research and policy advocacy for health & wellbeing in India.

Sanitation

Exploring the causes and consequences of widespread open defecation in India

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Sanitation

Social Inequality

Understanding how social discrimination impacts child and maternal health in rural India

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Social Inequality

Maternal Health

Exploring challenges and policy responses to adequate nutrition in motherhood to improve child health

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Maternal Health

Environment

Understanding the health consequences of climate change and air pollution, and exploring policy responses.

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Environment

Hunger and health: Royal Economic Society video highlights prize-winning r.i.c.e. research

In last few decades, India has seen a declining household per capita average calorie consumption. This throws a puzzle, as over the same time people in India have gotten richer. Dean and Josephine investigate how India’s improving disease environment can explain part of the calorie decline.
Their research matches data on infant mortality rates (IMR) and open defecation with survey data on per capita calorie consumption. They find that between 1988 and 2004-05, districts that had a larger decline in IMR saw a larger decline in household per capita calorie consumption. Also, those households that live in villages where more of their neighbours defecate in open are also the ones that eat more calories on average.
An implication of this research is that as more households use toilets, then the food that government provides to them can be used more efficiently and there could even be cost savings. Not only will children be healthier and more likely to survive, they will also have better nutritional outcomes. Additionally, the money that the government spends on food subsidies can also be put to better use. Access this article here 

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Dean talks to the Institute of Development Studies on what motivated ‘Where India Goes?’

In this short interview, Dean talks to the IDS about what motivated him and Diane to write their book “Where India Goes: Abandoned toilets, stunted development, and the cost of caste.” While the book addresses the puzzle of widespread open defecation in rural India, originally, they were interested in a different puzzle- the puzzle concerning child health and well-being in India.  The statistical data, for example, revealed that India had a higher neonatal mortality and shorter children compared to many other developing countries with lower per capita incomes. In their effort to learn about child health they stumbled at the puzzle of open defecation in rural India.

There is a number of things that make situation tough for children in India. The lower status of women, for instance, means that young mothers do not eat a lot which shows in the health of their babies. Another important reason for this is sanitation and disease environment. India is a place with a very high density of population on one hand and a lot of open defecation on the other hand. Together, they create an environment, especially in rural parts of the northern states,

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r.i.c.e. research in Scroll article on support for breastfeeding

Earlier this month, Scroll published this article calling for more support for women to help them successfully breastfeed their babies.   This support includes not only compensation and time off of work, but also assistance in order to get adequate nutrition in pregnancy and after child birth.

It is very exciting to see r.i.c.e.’s research on maternal nutrition and India’s maternity entitlements program mentioned in the article, referred to as commonly known fact.    For example, the article says that “Forty-two percent of Indian women are underweight during pregnancy,” a finding from Diane’s 2015 paper, Prepregnancy body mass and weight gain during pregnancy in India and sub-Saharan Africa.  And in explaining the cash assistance benefit for pregnant women required by the NFSA, it states that “The cash can help them buy nutritional support through pregnancy and lactation.”  This is a recommendation that Diane and Payal made in their 2016 article, Underweight and Pregnant: Designing Universal Maternity Entitlements to Improve Health, which suggests improvements in the structure of the NFSA’s maternity entitlement to address poor maternal nutrition.

The Scroll article also highlights how the 2016/17 national expansion of the maternity entitlements program actually promises less to pregnant women by adding on new restrictions.  It is good to see this important issue getting coverage –

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Breastfeeding promotion in EPW Engage

Check out Nikhil’s article in EPW Engage in which he explores the government’s current pilot program (Mother’s Absolute Affection, or MAA) to improve breastfeeding.  Breastfeeding is known to help children survive, providing vital nutrition and protection from disease.  Nikhil argues that the current funding allocation and design of the MAA program is unlikely to incentivize frontline health workers to carry out the critical task of breastfeeding sensitization.

Through his work on a small pilot project to encourage first time mothers to initiate breastfeeding early and to continue exclusive breastfeeding in a government hospital in UP, Nikhil describes how effective one on one counseling can be:

Of the 1,236 women, who were first-time mothers and who were visited by a lactation consultant, 74% did not have a good latch on the first try, causing delays and hardships for breastfeeding. After one counselling session, almost a third of the women were able to correct the position of the child for a good latch, allowing the newborn to feed and encouraging the mother to continue breastfeeding.

The government’s interest in this important issue is laudable.  But alongside the MAA program, Nikhil advocates for full-time, dedicated breastfeeding and newborn care consultants at each district hospital across the country.   While monetary resources are essential,

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Where India Goes makes The Hindu’s Top 10 list!

The Hindu recently compiled its list of top ten non-fiction books of 2017, and Dean and Diane’s Where India Goes made the list!  They write:

Coffey and Spears have come out with a deeply researched and thoughtfully written book about open defecation, the role of caste, and the challenges of implementing policy interventions at this scale. They explain why Indian children are stunted, pointing out that poor nutrition is not the only reason.

See the full list here.

 

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