uganda using two pathways: (i) through shifts in cognitive development, and (ii) through shifts in schooling years as a function of change in cognitive development. Random-effects meta-analysis was used to estimate the pooled effect of SQ-LNS on the combined construct of ‘cognition’ based on data from trials (n=13) investigating the effect of SQ-LNS on developmental outcomes. We then used the effect size for returns to lifetime income as a function of change in cognition: directly (pathway 1), based on a de novo meta-analysis of the economics literature; or indirectly (pathway 2) through school years gained based on published effect sizes from five birth cohort studies conducted in low- and middle-income countries. We estimated the returns to schooling and lifetime income attributable to scaling up SQ-LNS intervention from 0% to 50% and 90% per 5-year birth cohort in each country.

Results: Scaling-up SQ-LNS to 90% coverage was estimated to increase average cognitive development by 0.061 SD (95%CI: 0.031, 0.091) at the population level, yielding an estimated increase in lifetime income between $US 382 million (95% uncertainty interval [UI]: 140, 708) in Burkina Faso and $US 6414 million (95% UI: 2346, 11900) in Pakistan, per birth cohort. Improvements in cognitive development also resulted in an estimated increase in school years ranging from 0.14 million school years (95%UI: 0.064, 0.25) in Burkina Faso to 1.18 million school years (95%UI: 0.54, 2.11) in Pakistan per birth cohort; though returns to lifetime income through schooling were lower than through cognition directly. 

Conclusions: Scaling-up SQ-LNS among children 6-24 months of age may lead to substantial population-level increases in human capital in countries with a high-burden of child undernutrition.

Funding Sources: Bill and Melinda Gates Foundation