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

Paper on child height published in EPW

Please check out the Research page to read Dean and my new paper on child height using the NFHS-4 data.  It was just published in the journal Economic & Political Weekly on August 4th.  We discuss the improvements in child height in the last 10 years, compare changes in India to other countries, and try to understand how the factors that influence child height have changed.

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Swachh Bharat Mission Grameen releases a commendable ad to promote twin pit latrines!

The Swacch Bharat Mission Grameen recently launched an advertisement campaign video with Hindi movie stars Bhumi Pednekar and Akshay Kumar. In the video the actors educate viewers about how twin pit latrines work. The ad also teaches viewers how the decomposed feces can be used for greater farming benefits and prosperity.
An important feature of the ad which distinctly stands out is that Akshay Kumar touches the decomposed feces with his own hands. We know from years of field research that misplaced beliefs and untouchability-related barriers around handling of feces is one important reason why such a high fraction of the Indian population still defecates in the open. The message of this advertisement is therefore really important, and its makers should be commended.

For the readers who don’t understand Hindi, here is a translation of the dialogues from the video.
Mishra [M]: [In an astonished tone] So many varieties of flowers and fruits…this is incredible!
Akshay Kumar [AK]: It’s all because of the latrine Mishra.
M: [surprised and with a disgusted look on his face] LATRINE?
Bhumi Pednekar [BP]: [disapproving of Mishra’s tone and disgusted face] Yes, the latrine..and that also with two pits.

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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. 

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