research institute for compassionate economics

Maternal Health

Healthy, well-nourished mothers are more likely to raise healthy, well-nourished children. This is in part because women provide nutrition to their children during pregnancy and through breastfeeding. In fact, women’s bodies provide much of the nourishment for growing children during the crucial first 1,000 days of life, when the course of their physical and cognitive development is determined. Thus a mother’s net nutrition has large effects on her child’s early-life human capital accumulation and therefore on the child’s life chances.

Unfortunately, India, which is home to one fifth of the world’s births, has no monitoring system to track maternal nutrition indicators such as pre-pregnancy body mass and weight gain during pregnancy. Further, there is no monitoring system that records how many babies are born at low birth weights. However, evidence suggests that despite its economic progress, India has among the highest rates of low birth weight in the world.  One way that we know that low birthweight is a big problem is that a large number of babies die in the first month of life. A national survey has shown that low birth weight is the leading cause of these deaths.

Poor maternal nutrition is a major cause of low birth weight.  r.i.c.e. research on maternal nutrition using Demographic and Health Surveys find that a large proportion of women are underweight before they become pregnant and do not gain adequate weight during pregnancy.

Government programs are not doing enough to address poor maternal health

Janani Suraksha Yojana (JSY)

India’s largest program for improving neonatal health and preventing neonatal deaths does not focus on improving maternal nutrition, and improving birthweight but rather on encouraging women to give birth in hospitals.  The JSY scheme has used cash incentives to increase the number of births in hospitals, but neonatal and maternal mortality have not improved as a result.  A recent r.i.c.e. study found that the JSY cash transfer to new mothers is actually much less than the government advertises because much of it is used to pay for deliveries, which are supposed to be free.  Like many other studies of the JSY program, this study also finds that women receive abysmal health care both before and during delivery, and are often mistreated at the hospital.

Integrated Child Development Services (ICDS)

The ICDS is a program that is intended to give food to pregnant women and young children. However, the program is very poorly implemented, especially in the states with the most undernourished women. Thus, it has done little to improve maternal nutrition.  Less than 30% of women received any food supplements from the government’s ICDS program during their last pregnancy, despite the fact that ICDS is intended to be universal.

Pradhan Mantri Matru Vandana Yojana (PMMVY)

The PMMVY is a conditional cash transfer to pregnant women and new mothers that is being rolled out by the government.  The program was designed in response to the 2013 National Food Security Act (NFSA), which legislated a maternity entitlement of not less than 6,000 rupees to pregnant and lactating mothers.  Despite the NFSA’s mandate that the maternity entitlement be given for each pregnancy, program guidelines limit the transfer to a woman’s first birth.  The program should be expanded to cover all births rather than just the first, and funds should be given early in pregnancy so that they can be used to promote nutrition during pregnancy.  The government should also educate families about the importance of weight gain and encourage them to use the funds to invest in the pregnancy.

What is r.i.c.e. doing now?

r.i.c.e. is advocating for PMMVY to be designed and implemented in a way that promotes maternal nutrition.  We also advocate for better monitoring of maternal and infant health, and are analyzing newly released data from the NFHS-4 to better understand changes in maternal and infant health in India in the last decade.



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