There is a very active and informed debate in India about what to do about infant undernutrition. My previous blog gives you an idea of the nature of the malnutrition problem-- all the more stark given it is against a backdrop of dazzling economic growth.
The IDS Bulletin on this issue was the latest opportunity to temporarily intensify the debate. I spent several days in meetings with senior members of the Planning Commission, the Ministry of Women and Child Development, the Ministry of Health and DFID India. The senior policymakers I met in India are very knowledgeable about the extent of the problem, the causes and the consequences.
They are, however, bombarded with a large number of solutions, many of them driven by single-intervention campaigners. There is a real need to focus. But how? Perhaps the first step is to focus by age group. The 0-2 age group is the period when the die is cast in terms of the development of the child, so this is an obvious candidate. But which intervention?
The consensus is that breastfeeding is the most effective behaviour for reducing infant mortality. But “exclusive breastfeeding” for the 6 months is not an easy message to understand and its practice is challenging for a mother who may be malnourished herself and without the support of family, community and employers. So focus more--on promoting breastfeeding within the first hour of life ("one hour to save a life"). For attended birthing, this seems feasible, but perhaps less so for unattended births.
The week was a good example of how a modest research report, with influential backing, can serve to temporarily engage the media and energise the community. It was also a good reminder of how senior policymakers are always looking for the “first thing” to do to navigate through complexity and a reminder of how researchers like me are initially reluctant to make that “first thing” recommendation.
Here is the presentation I made at the IDS Bulletin launch
Launch of Bulletin