Department of Economics and Public Policy, Imperial College London, London, England, United Kingdom.
Graduate School of Education, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
PLoS One. 2020 Apr 3;15(4):e0230965. doi: 10.1371/journal.pone.0230965. eCollection 2020.
The burden of food insecurity is large in Sub-Saharan Africa, yet the evidence-base on the relation between household food insecurity and early child development is extremely limited. Furthermore, available research mostly relies on cross-sectional data, limiting the quality of existing evidence. We use longitudinal data on preschool-aged children and their households in Ghana to investigate how being in a food insecure household was associated with early child development outcomes across three years. Household food insecurity was measured over three years using the Household Hunger Score. Households were first classified as "ever food insecure" if they were food insecure at any round. We also assessed persistence of household food insecurity by classifying households into three categories: (i) never food insecure; (ii) transitory food insecurity, if the household was food insecure only in one wave; and (iii) persistent food insecurity, if the household was food insecure in two or all waves. Child development was assessed across literacy, numeracy, social-emotional, short-term memory, and self-regulation domains. Controlling for baseline values of each respective outcome and child and household characteristics, children from ever food insecure households had lower literacy, numeracy and short-term memory. When we distinguished between transitory and persistent food insecurity, transitory spells of food insecurity predicted decreased numeracy (β = -0.176, 95% CI: -0.317; -0.035), short-term memory (β = -0.237, 95% CI: -0.382; -0.092), and self-regulation (β = -0.154, 95% CI: -0.326; 0.017) compared with children from never food insecure households. By contrast, children residing in persistently food insecure households had lower literacy scores (β = -0.243, 95% CI: -0.496; 0.009). No gender differences were detected. Results were broadly robust to the inclusion of additional controls. This novel evidence from a Sub-Saharan African country highlights the need for multi-sectoral approaches including social protection and nutrition to support early child development.
撒哈拉以南非洲的粮食不安全负担沉重，但家庭粮食不安全与儿童早期发展之间关系的证据基础极为有限。此外，现有的研究大多依赖于横断面数据，限制了现有证据的质量。我们利用加纳学龄前儿童及其家庭的纵向数据，调查了三年内家庭粮食不安全状况与儿童早期发展结果之间的关系。家庭粮食不安全状况在三年内使用家庭饥饿评分进行衡量。如果家庭在任何一轮中都处于粮食不安全状态，则家庭将首先被归类为“曾经粮食不安全”。我们还通过将家庭分为以下三类来评估家庭粮食不安全的持续性：（i）从未粮食不安全；（ii）如果家庭仅在一波中粮食不安全，则为短暂粮食不安全；（iii）如果家庭在两波或所有波中粮食不安全，则为持续粮食不安全。儿童发展在读写、算术、社会情感、短期记忆和自我调节领域进行评估。在控制每个相应结果以及儿童和家庭特征的基线值后，来自曾经粮食不安全家庭的儿童的读写、算术和短期记忆能力较低。当我们区分短暂和持续粮食不安全时，短暂的粮食不安全时期与较低的算术能力（β=-0.176，95%CI：-0.317；-0.035）、短期记忆（β=-0.237，95%CI：-0.382；-0.092）和自我调节（β=-0.154，95%CI：-0.326；0.017）相关，而与来自从未粮食不安全家庭的儿童相比。相比之下，居住在持续粮食不安全家庭的儿童的读写分数较低（β=-0.243，95%CI：-0.496；0.009）。没有发现性别差异。纳入其他控制变量后，结果基本稳健。来自撒哈拉以南非洲国家的这一新证据强调需要采取多部门办法，包括社会保护和营养，以支持儿童早期发展。
