TURNING ECONOMIC GROWTH INTO NUTRITION-SENSITIVE GROWTH 41
extremely rapid agricultural and nonagricultural growth without any significant reductions in malnutrition. Third, increased food production seems to be the most important linkage between
agricultural growth and nutrition. Tests show that increased agricultural growth has a very large effect on average calorie availability, especially when initial calorie availability is low. However, nonagricultural growth seems to have larger effects on dietary diversity. This is consistent with the idea that poor economies first fulfill their basic calorie requirements through domestic food production (since many food staples are basically nontradable), before rising incomes eventually lead to more diverse diets.
Social Dimensions of Nutrition-Sensitive Growth: A Nutrition-Sensitive Social Development Index (NUSSDI) While the source of economic growth matters, it is also important to consider how the benefits of growth are used for social sector development. A large amount of survey-based literature has uncovered significant associations between nutri- tion outcomes and a range of policy-related social sector outcomes. To see which outcomes systematically explain changes in stunting in a cross-country setting, a range of variables were tested with a view to constructing an index. The strongest relationships hold for four variables: (1) a poverty proxy (ownership of at least one asset), (2) a health proxy (medically attended births), (3) a female education proxy (women’s secondary and tertiary education), and (4) a family planning proxy (fertility rates). Infrastructure variables—such as improved water, sanitation, and electricity access—show weak relationships, although they could still be important as parts of an overall development strategy that includes a focus on malnutrition. The four strongest variables neatly capture several different determinants of
malnutrition and may be good proxies for broader socioeconomic dimensions that are relevant to nutrition outcomes, such as gender empowerment (female education and fertility rates), birth spacing and age at marriage (fertility rates), and overall health access (medically attended births). Hence the final nutrition-sensitive social development index (NUSSDI) is an equally weighted sum of these four variables, and it ranges between 0 and 100. This index and its components can be used to answer two questions. First,
are improvements in NUSSDI scores as powerful a determinant of reductions in stunting as general economic growth? Second, does economic growth drive changes in NUSSDI scores? In answer to the first question, there is evidence that improve- ments in NUSSDI scores have larger effects on stunting than commensurate increases in GDP per capita. In answer to the second question, the results suggest that economic growth has positive effects on all four components of NUSSDI. For
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