A growing body of literature suggests that in utero exposure to hunger negatively affects
children’s survival and linear growth. In this paper, we retrospectively linked data on local
agricultural output and household food reserves during the in utero period to children’s health
and nutritional status in the first five years of their life. We hypothesized that seasonal variations
in agricultural yields and food reserves affect the quantity and diversity of food intake during
pregnancy, and that pregnancies during periods with limited food reserves are associated with
poorer child health outcomes. We generated a food reserve scarcity index (FRSI) based on
reported food stocks at the household level reported in post-harvest surveys from 2001-2007 and
estimated associations with child survival, birth size and World Health Organization (WHO)
growth Z scores using multivariable regression model. We found negative and statistically
significant associations between children’s weight and height Z-scores (WAZ and HAZ) and
food scarcity in all trimesters with largest associations for the first and third trimesters. While we
found that food scarcity in the second trimester increases children’s mortality risk, food scarcity
in early gestation had protective effects on mortality. The results suggest that policies aimed at
reducing vulnerability to food scarcity require targeting the vulnerable populations and proper
timing of policies. Policy implications encompass two pathways: One is through nutrition such
as food aid and supplements; And with the recurrence of food scarcity problem, the second more
sustainable solution is through agriculture and extension such as proper food storage.