Assessing the impact of COVID-19 on women’s dietary diversity in india using a difference-in-differences approach

The COVID-19 pandemic caused unprecedented economic crises and supply chain disruptions, adversely affecting access to food. The existing studies in India are based on micro-surveys, and show affluent groups improving dietary intake, while poorer sections face food scarcity and reduced nutrient consumption. Using difference-in-differences, this study evaluates the impact of the COVID-19 pandemic on food consumption of women for seven types of foods—milk and curd, pulses and beans, dark green leafy vegetables, fruits, eggs, fish, and chicken and meat—from the nationally representative National Family Health Survey data (N = 1,213,973). Without granular data on pre-pandemic trends, the common trends assumption could not be tested. Instead, matching is used to ensure comparability between treatment and control groups. The results suggest that the pandemic caused an increase in the proportion of women eating nutrient-dense animal products such as eggs, fish, and chicken and meat infrequently by 2.4, 3.2, and 3.8 percentage points respectively (p < 0.001). This is more pronounced in the urban areas—where the prevalence of COVID-19 cases and the disruption of the food supply chain due to the pandemic were greater—than in the rural, and more among poor women. Probably as a compensatory act, consumption of relatively cheaper plant-based foods increased to an extent, as the proportion of women eating pulses and beans, and dark green leafy vegetables infrequently has reduced by 2.6 and 1.3 percentage points respectively (p < 0.001). Increase in consumption of plant-based foods is more pronounced in rural areas where they are more easily available from own agricultural produce or collection from kitchen gardens and common places. The reduction in consumption of animal products also caused a statistically significant reduction in dietary diversity, particularly among the urban poor women (2.6 percentage points; p < 0.01). Given the already low level of consumption of animal foods in India, which is vital for nutrient adequacy, the effect of the pandemic is worrisome. Strengthening of Government food support programmes through the expansion of India’s Public Distribution System and proper implementation of supplementary feeding schemes, such as the Mid Day Meal programme for school going children and Integrated Child Development Scheme for pregnant and lactating mothers and children, is recommended.