The economic implications of noncommunicable diseases on food security and resilience in Malawi

Abstract

Malawi is facing an increase in Non-Communicable Diseases (NCDs) and ongoing food insecurity. Recent reports from the Malawi Vulnerability Assessment Committee (MVAC) indicate that approximately 4.2 million people are expected to experience high levels of acute food insecurity. Additionally, NCDs are now the second leading cause of death among adults in Malawi, accounting for 16 % of all fatalities, with a prevalence of 17 % in males and 14 % in females. Despite the increasing prevalence of NCDs, their specific impact on nutritional status within the context of food security and resilience remains inadequately understood. We assessed the economic implications of NCDs on food security and resilience by utilizing the household dietary diversity score, the food consumption score, and a reducing coping strategy index (rCSI). The study estimated a Propensity Score Matching (PSM) model on a sample of 11,434 households from the Fifth Malawi Household Integrated Survey (IHS5). The results revealed a multifaceted impact of NCDs on food security. Households with NCD-affected members experienced challenges in accessing a balanced diet, with a decrease in the food consumption score of approximately 0.764 units compared with nonaffected households. Additionally, these households demonstrated an increase in their rCSI score of approximately 1.162 units, suggesting reliance on different coping strategies to address food insecurity. The results also indicate that affected households struggled to obtain nutritious meals, with a reduction in their household dietary diversity score of approximately 0.117 units. The findings highlight the importance of integrating health, agriculture, and social protection policies. Expanding initiatives such as the Affordable Input Subsidy (AIP), school feeding programmes and food nutrient fortifications, which not only serve as a social protection measure but also improve food security and nutrition, can have a substantial impact on long-term health outcomes.