Nutrition
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Venue Changed to the Philippines Conference Room

China has recently reformed its health care system with the intent of providing universal coverage for basic health care to every Chinese citizen. Three separate health insurance plans have recently been launched to achieve this objective: the rural newly cooperative medical scheme, urban resident health insurance, and urban employee-based health insurance. Each plan differs substantially in terms of insurers, insured population, premiums, and benefits packages. Using data from the 2009 China Health and Nutrition Survey, Hai Fang will discuss a study that investigates whether and to what extend different health insurance plans have created disparities in health care utilization and expenditure.

Hai Fang is an assistant professor in the Department of Health Systems, Management, and Policy at the University of Colorado Denver, and a research associate in the Kennedy School of Government at Harvard University. He earned his doctorate in economics and master of public health from the State University of New York at Stony Brook in 2006. Before joining the University of Colorado Denver, he taught at the University of California, Davis, and the University of Miami. His research interests include health economics, labor economics, and public health.

Philippines Conference Room

Hai Fang Associate Professor, Department of Health Systems, Management, and Policy Speaker University of Colorado Denver
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Promotion of smallholder irrigation is cited as a strategy for enhancing income generation and food security for sub-Saharan Africa’s poor farmers, but what makes this technology a successful poverty alleviation tool? In the short run, the technology should pave the way for increased consumption, asset accumulation, and reduced persistent poverty among users. Over the longer run, it should lead to institutional feedbacks that support sustained economic development and nutritional improvements. Our conceptual model and review of case studies reveal the importance of three sub-components of irrigation technology—access, distribution, and use—and the ways in which the design of the technology itself can either bridge, or succumb to, institutional gaps. These critical features are illustrated in an experimental evaluation of a solar-powered drip irrigation project in rural northern Benin, which provides a controlled study of technology impacts in the Sudano-Sahel. The combined evidence highlights the technical and institutional requirements for project success and points to two important areas of research in the scale-up of any small-scale irrigation strategy: the risk behavior of water users, and the evolution of institutions that either support or obstruct project replication over space and time.

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Journal Articles
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World Development
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Rosamond L. Naylor

Encina Commons Room 210,
615 Crothers Way,
Stanford, CA 94305-6006

(650) 723-1919
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Professor, Pediatrics
Professor, Health Policy
Professor, Epidemiology & Population Health (by courtesy)
sanders_photo_20153.jpg MD, MPH

Dr. Lee Sanders is a general pediatrician and Professor of Pediatrics at the Stanford University School of Medicine, where he is Chief of the Division of General Pediatrics. He holds a joint appointment in the Center for Health Policy in the Freeman Spogli Institute for International Studies, where he is a co-director of the Center for Policy, Outcomes and Prevention (CPOP).

An author of numerous peer-reviewed articles addressing child health disparities, Dr. Sanders is a nationally recognized scholar in the fields of health literacy and child chronic-illness care.  Dr. Sanders was named a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar for his leadership on the role of maternal health literacy and English-language proficiency in addressing child health disparities.  Aiming to make the US health system more navigable for the one in 4 families with limited health literacy, he has served as an advisor to the Institute of Medicine, the Centers for Disease Control and Prevention, the Food and Drug Administration, the American Academy of Pediatrics, the Academic Pediatric Association, and the American Cancer Society.  Dr. Sanders leads a multi-disciplinary CPOP research team that provides analytic guidance to national and state policies affecting children with complex chronic illness – with a focus on the special health-system requirements that arise from the unique epidemiology, care-use patterns, and health-care costs for this population.  He leads another CPOP/PCOR-based research team that applies family-centered approaches to new technologies that aim to improve care coordination for children with medical complexity.    Dr. Sanders is also principal investigator on two NIH-funded studies that address health literacy in the pediatric context: one aims to assess the efficacy of a low-literacy, early-childhood intervention designed to prevent early childhood obesity; the other aims to provide the FDA with guidance on improved labeling of pediatric liquid medication.  Research settings for this work include state and regional health departments, primary-care and subspecialty-care clinics, community-health centers, WIC offices, federally subsidized child-care centers, and family advocacy centers.

Dr. Sanders received a BA in History and Science from Harvard University, an MD from Stanford University, and a MPH from the University of California, Berkeley.  Between 2006 and 2011, Dr. Sanders served as Medical Director of Children’s Medical Services South Florida, a Florida state agency that coordinates care for more than 10,000 low-income children with special health care needs.  He was also Medical Director for Reach Out and Read Florida, a pediatric-clinic-based program that provides books and early-literacy promotion to more than 200,000 underserved children.  At the University of Miami, Dr. Sanders directed the Jay Weiss Center for Social Medicine and Health Equity, which fosters a scholarly community committed to addressing global health inequities through community-based participatory research.  At Stanford University, Dr. Sanders served as co-medical director of the Family Advocacy Program, which provides free legal assistance to help address social determinants of child health.

Fluent in Spanish, Dr. Sanders is co-director of the Complex Primary Care Clinic at Stanford Children’s Health, which provides multi-disciplinary team care for children with complex chronic conditions.  Dr. Sanders is also the father of two daughters, aged 11 and 14 years, who make sure he practices talking less and listening more.

Co-Director, Center for Policy, Outcomes & Prevention (CPOP)
Chief, Division of General Pediatrics, School of Medicine
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Studies show high levels of anemia, nearsightedness, intestinal worms, and poor health and sanitation among children in China’s rural boarding schools. This project is first measuring initial health and nutrition levels of students in a randomized control setting, then deploying a toolkit of affordable and sustainable interventions in a set of treatment schools that includes multivitamins, eyeglasses, deworming medication, and nutrition and sanitation training for parents and educators. Finally, the project will assess what works and what does not by comparing improvements in academic performance in treatment and control groups. The results of this experiment are intended to inform education and nutrition policy in China at the central and provincial levels.

Walter P. Falcon Lounge

Encina Hall East, E404
Stanford, CA 94305-6055

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Helen F. Farnsworth Endowed Professorship
Senior Fellow at the Freeman Spogli Institute for International Studies
Senior Fellow at the Stanford Institute for Economic Policy Research
Director of the Rural Education Action Program, Stanford Center on China's Economy and Institutions
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
scott_rozelle_new_headshot.jpeg PhD

Scott Rozelle is the Helen F. Farnsworth Senior Fellow at the Freeman Spogli Institute for International Studies and Stanford Institute for Economic Policy Research at Stanford University. He received his BS from the University of California, Berkeley, and his MS and PhD from Cornell University. Previously, Rozelle was a professor at the University of California, Davis and an assistant professor in Stanford’s Food Research Institute and department of economics. He currently is a member of several organizations, including the American Economics Association, the International Association for Agricultural Economists, and the Association for Asian Studies. Rozelle also serves on the editorial boards of Economic Development and Cultural Change, Agricultural Economics, the Australian Journal of Agricultural and Resource Economics, and the China Economic Review.

His research focuses almost exclusively on China and is concerned with: agricultural policy, including the supply, demand, and trade in agricultural projects; the emergence and evolution of markets and other economic institutions in the transition process and their implications for equity and efficiency; and the economics of poverty and inequality, with an emphasis on rural education, health and nutrition.

Rozelle's papers have been published in top academic journals, including Science, Nature, American Economic Review, and the Journal of Economic Literature. His book, Invisible China: How the Urban-Rural Divide Threatens China’s Rise, was published in 2020 by The University of Chicago Press. He is fluent in Chinese and has established a research program in which he has close working ties with several Chinese collaborators and policymakers. For the past 20 years, Rozelle has been the chair of the International Advisory Board of the Center for Chinese Agricultural Policy; a co-director of the University of California's Agricultural Issues Center; and a member of Stanford's Walter H. Shorenstein Asia-Pacific Research Center and the Center on Food Security and the Environment.

In recognition of his outstanding achievements, Rozelle has received numerous honors and awards, including the Friendship Award in 2008, the highest award given to a non-Chinese by the Premier; and the National Science and Technology Collaboration Award in 2009 for scientific achievement in collaborative research.

Faculty affiliate at the Center on Democracy, Development, and the Rule of Law
Faculty Affiliate at the Walter H. Shorenstein Asia-Pacific Research Center
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Scott Rozelle FSI senior fellow; director, FSI/Rural Education Action Program Speaker
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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
rsd15_081_0253a.jpg MD, MPH

Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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Paul H. Wise professor of pediatrics; FSI senior fellow Speaker
Patricia Foo MD/PhD student in economics Speaker
Seminars
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Policies promoting ethanol and biodiesel production and use in the U.S., Europe, and other parts of the world since the mid-2000s have had profound—and largely unintended—consequences on global food prices, agricultural land values, land acquisition, and food security in developing countries. They have also created regional opportunities in the form of agricultural investments, crop yield growth, and booming farm economies. Rising incomes in emerging economies are generating increased demand for transportation fuels, thus stimulating further growth of the global biofuel industry. This seminar will explore the politics, economics, and global food security implications of the expanding biofuel sector. Several policy questions will be raised, including the role of biofuel mandates on food prices, the role of trade policies for stabilizing food prices in an era of increasingly tight demand, and the role of land policies and institutions for feedstock production and income distribution in the developing world.

Siwa Msangi, Senior Research Fellow in the Environment and Production Technology Division at the International Food Policy Research Institute (IFPRI) will provide commentary. Msangi's work focuses on the major socio-economic and bio-physical drivers affecting agricultural production and trade, and their impacts on nutrition, poverty and the environment. Dr. Msangi manages a research portfolio that includes the economic and environmental implications of biofuels, and has coordinated the project Biofuels and the Poor in partnership with FSE.  

Biofuels videos: Roz Naylor talks food security and energy with Near Zero

Bechtel Conference Center

(650) 723-5697
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Senior Fellow, Emerita, Stanford Woods Institute and Freeman Spogli Institute for International Studies,
William Wrigely Professor, Emerita, Department of Environmental Social Sciences
Roz_low_res_9_11_cropped.jpg PhD

Rosamond (Roz) Naylor is the William Wrigley Professor, Emerita, of Global Environmental Policy in the Doerr School of Sustainability; and founding Director of the Center on Food Security and the Environment (FSE) at Stanford University. Her research focuses on policies and practices to improve global food security and protect the environment on land and at sea. She has been involved in numerous field-level research projects around the world with her students and has published widely on issues related to global food systems, food policy, and aquaculture. She is the co-chair of The Blue Food Assessment, an international initiative aimed at providing a comprehensive scientific evaluation of the sustainability, nutrition, equity, and justice dimensions of aquatic foods cultured and captured in freshwater and marine environments within the global food system. She is a Member of the National Academy of Sciences, a Fellow of the American Association for the Advancement of Science (AAAS), Fellow of the Ecological Society of America (ESA), a Pew Marine Fellow, and a Leopold Leadership Fellow. She is also the Chair of the Board of Directors for the Aspen Global Change Institute and a member of the Scientific Advisory Committee for Oceana. At Stanford, she teaches courses on The World Food Economy, Human Society and Environmental Change, and Food and Security.
 

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Rosamond L. Naylor Speaker
Siwa Msangi Senior Research Fellow Commentator International Food Policy Research Institute
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Pinstrup-Andersen, H.E. Babcock Professor of Food, Nutrition and Public Policy and J. Thomas Clark Professor of Entrepreneurship at Cornell University will talk about new evidence on the linkages among agriculture, nutrition, and health, with a special emphasis on sub-Saharan Africa. Currently lost in debate—growing more food does not necessarily lead to better nutrition or health unless other things are put in place. Pinstrup-Aandersen is a world-renowned specialist on undernutrition, health, poverty, and food, and in 2001 was named World Food Prize Laureate.

Eran Bendavid, Assistant Professor of Medicine (infectious diseases) and CHP/PCOR Associate, will provide additional commentary. Bendavid was trained at Harvard Medical School, and is currently a FSE collaborator on a rural health and development project that examines the links between food production, health, water and nutrition in sub-Saharan Africa.

Bechtel Conference Center

Per Pinstrup-Andersen H.E. Babcock Professor of Food, Nutrition and Public Policy, J. Thomas Clark Professor of Entrepreneurship Speaker Cornell University

Encina Commons, Room 102,
615 Crothers Way,
Stanford, CA 94305-6019

(650) 723-0984 (650) 723-1919
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Professor, Medicine
Professor, Health Policy
Senior Fellow, by courtesy, Freeman Spogli Institute for International Studies
Senior Fellow, Woods Institute for the Environment
eran_bendavid MD, MS

My academic focus is on global health, health policy, infectious diseases, environmental changes, and population health. Our research primarily addresses how health policies and environmental changes affect health outcomes worldwide, with a special emphasis on population living in impoverished conditions.

Our recent publications in journals like Nature, Lancet, and JAMA Pediatrics include studies on the impact of tropical cyclones on population health and the dynamics of SARS-CoV-2 infectivity in children. These works are part of my broader effort to understand the health consequences of environmental and policy changes.

Collaborating with trainees and leading academics in global health, our group's research interests also involve analyzing the relationship between health aid policies and their effects on child health and family planning in sub-Saharan Africa. My research typically aims to inform policy decisions and deepen the understanding of complex health dynamics.

Current projects focus on the health and social effects of pollution and natural hazards, as well as the extended implications of war on health, particularly among children and women.

Specific projects we have ongoing include:

  • What do global warming and demographic shifts imply for the population exposure to extreme heat and extreme cold events?

  • What are the implications of tropical cyclones (hurricanes) on delivery of basic health services such as vaccinations in low-income contexts?

  • What effect do malaria control programs have on child mortality?

  • What is the evidence that foreign aid for health is good diplomacy?

  • How can we compare health inequalities across countries? Is health in the U.S. uniquely unequal? 

     

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Eran Bendavid Commentator
Symposiums
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More than two-thirds of the population in Africa must leave their home to fetch water for drinking and domestic use. It is estimated that some 40 billion hours of labor each year are spent hauling water, a responsibility often borne by women and children. Cutting the walking time to a water source by just 15 minutes can reduce under-five mortality of children by 11 percent, and slash the prevalence of nutrition-depleting diarrhea by 41 percent.

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This paper was prepared for Stanford University’s Global Food Policy and Food Security Symposium Series, hosted by the Center on Food Security and the Environment, and supported by the Bill and Melinda Gates Foundation.


Sub-Saharan Africa (SSA) is home to two-thirds of the world’s ultra-poor today. This paper offers current thinking on the structural causes of the spatially concentrated, persistent ultra-poverty that has plagued Africa for a generation and some key entry points for facilitating Africans’ escape from persistent ultra-poverty.

The increased recognition of persistent ultra-poverty has rekindled long-dormant interest in poverty traps. The essence of a poverty trap is that there exists one or more low equilibrium level(s) of well-being in which people appear caught unnecessarily. Small adjustments fail to move people out of those equilibria sustainably. Rather, systems must change, major positive shocks must occur, or both. And in the absence of systemic change, recurring adverse shocks only drive more people into the trap.

The ultra-poverty trap that characterizes much of rural SSA today is intimately caught up with (i) the bidirectional interrelationship among hunger, ill-health, low productivity, weak institutions and natural resources degradation, all of which become manifest in low incomes, (ii) poor initial conditions associated with health and nutrition, especially early in childhood, but also with the state of infrastructure and the natural resource base on which rural livelihood disproportionately depend, and (iii) uninsured risk exposure, which is especially severe in rural areas and in agriculture. The closely coupled nature of these problems adds substantially to the challenge of addressing any one of them on its own and thereby makes integrated strategies essential. 

The available theory and evidence suggests that the policy focus must fall squarely on stimulating a smallholder food productivity revolution. Toward that end, the paper concludes by identifying and explaining key entry points for assisting the escape from persistent ultra-poverty in sub-Saharan Africa.

  1. Build and protect the productive asset endowments of the ultra-poor
  2. Improve the productivity of the ultra-poor’s current asset holdings
  3. Improve risk management options for the ultra-poor
  4. Facilitate favorable transitions out of agriculture

Although the topic of persistent ultra-poverty would seem to lend itself to a pessimistic ending, the future for Africa is actually rather hopeful. The East Asian experience demonstrates that mass, rapid escape from persistent ultra-poverty is feasible. Real agricultural output growth rates are accelerating in SSA, nearly doubling from the 1980s rate so that per capita food output is growing again, helping reduce rural poverty rates in countries enjoying increased agricultural productivity. Finally, the  policymaking and donor communities are now appropriately focusing on how best to stimulate investment incentives, productivity growth, risk management and productive transitions out of agriculture. These broad foci are appropriate and reasonably well-grounded in both theory and empirical evidence.  

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Center on Food Security and the Environment
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