Working Paper - Dov Chernichovsky


The purpose of this paper is to estimate the level of consumption of food and of nutrients for the Indonesian population; to identify population groups with nutrient deficiencies, to identify the major sources of different nutrients, and to estimate income and price elasticites of demand for both food and nutrients. The survey data indicates that serious deficiencies in all nutrients exist in Indonesia and that the problem is more one of maldistribution than of an overall shortfall in the availability of foods, tending to affect the poorer households. The importance of rice as a contributor of most nutrients is striking. A household utility-maximization model is used to derive the household's demand for food and hence nutrients. For estimation purposes the double-logarithmic function is used. The paper concludes that there is wide scope for nutrition policies based on changes in incomes and relative prices, as food and nutrition consumption respond rather dramatically to such changes. The data also suggest that, although inadequate diets are a greater problem among poorer households, they are also prevalent among the better-off and better-educated. Alleviating malnutrition in Indonesia is a matter of nutrition education as well as one of raising incomes.

  • Country: Indonesia
  • # Pages: 71
  • Publication Year: 1978
  • Type of Media: Scientific Report


This paper evaluates the Profamilia's outreach effort of 1986. Profamilia is an affiliate of the International Planned Parenthood Federation and provides more than 60 percent of Colombia's family planning services. This paper focuses around the question of Profamilia's ability to provide more protection with the same resources. The authors found that: (i) operations tend to be constrained by limited personnel and supplies; (ii) the labor costs and unit costs of contraception are lower in the outreach and clinical programs, which can be expanded with available infrastructure; (iii) the clinical and outreach program is the least cost-effective because of the higher cost of sterilization; (iv) more resources should be targeted to areas where there are proportionately more mothers and where people are better educated; (v) experienced and married workers sell more in the outreach program than their junior unmarried colleagues; and (vi) in both the clinical and surgical programs, output would increase if there were proportionately more nurses and fewer doctors.

  • Country: Colombia
  • # Pages: 113
  • Publication Year: 1991
  • Type of Media: Scientific Report
Dov Chernichovsky, Uri Spiegel, Uri Ben Zion, and Mark Gradstein

Dov Chernichovsky is affiliated with the Department of Health Policy and Management and the Program for Health Policy in Economies Under Stress at the Ben-Gurion University of the Negev in Beer-Sheva, Israel. Uri Spiegel is with the Interdisciplinary Department of Social Sciences at Bar-Ilan University, Israel, and the Department of Economics at the University of Pennsylvania in Philadelphia, Pennsylvania, USA. Uri Ben Zion is affiliated with the Faculty of Industrial Engineering and Management in Technion, Haifa, Israel. Mark Gradstein is with the Department of Economics at the Ben-Gurion University of the Negev.


The supply of food is no longer a major determinant of malnutrition in the developing world. Rather, a lack of purchasing power, ignorance about nutrition, and subjective tastes or preferences prevent some households and individuals from securing adequate diets. Some households spend more on food and other consumer items than would be needed for a minimum balanced diet. Yet they remain malnourished or have nutritionally undesirable diets. Food subsidies and income transfers have been major policy options available to governments to augment household purchasing power and change consumer preferences in order to alleviate malnutrition. Those options have traditionally addressed the problem by considering one critical nutrient and one common staple. The model discussed here provides and demonstrates a solution to the question: What is the combined optimal income-transfer and subsidy programme that would meet particular nutritional requirements with the least budget expense to the government? It is argued and shown, with the aid of an initial model, that a combination of income transfers and food subsidies that consider a range of foods, rather than a single staple, and a range of nutrients, rather than a particular nutrient, may lead to cost-beneficial policies that meet wider nutritional objectives for less cost.


The supply of food is not a major determinant of malnutrition in the developing world. Rather, it is a lack of purchasing power of some households (and nations) that prevents them from securing adequate diets. This is one of the most important conclusions of the recent World Food Summit [1]. This view has been held for more than two decades [2].

In the classical articulation of the diet problem, Stigler [3] concluded that malnutrition is more than a problem of insufficient income to purchase enough food. Indeed, many households, especially in developing economies, probably spend more on food and other consumer items than would be needed for the minimum required diet. Yet many of them remain malnourished, in part because of ignorance about nutrition and in part because of subjective tastes or preferences that may lead to nutritionally undesirable diets.

Consequently, “ignorance” and “tastes” must be considered explicitly in food policies and programmes that in most instances attempt to modify human behaviour by changing incomes and relative prices in the short term, while relevant health education takes root [4].

Price subsidies and income transfers have been major policy options available to governments to augment household purchasing power and alleviate malnutrition [5]. Both income transfers and subsidies, largely confined to a market economy, are, however, innately problematic in that some “leakage,” i.e., support to some “wrong” people and for some “wrong” commodities, is inevitable. In spite of these shortcomings, income transfers and subsidies have major attractions. Compared with the alternatives (e.g., feeding programmes), subsidies and transfers are most effective [2]. They also rely on market rather than on administrative mechanisms. This makes them appealing in developing economies where the share of the market economy is growing but administrations may still be weak.

Through presentation of a basic model, we seek to outline the key parameters involved in the answer to the question: What is the optimal combined price subsidy and income-transfer programme that would meet particular nutritional requirements with the least budget expense? This issue of optimizing and minimizing the total amount of income transfers and subsidies has become especially significant as governments try to reduce their budgets as part of economic structural adjustment efforts.

To start answering the question, we follow earlier work by Reutlinger and Selowsky [2]. Similar to that work, we focus on “market-wide” subsidies and “target-group-oriented” income transfers. We deal also with the same parameters: income and price elasticities to capture consumer behaviour, and income distribution to capture the policy environment. The model also follows empirical research looking into the determinants of household food consumption and nutrition [6]. We depart from the work of Reutlinger and Selowsky and from common policy programmes in several ways. First, we attempt to deal with optimal combinations, from a fiscal perspective, of the alternative policies rather than viewing them as mutually exclusive options. The view that pertinent policies and programmes are mutually exclusive is also evident in the concluding remarks of the review of these policies by Pinstrup-Andersen [5]. Second, we consider a vector of nutrients rather than just one or two. Third, we deal with all foods rather than just with a particular item. A “single-nutrient, single-food” approach may be outright detrimental; it may induce consumption of, say, calories at the expense of some critical vitamins that may be ignored [7].

This paper should be viewed as part of a more general effort to develop a model that would consider optimizing income transfers and subsidies from a nutritional perspective under a variety of budgetary, production, and foreign-exchange constraints [8].


By studying intergenerational benefits from children, this paper shows that the economic analysis of fertility behavior in developing economics can provide a systematic discussion of this behavior. The major hypotheses set forth are: 1) the effect of income on fertility depends on the source and timing of income; 2) in a lifetime context, parents, or would-be parents, who have higher incomes at young ages compared with the income they anticipate at old age, are expected to have a higher demand for children; and 3) the reverse of the latter is predicted for parents who anticipate relatively higher incomes at old age. These hypotheses follow the idea that, in the absence of other appropriate means for intertemporal transfers of wealth, parents even out the lifetime welfare through fertility behavior. Under these circumstances, fertility rates are expected to increase in communities where children abandon their traditional commitments to their aging parents, as may happen during periods of economic and cultural transition. A decline in mortality rates will induce lower fertility. This model suggests that a tax-financed social security scheme along with family planning will be conducive to a reduction in fertility. A test on data from an Indian village in 1968-69 suggests that in a traditional setting there is a correlation between household welfare, measured by income or assets, and the presence of grown children. Income has a positive effect on fertility when the parents' incomes comes from labor rather than human and nonhuman capital which provides income at later stages of life. Longitudinal data depicting income, savings, and fertility patterns over time should prove more promising in exploring the issues discussed.

The purpose of this paper is to investigate the extent to which family income and education are obstacles to the provision of adequate diets for young children in the United States. An examination of the Health and Nutrition Examination Survey reveals the following: 1. Average nutrient intakes of young children are well above recommended dietary standards, with the exception of iron. 2. Average nutrient intakes for children in households of lower economic status are very similar to intakes of children in households of higher economic status. Rates of children's growth are also similar in these households. 3. Family income and education of the household head have statistically significant but very small positive effects on the nutrient intake levels of young children. 4. There are substantial effects of protein intakes on children's height and head growth, even though protein is consumed in excess of dietary standards. This finding and the apparent correlation between children's growth and their intellectual development brings to question the adequacy of present protein standards. Could American mothers, who provide very high protein diets for their children in households at all levels of socioeconomic status know more about what constitutes an adequate diet for their children than the experts do?

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