How Does Healthcare Quality Moderate the Impact of Drought on Child Nutrition?

Aijie Zhang , Max Planck Institute for Demographic Research; University of St Andrews

Life expectancy in Africa is comparatively low due to high child mortality and suboptimal health outcomes, which are particularly sensitive to climate changes. Drought poses a risk factor to the provision of child nutrition in Sub-Saharan Africa, but little is known about how healthcare systems moderate this relationship. To address this gap, this study examines how regional healthcare quality moderates the impact of drought on child growth in Senegal. This study merges high-resolution Standardized Precipitation-Evapotranspiration Index (SPEI) data, geocoded Demographic and Health Surveys (DHS) data, and regional healthcare indicators from Service Provision Assessments (SPA) for 24,857 children from 2012 to 2019. Using fixed-effects models, this study leverages spatio-temporal drought variation to analyze healthcare moderation during two critical windows, in utero and 0–24 months after birth. Results show that early-life drought reduces children's height-for-age z-scores (HAZ) by 0.087 standard deviations, while in-utero effects are not detectable on average except among children from wealthy households. This harm is moderated by healthcare quality in early life, with a 10 percentage point rise in the regional share of private healthcare facilities buffering drought penalty on children’s HAZ by 0.054 standard deviations, while an equivalent rise in the share of facilities charging routine fees exacerbates harm by 0.053 standard deviations. Children in poor households are particularly sensitive to droughts. In contrast, middle-income households benefit the most from the private sector and the presence of IMCI–trained staff. The findings suggest market-driven healthcare could partially offset climate shocks on children’s health but exacerbate inequality.

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 Presented in Session P6. Health, Mortality, and Ageing 2