Mitigating Poverty And Undernutrition Through Social Protection A Simulation Analysis Of The Covid 19 Pandemic In Bangladesh And Myanmar

The COVID-19 pandemic resulted in severe income losses, but little is known about its impacts on diets and nutritional adequacy, or the effectiveness of social protection interventions in mitigating dietary and nutritional impacts. We first assess the likely impacts of COVID-19 shocks in Bangladesh and Myanmar on poverty and food and nutrient consumption gaps. We then analyze the estimated mitigating effects of five hypothetical social protection interventions of a typical monetary value: (1) cash transfers; (2) in-kind transfers of common rice; (3) in-kind transfers of fortified rice enriched with multiple essential micronutrients; (4) vouchers for a diversified basket of rice and non-staple foods; and (5) food vouchers with fortified rice instead of common rice. The simulation results suggest modest effectiveness of the cash transfers for mitigating poverty increases and little effectiveness of all five transfers for preventing increasing food and nutrient consumption gaps among the poorest 40%. Rice fortification is, however, effective at closing key micronutrient consumption gaps and could be a suitable policy instrument for averting ‘hidden hunger’ during economic crises.

This study addresses the policy-relevant question of how, in the face of major economic shocks, social protection interventions can more effectively mitigate undernutrition. In particular, it considers the scope of scaled-up fortification of staples to avert the “hidden hunger” of micronutrient deficiencies. As a re-cent and still relevant example, it focuses on the kinds of economic shocks brought about by the COVID-19 pandemic which, especially during the first lockdowns of April 2020, resulted in severe job and income losses for the poor and thus reduction and changes in spending, with urban and rural non-farm households typically affected more severely than farm households. However, the findings of this study are relevant for other economic shocks that severely reduce household’s disposable income. In this study, we examine the effects of stylized economic shocks on household incomes in Bangladesh, Myanmar, and Indonesia, with a focus on the difference between recommended and actual consumption of particular foods and nutrients. To this end, we use a novel combination of three integrated models to examine impacts and experiment with different types of social protection interventions. In Bangladesh and Indonesia, these are stylized models of the COVID-19 shock and government lock-downs; in Myanmar, however, we model the economic instability that took place after the February 2021 military takeover, which – in conjunction with COVID-19 impacts – resulted in an estimated 18 percent contraction in GDP (World Bank 2022).

In the decade prior to the COVID-19 pandemic, Myanmar was in the midst of a dietary transition driven by rapid economic growth and urbanization. In this study, we first use national survey data to compare household diets in 2015 to the healthy diet recommendations of food-based dietary guidelines adapted for Myanmar, as well as estimated nutrient consumption relative to recommended intakes. We use these food group and nutrient consumption gaps to estimate a new measure of multidimensional dietary deprivation developed by Pauw et al. (2022), and a novel extension of that index to nutrient deprivation. Both deprivation indices are strongly negatively correlated with total household expenditure. We then use food demand estimation to estimate income and own price elasticities, which reveal strong preferences for animal-sourced foods, but weaker preferences for vegetables and pulses. Expenditure data also point to strong demand for oils/fats – a problem observed throughout developing Asia (Pingali and Abraham 2022) – and for food away from home, which partially explains the rising burden of overweight/obesity in Myanmar. Moreover, since most nutrient-dense foods are income- and price-elastic, estimated income elasticities suggest that recent declines in household income and increases in food prices in Myanmar will result in declining dietary diversity. We show that this is indeed the case utilizing household phone surveys conducted in recent years. We first use a food vendor survey to show that the cost of a healthy diet increased by 61 percent between September 2021 and September 2022. Next, we analyze a rural Dry Zone panel survey implemented 10 times over 2020-2021 and find that maternal and child dietary diversity both declined significantly as Myanmar’s economic situation deteriorated. Then, in a nationally representative phone survey conducted quarterly in 2022 over a period of rapid food inflation, we find further deterioration in diet quality among adults, but no deterioration among children 6-23 months of age, suggesting parents may be trying to insulate their children from the worst effects of the crisis. Finally, we conclude the paper by discussing policy and program options in very difficult political circumstances. Malnutrition is a multidimensional problem requiring multisectoral solutions, but at present the breakdown in the provision of even basic services makes significant progress highly unlikely, and reversing the recent deterioration in dietary quality and nutrition will surely require resolution of Myanmar’s political crisis. In the interim, we discuss three potentially effective types of interventions: (1) rice fortification to reduce micronutrient deficiencies; (2) homestead food production to improve dietary quality in farm households and rural and peri-urban communities; and (3) nutrition-sensitive social protection for vulnerable mothers and young children, with transfers ideally accompanied by nutrition education interventions.

This study assesses the welfare impacts of COVID-19 on households in Myanmar by combining recent high-frequency telephone survey evidence for two specific rural and urban geographies with national-level survey-based simulations designed to assess ex-ante impacts on poverty with differing amounts of targeted cash transfers. The first source of evidence – the COVID-19 Rural and Urban Food Security Survey (C19- RUFSS) – consists of four rounds of monthly data collected from a sample of over 2,000 households, all with young children or pregnant mothers, divided evenly between urban and peri-urban Yangon and the rural Dry Zone. This survey sheds light on household incomes prior to COVID-19 (January 2020), incomes and food security status soon after the first COVID-19 wave (June 2020), the gradual economic recovery thereafter (July and August 2020), and the start of the second COVID-19 wave in September and October 2020. This survey gives timely and high-quality evidence on the recent welfare impacts of COVID-19 for two important geographies and for households that are nutritionally highly vulnerable to shocks due to the presence of very young children or pregnant mothers. However, the relatively narrow geographic and demographic focus of this telephone survey and the need for forecasting the poverty impacts of COVID-19 into 2021 prompt us to explore simulationbased evidence derived by applying parameter shocks to household models developed from nationally representative household survey data collected prior to COVID-19, the 2015 Myanmar Poverty and Living Conditions Survey (MPLCS). By realistically simulating the kinds of disruptions imposed on Myanmar’s economy by both international forces, e.g., lower agricultural exports and workers’ remittances, and domestic COVID-19 prevention measures. e.g., stay-at-home orders and temporary business closures, we not only can predict the impacts of COVID-19 on household poverty at the rural, urban, and national levels, but also can assess the further benefits to household welfare of social protection in the form of monthly household cash transfers of different magnitudes. Combined, these two sources of evidence yield insights on both the on-the-ground impacts of COVID-19 in recent months and the potential poverty reduction impacts of social protection measures in the coming year. We conclude the study with a discussion of the policy implications of these findings.

Myanmar had one of the lowest confirmed COVID-19 caseloads in the world in mid-2020 and was one of the few developing countries not projected to go into economic recession. However, macroeconomic projections are likely to be a poor guide to individual and household welfare in a fast-moving crisis that has involved disruption to an unusually wide range of sectors and livelihoods. To explore the impacts of COVID-19 disruptions on household poverty and coping strategies, as well as maternal food insecurity experiences, this study used a telephone survey conducted in June and July 2020 covering 2,017 mothers of nutritionally vulnerable young children in urban Yangon and rural villages of Myanmar’s Dry Zone. Stratifying results by location, livelihoods, and asset-levels, and using retrospective questions on pre-COVID-19 incomes and various COVID-19 impacts, we find that the vast majority of households have been adversely affected from loss of income and employment. Over three-quarters cite income/job losses as the main impact of COVID-19 – median incomes declined by one third and $1.90/day income-based poverty rose by around 27 percentage points between January and June 2020. Falling into poverty was most strongly associated with loss of employment (including migrant employment), but also with recent childbirth. The poor commonly coped with income losses through taking loans/credit, while better-off households drew down on savings and reduced non-food expenditures. Self-reported food insecurity experiences were much more common in the urban sample than in the rural sample, even though income-based and asset-based poverty were more prevalent in rural areas. In urban areas, around one quarter of respondents were worried about food quantities and quality, and around 10 percent stated that there were times when they had run out of food or gone hungry. Respondents who stated that their household had lost income or experienced food supply problems due to COVID-19 were more likely to report a variety of different food insecurity experiences. These results raise the concern that the welfare impacts of the COVID-19 crisis are much more serious and widespread than macroeconomic projections would suggest. Loss of employment and casual labor are major drivers of increasing poverty. Consequently, economic recovery strategies must emphasize job creation to revitalize damaged livelihoods. However, a strengthened social protection strategy should also be a critical component of economic recovery to prevent adversely affected households from falling into poverty traps and to avert the worst forms of food insecurity and malnutrition, particularly among households with pregnant women and young children. The recent second wave of COVID-19 infections in Myanmar from mid-August onwards makes the expansion of social protection even more imperative.

The COVID-19 pandemic has triggered a global economic crisis from which very few countries will be spared. As a result of few COVID-19 cases, a relatively short-lived lockdown, and economic momentum prior to COVID-19, Myanmar is one of the few developing countries that the World Bank (2020) forecasts will not go into recession in 2020 – a very modest expansion of just 0.87 percent is forecast. A Social Accounting Matrix multiplier analysis by IFPRI projected a 0.50 percent expansion under a fast economic recovery scenario, but a 2.00 percent contraction under a slow economic recovery scenario (Diao et al., 2020). The IFPRI study projects massive declines in GDP across a range of sectors during lockdown periods, including large increases in unemployment (5 million during the lockdown period) and declines in household income of 20 to 30 percent for April to June, albeit with fast recovery thereafter.

Myanmar had one of the lowest confirmed COVID-19 caseloads in the world in mid-2020 and was one of the few developing countries not projected to go into economic recession. However, macroeconomic projections are likely to be a poor guide to individual and household welfare in a fast-moving crisis that has involved disruption to an unusually wide range of sectors and livelihoods. To explore the impacts of COVID-19 disruptions on household poverty and coping strategies, as well as maternal food insecurity experiences, this study used a telephone survey conducted in June and July 2020 covering 2,017 mothers of nutritionally vulnerable young children in urban Yangon and rural villages of Myanmar's Dry Zone.Stratifying results by location, livelihoods, and asset-levels, and using retrospective questions on pre-COVID-19 incomes and various COVID-19 impacts, we find that the vast majority of households have been adversely affected from loss of income and employment. Over three-quarters cite income/job losses as the main impact of COVID-19 - median incomes declined by one third and $1.90/day income-based poverty rose by around 27 percentage points between January and June 2020. Falling into poverty was most strongly associated with loss of employment (including migrant employment), but also with recent childbirth. The poor commonly coped with income losses through taking loans/credit, while better-off households drew down on savings and reduced non-food expenditures. Self-reported food insecurity experiences were much more common in the urban sample than in the rural sample, even though income-based and asset-based poverty were more prevalent in rural areas. In urban areas, around one quarter of respondents were worried about food quantities and quality, and around 10 percent stated that there were times when they had run out of food or gone hungry. Respondents who stated that their household had lost income or experienced food supply problems due to COVID-19 were more likely to report a variety of different food insecurity experiences.These results raise the concern that the welfare impacts of the COVID-19 crisis are much more serious and widespread than macroeconomic projections would suggest. Loss of employment and casual labor are major drivers of increasing poverty. Consequently, economic recovery strategies must emphasize job creation to revitalize damaged livelihoods. However, a strengthened social protection strategy should also be a critical component of economic recovery to prevent adversely affected households from falling into poverty traps and to avert the worst forms of food insecurity and malnutrition, particularly among households with pregnant women and young children. The recent second wave of COVID-19 infections in Myanmar from mid-August onwards makes the expansion of social protection even more imperative.