How do government policies affect children's health? Do better health services and fairer access to land mean better nutrition? What role do parents and communities play in child health? Researchers from the Centre for the Study of African Economies in the University of Oxford collaborated with research partners from universities in The Netherlands and Zimbabwe to investigate these questions in 400 households in three resettlement areas in Zimbabwe. Differences over time were traced across all three locations. Results were compared with six earlier surveys spanning the period 1982 to 1995. It emerged that better access to land may not be enough by itself to improve levels of child nutrition. Parents' education, household income and health infrastructure can, however, have conspicuously positive effects on nutrition.

Children's general health is commonly assessed by measuring physical growth. This yardstick serves to indicate nutritional status in a well nourished population, in which it is possible to predict normal distributions of height and weight among children in any given age-group. Disruption caused by war and relocation can, however, affect nutrition levels. So can poverty and lack of health and education services. All could result in poor physical growth.

In post-independence Zimbabwe, land reform was seen as the key to redressing inequality and reducing rural poverty. Expected benefits have been limited by severe droughts, including one that persisted for three years. During drought years, severe nutritional problems among children in resettlement areas proved worse than in all other areas of the country. In other years, children whose body weight was less than expected for their age, were more commonplace in resettlement areas than elsewhere in the country. But children from wealthier households and those whose mothers were better educated than the average, tended to score higher on nutritional indicators.

Despite droughts and recurrent economic problems in Zimbabwe, there have been significant improvements in health infrastructure in resettlement areas. Almost all children now have access to protected water supplies, and can reach a clinic or hospital in hours rather than days. The report shows that these features have had a positive impact upon children's general health. The study catalogues factors likely to improve child health. They include:

• easier access to protected water sources
• reduced travel time to hospitals
• improved housing standards, for instance replacing mud and thatch with brick and tinned roof dwellings
• higher educational level of mothers and higher ('senior wife') status of a mother within multiple households
• higher absolute levels of household wealth.

Gradual reductions in serious undernutrition in resettlement areas were noted before the 1994 to 1995 dry season. The report expresses concern that this tendency has since gone into reverse. Policy-related conclusions were that:

• providing land to poor households is not a sufficient key on its own to improving the health of small children
• substandard child health is not necessarily associated with residence in areas with poor agricultural potential
• no significant differences in nutritional status were discernible between male and female children in the areas.

Source(s):
Development policies and rural wellbeing: Resettlement, health and household welfare in Zimbabwe. Overseas Development Administration ESCOR Research Report # R6185. B.Kinsey and J.Hoddinott (1996)

Funded by: DFID, UK (1995)

id21 Research Highlight: 1998-July-07

Further Information:
John Hoddinott
CSAE
St Cross Building
Manor Road
Oxford OX1 3UL
UK

Contact the contributor: econ@vax.ox.ac.uk

Centre for the Study of African Economies (CSAE), UK

Bill Kinsey
Vruje Universiteit
OAE
4A30
De Boelelaan 1105
1081 HV Amsterdam
The Netherlands

Contact the contributor: bkinsey@econ.vu.nl

Vruje Universiteit, The Netherlands