# Human capital and lifetime income gains of scaling-up small-quantity lipid nutrient supplements among children under 2 years: A modelling analysis

## TL;DR

This study models how providing lipid nutrient supplements to young children in undernourished countries could boost their education and lifetime income.

## Contribution

The study is the first to estimate long-term human capital gains from scaling small-quantity lipid nutrient supplements in undernourished children.

## Key findings

- Scaling SQ-LNS to 90% coverage could generate up to 1.18 million additional school years per five-year birth cohort in Pakistan.
- Estimated lifetime income gains range from $0.41 billion in Burkina Faso to $6.91 billion in Pakistan per five-year birth cohort.
- Income returns per child exceed the cost of providing SQ-LNS.

## Abstract

Undernutrition in early childhood is associated with adverse health and developmental outcomes later in life and remains a persistent global public health problem. Providing small-quantity lipid nutrient supplements (SQ-LNS) to children aged 6-24 months improves child growth and neurodevelopmental outcomes, but the potential long-term benefits to human capital have not been previously estimated. We estimated the potential returns to schooling and lifetime income attributable to increasing coverage of SQ-LNS for children <2 years of age from 0% to 50% or 90% per five-year birth cohort in five countries (Bangladesh, Burkina Faso, Ethiopia, Pakistan, and Uganda) with a high burden of undernutrition. Random-effects meta-analyses were used to estimate the effect of SQ-LNS on child development using evidence from randomized controlled trials, and to estimate the returns to lifetime income as a function of change in development based on a de novo meta-analysis of observational economic studies. Gains in school years attributable to scaling-up SQ-LNS to 90% coverage ranged from 0.14 million school years (95% uncertainty interval [UI]: 0.064, 0.25) in Burkina Faso to 1.18 million school years (95%UI: 0.54, 2.11) in Pakistan per five-year birth cohort. With an effect size of 18% return in income per one standard deviation increase in development, the estimated gains in lifetime income ranged from $US 0.41 billion (95% UI: 0.20, 0.68) in Burkina Faso to $US 6.91 billion (95% UI: 3.32, 11.4) in Pakistan per five-year birth cohort. Returns in income per child were above the estimated per child cost of providing SQ-LNS. These findings demonstrate that scaling-up SQ-LNS among children aged 6-24 months may lead to substantial human capital gains in countries with a high-burden of child undernutrition. Longitudinal studies on the long-term effects of SQ-LNS are needed to refine model parameters and to better characterize the impacts on broader health and human capital outcomes.