Reproductive Health, Nutritional Status, and Macroeconomic Shocks: A Multi-Level, Quasi-Natural Experimental Analysis of Food Commodity Prices

Global food price rises threaten to undermine progress in improving maternal and child health and nutrition. As the World Bank 2012 Global Monitoring Report titled 'Food prices, nutrition, and the MDGs' concluded "Even temporarily high food prices affect the long-term development of children...seemingly small shocks can exert great damage if they are not dealt with early." While there is strong evidence that maternal and fetal nutrition affect children's development, there is relatively little evidence linking aspects of reproductive health (e.g. breastfeeding, neonatal mortality) to the price and availability of nutritious food. Thus, our project aims to:
(1) Assess the effects of food commodity prices on reproductive and child health, specifically maternal and childhood nutrition, fetal development, neonatal mortality, and early-childhood development;
(2) Identify national, state and household policy responses which may mitigate or exacerbate the reproductive and child-health effects of rising food prices.
To fulfil these aims, the initial phase of the project will provide a detailed qualitative and quantitative multi-level, case-study of India, which will then be extended as a cross-national analysis of Demographic and Health Surveys in 84 countries. The project will combine PopDev priority resources such as DFID Young Lives with multiple data sources and large-scale surveillance projects containing rich information on economic policy, food prices, nutrition, reproductive health. The project will build a collaborative exchange between Public Health Foundation of India (PHFI), Cambridge, and LSHTM, supported by a multi-disciplinary international advisory team. Its findings will reach a wide group of stakeholders through a proposed policy workshop and briefs at Chatham House, as well as through meetings with Indian stakeholders at PHFI, and through publications in population, development, and public health journals.

Impacts
The research will contribute to understanding how contemporary food and nutrition policies operating nationally, at state level, and household practices might mitigate negative health effects of escalating food prices on women and children's health. The findings are particularly relevant to India, where a Food Security Bill is being debated to prevent such adverse effects, although critics have suggested the Bill will maintain access to unhealthy foods which will worsen rates of obesity and diabetes. The project's engagement with local Indian NGOs and the Public Health Foundation of India, together with international foreign policy bodies like Chatham House, will help achieve wide dissemination of results and increase policy impact.

Plans to Ensure Impact
At the onset of the project we plan to hold one-day, face-to-face conference in Delhi to develop the methodology, ensure data access (specifically for large-scale longitudinal MCH population surveillance data) and reinforce links with Indian stakeholders and partner institutions (including the National Rural Health Mission, Public Health Movement in India). This will help to further map available data sources, although our initial survey of literature and makes us confident we have identified the primary resources. This meeting of key stakeholders will be used to develop the summary communication plan using the template provided by ESRC. SANCD funds will contribute to cover international airfares and in-country costs of setting up the meeting. About six months in to the project we will hold an academic workshop at LSHTM to refine the cross-disciplinary methodology, bringing together the international advisory team. In the final month of the project we will host a high-level policy workshop at Chatham House, which has agreed to publish a policy brief, bringing together UNICEF representatives, Gates Foundation India, and women's empowerment groups.