Together for Nutrition 2015

1. Remoteness, Welfare and Nutrition:
Evidence from Rural Ethiopia
David Stifel
Lafayette College
15 June 2015
Addis Ababa, Ethiopia

2. How does remoteness (accessibility to markets) affect…
• Household well-being?
• Nutrition?
• Outcomes – mother & child anthropometrics
• Dietary diversity
• Food security

3. Data – Ethiopia Rural Transport Survey 2011
• Survey of 851 households in northwestern Amhara
• Sample area selected purposefully
• Without a passable road
• Land quality similar throughout
• Households use the same major market
• Remoteness defined relative to this market town
• Households’ circumstances differ because of differences in transport costs…
…not because of land characteristics.
• Technical purpose: Quasi-experimental setting addresses issue of endogeneity
and facilitates a causal interpretation of results

4. Ethiopia Rural Transport Survey 2011

5. HOUSEHOLD WELFARE & REMOTENESS

6. Household Per Capita Consumption & Transport Costs
0
500
1000150020002500
Birr/person
0 20 40 60 80
Transport Cost (Birr/kg)
Per Capita Household Consumption Food
Non-Food

7. Household Food Consumption & Transport Costs
0
500
1000150020002500
Birr/person
0 20 40 60 80
Transport Cost (Birr/kg)
Per Capita Food Consumption Purchased
Own-Consumption

8. NUTRITION & REMOTENESS

9. Outcomes: Mothers’ BMI
• Mean BMI = 19.2
• Percent underweight = 34.2
• Statistically not different by
remoteness
1015202530
0 20 40 60 80
Transport Cost (Birr/Quintal
bandwidth = .8
Note: Underweight is BMI < 18.5

10. Outcomes: Child Stunting
• 36 percent stunted
• Statistically not different by
remoteness
-6-2
026
0 20 40 60 80
Transport Costs (Birr/Quintal)
bandwidth = .8
Stunting: HAZ < -2

11. Outcomes: Child Wasting
• 17 percent wasted
• Statistically not different by
remoteness
-6-2
026
0 20 40 60 80
Transport Costs (Birr/Quintal)
bandwidth = .8
Wasting: WHZ < -2

12. Dietary Diversity
0
20406080
100
Percent
Least Remote Quintile 2 Quintile 3 Quintile 4 Most Remote
Percent of Households Consuming Particular Food Items
Oil Milk
Meat Fruit
0123456
0 20 40 60 80
Transport Cost (Birr/kg)
All Household Members Chldren under age 5
Average Number of Food Groups in Household Diet

13. Food Security
0
.1.2.3
PercentofHouseholds
Least Remote Quintile 2 Quintile 3 Quintile 4 Most Remote
Worry Not Enough Food in Past 30 Days
1-2 Times 3-10 Times
10+ Times

14. Food Security
0
.1.2.3
PercentofHouseholds
Least Remote Quintile 2 Quintile 3 Quintile 4 Most Remote
Ate Smaller Meals in Past 30 Days
1-2 Times 3-10 Times
10+ Times
0
.1.2.3
Least Remote Quintile 2 Quintile 3 Quintile 4 Most Remote
Ate Fewer Meals in Past 30 Days
1-2 Times 3-10 Times
10+ Times

15. IN SUMMARY

16. Remoteness in our survey area…
• Negatively affects household consumption
• Lower production – less own consumption
• Lower marketed surplus – less purchased
• Has no discernable effect on nutrition outcomes
• Mothers’ BMI
• Child stunting and wasting
• Negatively affects…
• Dietary diversity
• Food security

17. Tension in the results…
• Remoteness
• Negatively affects
• Food consumption
• Dietary diversity
• Food securty
• No discernable effect on nutrition outcomes
• Why no effect on nutrition outcomes?
• Low access to sanitation & healthcare throughout the survey area?
• Threshold effects – Food consumption & dietary diversity levels too low?
• Your thoughts?