The Question: Dose exposure to nutritional supplement in utero and during the first three years of life impact long-term adult educational, labor market and marriage outcomes in India?
What We Found: We looked at evidence from the Andhra Pradesh Children and Parents Study (APCAPS) in India, using follow up data from a 1987-1990 trial of nutritional supplement under the Integrated Child Development Services (ICDS) program of the Indian government in 29 villages near the city of Hyderabad. In 15 intervention villages, pregnant women and children below the age of six years were offered a daily cooked meal – made from locally available ingredients – which provided 500 kcal of energy and 20–25 g protein to women and half of those amounts to children. No supplement was offered in the remaining 14 control villages during the trial. There were three follow up surveys of children originally born between 1 January 1987 and 31 December 1990 in the study villages. This study used the 2010–2012 survey data to examine the outcomes of the study children (20-25 year old adults at that time). Researchers employed regression and a quasi-experimental methodology of propensity score matching to find that:
- Adults born in intervention villages were 9% more likely to complete secondary school and 11% more likely to complete graduate education, were 6% less likely to be ever-married at age 20–25 y, and were 5% more likely to be employed or enrolled in higher education.
- Estimated associations for graduate education completion and employment-study rates were greater for men, whereas the associations for secondary education and ever-married rates were greater for women.
Why It Matters: ICDS is the world’s largest maternal and child health program. It provides nutrition to over 100 million women and children, as well as preschool education to 40 million children. However, potential long-term effects of the ICDS nutrition are unknown. This study, along with a previous study by CDDEP researchers using data from the same cohort, shows that early life nutrition can bring substantial educational, labor market and demographics benefits in India. This is one of few studies in the world to provide high-quality evidence – by using longitudinal follow up data from a controlled nutrition trial – of future non-health benefits of early childhood nutrition.