09 May 2010

Does Policy Matter?

As the UK's Conservative and Liberal Democrat parties hash out post-election policy positions in a bid to form a coalition, an article last week in the influential Hindustan Times caught my eye.

An editorial by Abhijit Banerjee at the MIT Poverty Action Lab argued that policy and legislation cannot do much to reduce undernutrition if even wealthy Indian parents do not give their children the right food, water, sanitation, care and health to achieve a good height for age. He focuses mainly on food, which is a live issue right now given the pressure the Right to Food campaign is piling onto the Indian Government.

But there are a number of problems with this line of reasoning.

1. Is food the most important determinant of undernutrition in South Asia? Actually, no. According to peer-reviewed studies I have been involved in, the main driver is the low status of women. Women's low status drives choices about water, sanitation, health, and food. The status of women is something that is amenable to public policy. Policy can affect legislation around equal benefits and working conditions, a greater equality of economic opportunities and equal political representation in a range of decision making.

2. Prof Banerjee's arguments on the ineffectiveness of policy per se are countered by the wide variety of undernutrition rates within India. The states that have been most successful in combating undernutrition (Kerala, AP, Tamil Nadu) are those where their political leaders --and citizens-- have made it a priority.

3. Evidence from South East Asia shows how policy can make a difference. A recent paper on from Vietnam shows how the incredible success in reducing undernutrition in that country over a 10 year period starting in the mid 90s was half attributable to Vietnam's rapid economic growth and half to the strategic investments made in the health system by the Vietnamese Government.

At the national level neither India's rapid economic growth nor its current policies seem to be reducing undernutrition. But this is not inevitable. This is not a curse. This is something that policy and leadership can change.

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