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2019-07-11

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Developmental Issues
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The Integrated Child Development Services (ICDS) scheme is one of the world’s largest programmes for early childhood care and development. Now, a new study suggests that nutrition and health counselling delivered under the programme’s auspices is one of the best possible investments that can be made by any government.

This timely, non-partisan report is by India Consensus, a partnership between Tata Trusts and Copenhagen Consensus, which has undertaken a first-of-its-kind analysis of 100 government programmes. These were identified by NITI Aayog for their role in supporting India’s efforts to achieve the Global Goals.

The Global Goals have a dizzying array of 169 targets, such a long list that no country on Earth can achieve all of them. That’s why the unique India Consensus economic analysis approach is vital: it adds new knowledge about costs and benefits. This way, it can be clearer which programmes achieve the most good for every rupee spent.

Researchers have identified twelve programmes that have phenomenal benefits for every rupee spent. Among the top programmes is nutrition and health counselling.

As a behavioural change intervention, nutrition and health counselling is relatively low cost for every person that is reached. It’s important to note that this programme does not provide food, but instead provides information to the mother, making it more likely that the child will receive more and better food. And that in turn leads to lifelong benefits.

Many studies have now demonstrated that these benefits can be large. Improving the nutrition and health outcomes of the children of mothers reached makes this a highly cost-effective intervention.

Two analyses were undertaken in Andhra Pradesh and Rajasthan, looking at a six-year campaign of nutrition counselling and hand-washing. The average cost of counselling sessions for each woman was estimated at ₹1,177 and ₹1,250 for Andhra Pradesh and Rajasthan respectively. Based on previous studies, it is estimated that counselling leads to a 12% reduction in stunting. This leads to better cognitive skills.

Quantifying the increase in earnings shows that the per unit benefit for Andhra Pradesh and Rajasthan comes to ₹71,500 and ₹54,000.

What these figures mean is that the investment generates returns to society worth ₹61 and ₹43, respectively, for every rupee spent. While the analysis will differ for other States, these results show that nutritional counselling is a phenomenal investment. It’s relevant to note that these figures take into account the challenges of nutrition counselling: it’s a relatively difficult intervention to implement and ensure that every person is reached. But even if India’s implementation problems were worse than other countries studied by researchers, it is unlikely to make the investment less impressive. The takeaway point is that, among all the ways that the Indian government is spending money to achieve Global Goals targets, adding additional resources to nutrition counselling would be a phenomenal investment.

The preliminary results of this analysis show that there are many policies that can achieve amazing outcomes. If India were to spend ₹50,000 crore more on achieving the Global Goals, focussing on the most phenomenal programmes identified so far by India Consensus would create extra benefits for India worth ₹20 lakh crore — more than the entire Indian public consumption.

With returns like this at stake, there are compelling reasons to look favourably at approaches including nutrition counselling.

Bjorn Lomborg is president of the Copenhagen Consensus Center.

Shireen Vakil heads the Policy and Advocacy unit of the Tata Trusts

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