Role of Government Financial Support and Vulnerability Characteristics Associated with Food Insecurity during the COVID-19 Pandemic among Young Peruvians

Peruvian households have experienced one of the most prevalent economic shocks due to COVID-19, significantly increasing their vulnerability to food insecurity (FI). To understand the vulnerability characteristics of these households among the Peruvian young population, including the role of the government’s response through emergency cash transfer, we analysed longitudinal data from the Young Lives study (n = 2026), a study that follows the livelihoods of two birth cohorts currently aged 18 to 27 years old. FI was assessed using the Food Insecurity Experience Scale. Household characteristics were collected before and during the COVID-19 outbreak in Peru to characterise participants’ vulnerability to FI. Multivariate logistic regression was used to evaluate the association between government support and participants’ vulnerability characteristics to FI. During the period under study (March to December 2020), 24% (95% CI: 22.1–25.9%) of the participants experienced FI. Families in the top wealth tercile were 49% less likely to experience FI. Larger families (>5 members) and those with increased household expenses and decreased income due to COVID-19 were more likely to experience FI (by 35%, 39% and 42%, respectively). There was no significant association between government support and FI (p = 0.768). We conclude that pre-pandemic socioeconomic status, family size, and the economic disruption during COVID-19 contribute to the risk of FI among the Peruvian young population, while government support insufficiently curtailed the risk to these households.

Longitudinal association between food frequency and changes in body mass index: a prospective cohort study

ObjectivesAnalysing data of the Young Lives Study in Peru, we aimed at assessing the association between daily food frequency and body mass index (BMI) changes between 2006 and 2016.DesignSecondary analysis of a prospective ongoing cohort study.Setting20 sentinel sites in Peru.ParticipantsChildren enrolled in the younger cohort of the Young Lives Study. We used information from the second (2006–2007), third (2009–2010), fourth (2013–2014) and fifth (2016–2017) rounds of the younger cohort in Peru.Primary and secondary outcomesBMI as well as BMI-for-age z-score, both as numerical variables.ResultsData from 1948 children, mean age 4.3 (SD: 0.3) years and 966 (49.6%) women were included at baseline. In multivariable model, lower food consumption frequency was associated with increased BMI and BMI-for-age z-scores: children reporting <4 times of food consumption per day had a greater increase in BMI (β=0.39; 95% CI 0.17 to 0.62) and BMI-for-age z-score (β=0.07; 95% CI 0.01 to 0.13) compared with those reporting 5 per day. Results were consistent for those reporting exactly eating 4 times per day (β for BMI=0.16; 95% CI 0.02 to 0.30 and β for BMI-for-age z-score=0.05; 95% CI 0.01 to 0.09).ConclusionsChildren who eat <5 times per day, gain more BMI compared with those who eat ≥5 times. Parents should receive information to secure adequate nutrition for their children, both in terms of quality and quantity.

COVID-19 and the ‘Ethics of Disruption’: Current Dilemmas Facing Longitudinal Research in Low- and Middle-Income Countries

In this paper, we draw on recent experiences from the Young Lives study to discuss some of the ethical and practical challenges facing longitudinal cohort studies in low- and middle-income countries in the time of coronavirus. We argue that COVID-19 has instigated an &lsquo;ethics of disruption&rsquo; for social researchers across the world, and for longitudinal cohort studies like Young Lives, this requires navigating three core considerations: first, managing research relationships and reciprocity within an observational study design; second, maintaining methodological continuity and consistency across time; and third, balancing an immediate short-term response to COVID-19 against the longer-term perspective. We refer to the study&rsquo;s plan to implement a new COVID-19 phone survey to illustrate how the team are navigating this altered ethical terrain.

Conclusion: Learning from the experiences of Young Lives children

This concluding chapter summarises key messages and reflects on what has been learned from running the Young Lives study. There are six key reflections from the Young Lives study. First is the value of talking to children themselves in both qualitative and survey research. Second is the value of multidisciplinary perspectives for public policy research. Third is the centrality of maintaining respectful and effective engagement with research participants. Fourth is the importance of long-term partnerships for effective research and policy engagement. Fifth is the usefulness of international comparison and the balance between this and national specificity. Finally, it is important to value the type of knowledge a study like Young Lives generates. Young Lives is a resource that can be used by future researchers to extend the boundaries of what is known about children, poverty, and human development.

The Young Lives design and conceptual framework

This chapter outlines the Young Lives study design and conceptual framework. Child development is fundamentally shaped by the national, community, and family contexts in which children live, and by the relationships within which skills, beliefs, and wellbeing are fostered. As such, fully understanding children's development through the life course requires a broad framework that includes attention to the many structures and processes affecting caregivers, families, and households, as these in turn affect children. The bioecological model provides the core conceptual basis for the Young Lives study, identifying the many layers and influences on children's development, and encouraging an analysis of how those wider structural determinants shape poverty and inequalities facing children. Since the cascade approach helps explain how advantages and disadvantages accumulate, it provides a policy tool to assess the factors that make the greatest difference for which children and at which point in their lives.