Skip to main content
SpringerLink
Log in

Economic and Health Determinants of Child Nutritional Status in the Malawian District of Salima

  • Original Article
  • Published:
The European Journal of Development Research Aims and scope Submit manuscript

Abstract

This article investigates the long- and short-term determinants of child nutritional status in the Malawian district of Salima. On the basis of monthly data from July 2004 to June 2012, the study adopts as explanatory variables a set of indicators representative of the following: household food security; maternal and child care; access to and coverage of health services; and health environment and services. Two models are estimated by Ordinary Least Square in order to compare results based on historical series and their trend-cycle, seasonal and irregular components. Findings highlight the value of a multidimensional food security indicator and the relevance of seasonal events and climatic shocks to child malnutrition. Implications for policy relate to the urgent need to arrest the long-term cycle of food insecurity and malnutrition and the differential response of child nutritional status to policies on food and health.

Abstract

Cet article examine les déterminants à court et à long terme de la situation nutritionnelle des enfants dans le district de Salima, au Malawi. A partir de données mensuelles couvrant la période de juillet 2004 à juin 2012, cette étude utilise comme variables explicatives un ensemble d’indicateurs représentant les aspects suivants: la sécurité alimentaire des ménages; les soins maternels et infantiles; l’accès aux services de santé et la couverture sanitaire; l’environnement et les services de santé. Deux modèles sont estimés avec la méthode des MCO afin de comparer des résultats basés sur des séries historiques et leur tendance-cycle, leur composante saisonnière et leur composante irrégulière. Les résultats mettent en lumière la valeur d’un indicateur multidimensionnel de la sécurité alimentaire de même que le lien entre, d’une part, les phénomènes saisonniers et les chocs climatiques et, de l’autre, la malnutrition infantile. Leurs implications pour les politiques concernent le besoin urgent d’interrompre le cycle à long terme de l’insécurité alimentaire et de la malnutrition et la réponse différentielle de la situation nutritionnelle des enfants aux politiques alimentaires et de santé.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5

Similar content being viewed by others

References

  • Bategeka, L., Leah, M., Okurut, A., Barunji, M. and Apolot, J.M. (2009) The determinants of birth weight in Uganda. A Final Report Submitted to AERC, Nairobi, Kenya, http://www.csae.ox.ac.uk/conferences/2009-edia/papers/507-Bategeka.pdf, accessed 28 October 2013.

  • Burchi, F. and De Muro, P. (2012) A Human Development and Capability Approach to Food Security: Conceptual Framework and Informational Basis. Washington DC: UNDP Regional Bureau for Africa, Working Paper 2012–009.

  • Bonjean, C.A., Brunelin, S. and Simonet, C. (2012) Impact of climate related shocks on child’s health in Burkina Faso. CERDI, Etudes et Documents, E 2012.32, http://www.cerdi.org/uploads/ed/2012/2012.32.pdf, accessed 28 October 2013.

  • Chirwa, E. (2009) The 2007–2008 Food Price Swing: Impact and Policies in Malawi. FAO, Commodities and Trade Technical Paper 12, ftp://ftp.fao.org/docrep/fao/012/i0984e/i0984e00.pdf, accessed 28 October 2013.

  • Chirwa, M.L. (2010) Knowledge Synthesis on Malawi Health System: Literature Review. ChRAIC, Malawi, http://www.chraic.org/wp-content/uploads/2010/09/Malawi-Knowledge-Synthesis.pdf, accessed 28 October 2013.

  • Chisinga, B. (2012) The Political Economy of Agricultural Policy Processes in Malawi: A Case Study of the Fertilizer Subsidy Programme. Future Agricultures Working Paper no. 039, http://www.future-agricultures.org/publications/research-and-analysis/working-papers#.UTiZYdZE7f4, accessed 28 October 2013.

  • Clasen, T., Schmidt, W.P., Rabie, T., Roberts, I. and Caimcross, S. (2006) Interventions to improve water quality for preventing diarrhoea. Cochrane Database Systematic Reviews, http://www.thecochranelibrary.com/userfiles/ccoch/file/Water%20safety/CD004794.pdf.

  • Cornia, G.A., Deotti, L. and Sassi, M. (2012) Food price volatility over the last decade in Niger and Malawi extent, sources and impact on child malnutrition. Washington DC: UNDP Regional Bureau for Africa, Working Paper 2012–002.

  • Department of Climate Change and Meteorological Services Malawi (2013) Climate of Malawi, http://www.metmalawi.com/climate/climate.php, accessed 28 October 2013.

  • Department of Nutrition, HIV and AIDS (2009) Malawi National Nutritional Policy and Strategy (2007–2011). Lilongwe, Malawi: The Republic of Malawi, Office of the President and Cabinet.

  • Devereux, S. (2012) Social Protection for Enhanced Food Security in Sub-Saharan Africa. Washington DC: UNDP Regional Bureau for Africa, Working Paper 2012–010.

  • De Waal, A. (1997) Famine Crimes: Politics and the Disaster Relief Industry in Africa. Bloomington, IN: Indiana University Press.

    Google Scholar 

  • Dorward, A., Chirwa, E., Slater, R., Thom, J., Doughton, D. and Kelly, V. (2008) Evaluation of the 2006/7 agricultural input subsidy programme, Malawi, http://www.future-agricultures.org/pdf%20files/MalawiAISPFinalReport31March.pdf, accessed 28 October 2013.

  • Ellis, F. and Manda, E. (2012) Seasonal food crises and policy responses: A narrative account of three food security crises in Malawi. World Development 40 (7): 1407–1417.

    Article  Google Scholar 

  • Esrey, S.A., Potash, J.B., Roberts, L. and C., Shiff (1991) Effects of improved water supply and sanitation on Ascariasis, Diarrhoea, Dracunculiasis, Hookworm Infection, Schistosomiasis, and Trachoma. Bulletin World Health Organisation 69 (5): 609–621.

    Google Scholar 

  • FAO (2013) The Director-General’s Medium Term Plan 2014–2017 and Programme of Work and Budget 2014–2015. Rome, Italy: FAO.

  • FAO (2008) Nutrition Country Profile Republic of Malawi. Rome, Italy: FAO.

  • FAO Media Centre (2013) Malawi: EU and FAO Underline Support for Nutrition and Food Security in Malawi – EU Commissioner Piebalgs and FAO Director-General Graziano da Silva in high-level visit, http://www.fao.org/news/story/en/item/171061/icode/, accessed 28 October 2013.

  • Fewtrell, L., Kaufmann, R.B., Kay, D., Enanoria, W., Haller, L. and Colford Jr. J.M. (2005) Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: A systematic review and meta-analysis. Lancet 5 (1): 42–52.

    Article  Google Scholar 

  • Findley, D., Monsell, B., Bell, W., Otto, M. and Chen, B.C. (1998) New capabilities and methods of the X-12-ARIMA seasonal adjustment program (with discussion). Journal of Business and Economic Statistics 16 (2): 127–176.

    Google Scholar 

  • Guyatt, H.L. and Snow, R.W. (2004) Impact of malaria during pregnancy on low birth weight in sub-Saharan Africa. Clinical Microbiology Reviews 17 (4): 760–769.

    Article  Google Scholar 

  • Harvey, A.C. (1990) The Econometric Analysis of Time Series. Cambridge, USA: MIT Press.

    Google Scholar 

  • Howe, P. (2002) Reconsidering famine. IDS Bulletin 33 (4): 19–27.

    Article  Google Scholar 

  • ICN (1992) Plan of Action for Nutrition. Rome, Italy: FAO–WHO.

  • Jayne, T.S. and Tschirley, D. (2009) Food price spikes and strategic interactions between the public and private sectors: Market failures or policy failures? FAO, Commodity Market Review 2009–2010, http://www.fao.org/docrep/012/i1545e/i1545e00.pdf, accessed 28 October 2013.

  • Katz, K., Ngalande, R.C., Jackson, E., Kachale, F. and Mhango, C. (2010) Evaluation of Community-Based Distribution of DMPA by Health Surveillance Assistants in Malawi. September, Report prepared for USAID, Family Health International, http://www.fhi360.org/sites/default/files/media/documents/community-based-family-planning-malawi.pdf, accessed 28 October 2013.

  • MacKinnon, J.C. (1996) Numerical distribution functions for unit root and cointegration tests. Journal of Applied Econometrics 11: 601–618.

    Article  Google Scholar 

  • Malawi National Vulnerability Assessment Committee (various years) Malawi food security assessment report, http://moafsmw.org, accessed 28 October 2013.

  • Mason, J.B. et al (2005) AIDS, drought, and child malnutrition in southern Africa. Public Health Nutrition 8 (6): 551–563.

    Article  Google Scholar 

  • Minot, N. (2010) Staple food prices in Malawi. Paper prepared for the COMESA policy seminar on Variation in Staple Food Prices: Cause, Consequence, and Policy Options, Maputo, Mozambique, 25–26 January, http://fsg.afre.msu.edu/aamp/seminar_3/AAMP_Maputo_22_Malawi_ppr.pdf, accessed 28 October 2013.

  • Ministry of Health (2004a) Malawi health SWAP Memorandum Of Understanding. Lilongwe, Malawi: Ministry of Health.

  • Ministry of Health (2004b) A Joint Programme of Work for a Health Sector Wide Approach (SWAp) 2004–2010. Lilongwe, Malawi: Ministry of Health.

  • Ministry of Health, Planning Department, Health Management Information Unit (2005) Health Management Information Bulletin. Annual Report. July 2004–June 2005. Lilongwe, Malawi: Ministry of Health.

  • Ministry of Health, Planning Department, Health Management Information Unit (2010) Health Management Information Bulletin. Annual Report. July 2009–June 2010. Lilongwe, Malawi: Ministry of Health.

  • Ministry of Health and Population (2003) National Health Information Policy. Lilongue, Malawi: Ministry of Health, http://gametlibrary.worldbank.org/FILES/110_HMIS%20information%20Policy%20-%20Malawi.pdf, accessed 28 October 2013.

  • McMichael, A.J. et al (2003) Climate Change and Human Health – Risks and Responses. Geneva, Switzerland: WHO.

    Google Scholar 

  • Molina, H. (2012) Review of Health and Nutrition Indicators in early Childhood. Paris, France: UNESCO, UNESCO Report.

    Google Scholar 

  • Muula, A.S., Siziya, S. and Rudatsikira, E. (2011) Parity and maternal education are associated with low birth weight in Malawi. African Health Science 11 (1): 65–71.

    Google Scholar 

  • National Statistical Office, and ICF Macro (2011) Malawi Demographic and Health Survey 2010. Zomba, Malawi; Calverton, MD: NSO and ICF Macro.

  • Okurut, F.N., Kepaletswe, F. and Mmopelwa, D. (2013) Determinants of birthweight in Botswana. International Journal of Academic Research in Economics and Management Sciences 2 (52): 107–117.

    Google Scholar 

  • Onalo, R. and Olateju, K.E. (2013) Trend and seasonality in admission and outcome of low birthweight infants in Gawagwalwda-Abuja, Nigeria. International Journal of Tropical Disease and Health 3 (3): 190–198.

    Article  Google Scholar 

  • Perron, P. (1989) The great crash, the oil price shock, and the unit root hypothesis. Econometrica 57 (6): 1361–1401.

    Article  Google Scholar 

  • President’s Malaria Initiative (2012a) Malawi – Country Profile. April, http://pmi.gov/countries/profiles/malawi_profile.pdf, accessed 28 October 2013.

  • President’s Malaria Initiative (2012b) Malaria Operational Plan (MOP) – Malawi – Year six – FY 2012. September, http://pmi.gov/countries/mops/fy12/malawi_mop_fy12.pdf, accessed 28 October 2013.

  • President’s Malaria Initiative (2013) Malawi – Malaria Operational Plan FY 2013, http://pmi.gov/countries/mops/fy13/malawi_mop_fy13.pdf, accessed 28 October 2013.

  • Ramakrishnan, U., Martorell, R., Schroeder, D.G. and Flores, R. (1999) Role of intergenerational effects on linear growth. Journal of Nutrition 129: 5445–5495.

    Google Scholar 

  • Reddy, V., Pralhad Rao, N., Shekar, M. and Gillespie, S.R. (1992) Nutrition in India. ACC/SCN Country Review. Geneva, Switzerland: ACC/SCN.

    Google Scholar 

  • Republic of Malawi (2012) Integrated Household Survey 2010–2011. Household Socio-Economic Characteristics Report, September Lilongwe, Malawi: Republic of Malawi.

  • Republic of Malawi – Salima District Assembly (2006) Salima District – Socio Economic Profile. Salima, http://www.scotland-malawipartnership.org/documents/68-SALIMASEP2006FINAL.pdf, accessed 28 October 2013.

  • Republic of Malawi, Office of the President and Cabinet (2009) National Nutritional Policy and Strategic Plan. Lilongwe, Malawi: Department of Nutrition, HIV and AIDS.

  • Roca-Feltrer, A. et al (2012) Lack of decline in childhood malaria, Malawi, 2001–2010. Emerging Infectious Disease Journal 18 (2): 272–278.

    Article  Google Scholar 

  • Rossel, J.D. (2008) The Impact of Climatic Shocks on Child Nutrition in Peru, Young Lives Student Paper, August, http://www.younglives.org.uk/files/student-papers/the-impact-of-climatic-shocks-on-child-nutrition-in-peru, accessed 28 October 2013.

  • Sassi, M. (2012) Short-term determinants of malnutrition among children in Malawi. Food Security 4 (4): 593–606.

    Article  Google Scholar 

  • Sen, A.K. (1981) Ingredients of famine analysis: Availability and entitlements. The Quarterly Journal of Economics 96 (3): 433–464.

    Article  Google Scholar 

  • Smith, L.C. and Haddad, L. (2000) Explaining Child Malnutrition in Developing Countries: A Cross-Country Analysis. Washington DC: IFPRI.

    Google Scholar 

  • UNICEF (1990) Strategy for Improved Nutrition of Children and Women in Developing Countries. New York: UNICEF.

  • UNICEF (2009) Tracking Progress on Child and Maternal Nutrition – A Survival and Development Priority. New York: UNICEF.

  • UNICEF and WHO (2004) Low Birthweight: Country, Regional and Global Estimates. New York: UNICEF.

  • USAID (2012) Malawi Private Health Sector Assessment, (Brief) Bethesda, MD: SHOPS Project, Abt Associates.

  • Verhoeff, F.H. et al (2001) An analysis of intra-uterine growth retardation in rural Malawi. European Journal of Clinical Nutrition 55 (8): 682–689.

    Article  Google Scholar 

  • Verhoeff, F.H., Brabin, B.J., Chimsuku, L., Kazembe, P., Wit, J.M. and Broadhead, R.L. (1999) Malaria in pregnancy and its consequences for the infant in rural Malawi. Annals of Tropical Medicine and Parasitology 93 (Supplement 1): S25–33.

    Article  Google Scholar 

  • Webster, M.J. (2013) Malawi – Second National Water Development Project: P096336 – Implementation Status Results Report: Sequence 13. Washington DC: World Bank.

    Google Scholar 

  • World Food Programme (WFP) (2010) Republic of Malawi: Comprehensive Food Security and Vulnerability Analysis. Rome, Italy: World Food Programme.

  • World Bank (2012) Main Report: Volume 1 of Malawi – Water Sector Investment Plan. World Bank Water Partnership Program. Washington DC: World Bank.

  • World Food Programme (2012) Malawi: Comprehensive Food Security and Vulnerability Analysis. Rome, Italy: World Food Programme.

  • World Food Programme, and Centres for Disease Control and Prevention (2005) A Manual: Measuring and Interpreting Malnutrition and Mortality. Rome, Italy: World Food Programme.

  • Wort, U.U., Hastings, I.M., Carlstedt, A., Mutabingwa, T.K. and Brabin, B.J. (2004) Impact of El-Niño and malaria on birthweight in two areas of Tanzania with different malaria transmission patterns. International Journal of Epidemiology 33 (6): 1311–1319.

    Article  Google Scholar 

Download references

Acknowledgements

The author would like to express her gratitude, for valuable comments and information, to James Bwirani (FEWSNet, Malawi); Olex Kamowa (FEWSNet, Malawi); Gift Kawamba (Ministry of Agriculture, Malawi); Irene Kumwenda (Development Aid from People to People, Malawi); Fydess Mkomba (Centre For Social Concern, Malawi); Carlo Bernini Carri (University of Pavia); Eduardo Rossi (University of Pavia); Carolina Castagnetti (University of Pavia) and anonymous referees. The contents of this article reflect only the opinion of the author.

Author information

Authors and Affiliations

  1. Department of Economics and Management, University of Pavia, Pavia, Italy

    Maria Sassi

Authors
  1. Maria Sassi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sassi, M. Economic and Health Determinants of Child Nutritional Status in the Malawian District of Salima. Eur J Dev Res 26, 761–782 (2014). https://doi.org/10.1057/ejdr.2013.62

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/ejdr.2013.62

Keywords

Search

Navigation