4. Household Food Expenditure, Dietary Diversity, and Child Nutrition in Nepal

Over the past two decades, many developing countries have achieved remarkable progress in improving dietary quality and reducing child stunting rates. But our understanding of the linkages between food expenditures, dietary quality, and nutritional outcomes is limited. Using data from the 1995–1996 and 2010–2011 rounds of the Nepal Living Standards Survey, we study the empirical connections between household food expenditure and nutrition outcomes of children below the age of five years using multilevel and dose–response function approaches. We also examine the effects of dietary quality changes on child nutrition improvement between 1995 and 2011 employing Blinder–Oaxaca decomposition. We find that number of food groups consumed, monthly food expenditure, dietary diversity, and the expenditure shares on fruits and vegetables and animal protein have a positive impact on the expected height-for-age Z-scores. The dietary changes explain about 71% of the improvement in those scores between 1995 and 2011, underscoring the importance of dietary quantity, dietary diversity, and nutrient-dense food items for child nutrition outcomes.