with higher prices for staple food items such as rice and wheat. As discussed earlier, the combined effect of reduced agricultural wages and higher prices is reflected in lower child nutrition status. Mendiratta (2015) also finds for India that all five of the country’s major staple crops are significantly associated with rainfall shocks, indicating that the income of agricultural households is sensitive to rainfall. The importance of the income pathway is also implicit in Kumar et al. (2016), who find that household assets decline during the harvest season immediately following a deficit monsoon season in Pakistan.

Direct evidence of the role of the disease environment pathway comes from three studies that look at the association of rainfall and other weather shocks with diarrheal incidence and illness symptoms such as fever and cough (Tiwari et al. 2013; Portner 2010; Wang et al. 2009). In Nepal, Tiwari et al. (2013) examine the association of current rainfall shock with diarrhea episodes in the two weeks preceding the survey and find a significant, positive association. In a cross-country study of 19 Sub-Saharan African countries, Wang et al. (2009) also find that prolonged rainfall shock (i.e., excess rainfall for two months in a wet season) is significantly associated with higher incidence of diarrhea. The incidence of diarrhea is 2.6 percentage points higher among these children than among children who experienced zero months of excess rainfall in the wet season.<sup>6</sup> In contrast, Portner (2010) does not find significant association in Guatemala between any of the five types of weather shocks he examines and the probability that a child suffered from diarrhea in the two weeks prior to the survey. However, he finds fever and cough among children are more likely, especially as a result of heavy rain. An additional episode of heavy rain in the six months prior to the survey is found to increase the probability of child fever and cough by 25 and 8 percentage points, respectively. Measurement error in the timing of shocks vis-à-vis when these symptoms were collected in the survey is expected to result in attenuation bias. Considering this, the findings collectively suggest the importance of the disease environment pathway.

With respect to the childcare pathway, in India, Mendiratta (2015) hypothesized that negative rainfall shocks that reduce returns on farming could lead to a reallocation of mother’s time away from agriculture and domestic chores towards market activities. Reduced time spent on domestic chores leads to less time spent on childcare, which can undermine child nutrition status. However, the study does not find a significant association of negative rainfall shock with time spent on domestic chores. Moreover, using a more direct measure of childcare–the risk of termination of breastfeeding for those who are 0–36 months old–the study does not find supporting evidence of shocks leading to poor childcare. This is despite the positive effect of the shock on the supply of mothers’ labor in market activities. Also, restricting to the sample for which interviews were conducted during the wet season, the shock is found to have no effect on the probability that a child who was ill in the days prior to the survey sought medical attention, suggesting that this pathway plays relatively little role compared to the income and disease environment pathways.

This conclusion is also supported by Ahmed (2015), who does not find a significant association between rainfall anomalies and the probability that a child is vaccinated, or between rainfall anomalies and the duration that a child is nursed by the mother. This is despite the strong effect of

> 6 Although not introduced as a shock, an increase in average maximum temperature is also found to be associated with higher incidence of diarrhea in this study, while minimum temperature is associated with lower diarrhea rates, further suggesting climatic variations can affect the disease environment.

12