Labour-saving technology in Ethiopia is increasing child malnutrition

Development initiatives designed to improve people's health may sometimes have unintended consequences. Introducing labour-saving technology to a rural area improves mothers’ energy levels. But, without contraception, greater energy reserves also mean higher birth rates. What happens when local resources fail to keep up with the resulting population growth?

Researchers fromthe University of Bristol and University College London, UK, studied the impactof a water development scheme on women and children from a community in Arsi, southernEthiopia. Arsi is a drought-prone area which suffers from chronic foodinsecurity. There is no free land available for farming, little for herding, andeconomic opportunities are very limited.

Water shortages inthis area can be severe. Traditionally, women have done the bulk of the watercollection, transporting it on their backs over distances of up to 30kilometres. Between 1996 and 2000, tap stands were installed in some villagesin Arsi, reducing the energy and time women spent carrying water during thedriest months from around three hours to just 15 minutes. But has the effect ofthis technology been wholly beneficial?

The researchers collectedinformation from nearly 2,000 households to assess the impact of the technologyon fertility and child mortality rates. They found that, while infant mortalitydeclined in areas with improved water access, the birth rate also increased,making household resources more scarce. Indeed, children living in villageswith water access were at a much greater risk of being malnourished than thosewithout water. Results showed that:

• A woman with access to water taps wasthree times more likely to give birth in any given month than a womanwithout an improved water supply.
• A shorter gap between births (lessthan 23 months) was associated with an increased risk of death for theyounger child.
• Early child death and stoppingbreastfeeding early were key factors in shorter birth spacing.
• Access to water taps did not improvewomen’s health or nutrition.
• Children who were born after the tapinstallation had lower nutrition levels than those born before the tapswere installed.
• There were no reported differences inbreastfeeding practices or in use of contraception, which remained very lowafter the tap installation.

The researchers arguethat women’s nutritional status did not improve with the labour-savingtechnology as their energy was diverted to higher birth rates. Higher fertilitycombined with lower infant mortality is fuelling population growth in Arsi,making existing economic problems worse and increasing rates of childhoodmalnutrition. They conclude that:  

• Future development initiativesdesigned to improve maternal and child health must include a familyplanning component if they are to avoid the problem of increased familysize, particularly in areas with limited resources.
• Development programmes need to be multi-sectoral;those that focus on just one issue (such as water supply) can causelong-term problems.