title: An energy-saving development initiative increases birth rate and childhood malnutrition in rural Ethiopia.
abstract: BACKGROUND
  Evolutionary life history theory predicts that, in the absence of contraception, any enhancement of maternal condition can increase human fertility. Energetic trade-offs are likely to be resolved in favour of maximizing reproductive success rather than health or longevity. Here we find support for the hypothesis that development initiatives designed to improve maternal and child welfare may also incur costs associated with increased family sizes if they do not include a family planning component.
  
  
  RESULTS
  Demographic and anthropometric data were collected in a rural Ethiopian community benefiting from a recent labour-saving development technology that reduces women's energetic expenditure (n = 1,976 households). Using logistic hazards models and general linear modelling techniques, we found that whilst infant mortality has declined, the birth rate has increased, causing greater scarcity of resources within households.
  
  
  CONCLUSIONS
  This study is, to our knowledge, the first to demonstrate a link between a technological development intervention and an increase in both birth rate and childhood malnutrition. Women's nutritional status was not improved by the energy-saving technology, because energy was diverted into higher birth rates. We argue that the contribution of biological processes to increased birth rates in areas of the developing world without access to modern contraception has been overlooked. This highlights the continued need for development programmes to be multisectoral, including access to and promotion of contraception.
authors.affiliation: Department of Archaeology and Anthropology, University of Bristol, Bristol, United Kingdom. mhairi.gibson@bris.ac.uk
authors.forename: Mhairi A
authors.initials: MA
authors.lastname: Gibson
authors.forename: Ruth
authors.initials: R
authors.lastname: Mace
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001723:Birth Rate; D002648:Child; D046688:Child Mortality / Q000639:trends*; D015362:Child Nutrition Disorders / Q000209:etiology; D003710:Demography; D004734:Energy Metabolism; D005002:Ethiopia / Q000453:epidemiology; D005193:Family Planning Services; D005260:Female; D005298:Fertility; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D012424:Rural Population; D013672:Technology / Q000639:trends*; D014881:Water Supply