Hang tight while we fetch the video data and transcripts. This only takes a moment.
Connecting to YouTube player…
Fetching transcript data…
We’ll display the transcript, summary, and all view options as soon as everything loads.
Next steps
Loading transcript tools…
Targeting Child Malnutrition in India | Dr. Prakarsh Singh | TEDxAmherstCollege | TEDx Talks | YouTubeToText
YouTube Transcript: Targeting Child Malnutrition in India | Dr. Prakarsh Singh | TEDxAmherstCollege
Skip watching entire videos - get the full transcript, search for keywords, and copy with one click.
Share:
Video Transcript
Video Summary
Summary
Core Theme
This content highlights a successful intervention in India that significantly reduced child malnutrition by combining maternal education through recipe books with performance-based incentives for childcare workers, demonstrating the power of complementary strategies.
Mind Map
Click to expand
Click to explore the full interactive mind map • Zoom, pan, and navigate
let me take you to an urban slum in the
North Indian city of
chandigar here water buffalos and
chickens are looking for their grain of
Life Pools of stagnant water act as
breeding ground for
mosquitoes I cross one such open
sewage and enter the residential area of the
the
slum step into a small room
room
this room houses 25 kids between the
ages of 3 and 6 years and is staffed by
a worker called the angan Bari
worker this daycare center is called an angan
angan
Vari even though there are alphabet
charts on walls there is no
lighting the temperature is over 100° fah
fah
but there are no ceiling
fans I take a picture of these kids and
show it to them many of them haven't
before I weigh all these kids who are
present at the
center and
malnourished this angari in chandigar is
not unique
all around the world 3 million children
die every year because they are
malnourished that's about four times the
size of
Boston half of all child mortality
happens directly because of
undernutrition even though there has
been steep declines in
undernutrition from 1980 to
2015 the global uh malnutrition rate for
instance has dropped from 40% to about
23% much remains to be
outlier on the xaxis here you see
malnutrition rates and on the y- AIS is
the per capita income each bubble here
represents a
country and the size of the bubble is
the population
as you can see India has higher
malnutrition than Ethiopia Democratic
Republic of Congo
Liberia and even though the per capita
income is the same as Ghana the
malnutrition is three times as
high what is the reason that despite
being one of the fastest growing
economies in the last 20
years India's malnutrition has
been declining only very
slowly has the income not trickled down
to the poor that doesn't seem to be the
case the poor are increasing in their
incomes so what could be the reason
behind High malnutrition in India and
undernutrition India's home to over a
third of the world's stunted children
and 1.27 million children approximately
die every year in India because of
worker why it is that almost half the
class is
malnourished she blames the mother she
says that the mothers lack the knowledge
on what to feed the
child they they don't feed the right
amount of calories and
protein now an angeni worker
herself can affect the health of a child
through two main channels she's supposed
to provide a midday meal to the kids one
the porridge Bowl as you can
see um so she's supposed to distribute
this amongst her kids in the class and
the other channel through which she can
change the health of the child
is by talking to mothers and guiding
them on nutrition and health
behavior so the worker blames the
mother I go further into the
slums and interview a mother and ask her
malnourished the mother
mother
state angan Vari is part
of uh the integrated child development
services which was set up by the
government of India in
1975 it's the world's largest Child Care
Program it encompasses over 1.3 million
daycare centers and each Center is
staffed by only one worker so there are
1.3 million workers in India trying to
children these workers are paid very
meager wages their wages are about $50 a
month which is about a tenth of what a
government assistant would earn in in uh
region so she blames a lack of worker
effort the worker doesn't teach me what
I should should cook the worker doesn't
show me that my child is undernourished
the worker doesn't show me the growth
chart that she's supposed to show and
absent so here was a problem the supply
side was blaming the demand side and the
side what could be done so we designed
an experiment in the city of chandigar in
2010 and uh and there were three
components to this experiment the first
component was a recipe book this was
done to address the lack of maternal
knowledge so to speak in the 20056
demographic and health survey for
instance nine out of 10 mothers don't
increase the fluid intake in their
children when their CH child has diarrhea
diarrhea
this is against the recommendation of
the World Health
Organization so we designed a recipe
book in collaboration with the local
food and nutrition
board that contained 10 simple easy
toake nutritious delicious calorific
recipes all of them contain local
ingredients and we said that what if we
just give this to the mothers this would
solve the maternal knowledge problem
hopefully and that could improve the
kids now remember that the mother had
blamed the state so we had to also think
about ways to motivate the worker and
when we had spoken with the workers
workers were obviously they they were
not satisfied with their wages they
wanted their wages to go up for the
amount of work that they were putting in
so we thought of an incentive scheme
wherein the worker would get a
performance-based bonus
and the performance would be based on
the decline in malnutrition that would
happen in her Center so she would get $3
for every child that improved a grade of
malnutrition so if a child went from
severely malnourished to moderately
malnourished that's one grade
Improvement or from moderate to mild
that's another gr Improvement so the
worker would get $3 for nutritional
grade improvements and then we'd also
subtract from the total bonus if there
were kids who declined in their nutritional
nutritional
status so for instance if three kids
went up and one kid went down then the
$6 4,11 children were weighed twice
during the course of this experiment in
2010 in the city of chandigar that I
just showed
you there were three treatment arms the
first treatment was the recipe
group treatment where um about 900
mothers got a recipe
book in the incentive treatment which
was the second treatment and the bonus
treatment for the
worker there were, 1,61
children and 38
workers in the combined treatment again
they were close to a thousand children
and the combined treatment the mothers
got the rescue books and the workers got
the incentives
the intuition behind the combined
tango
perhaps you need both the mother and the
worker to reduce undernutrition and not
one or the
other in economics this is called
complimentarity so to test for
complimentarity we had to test whether
the effect of of the combined treatment
was greater than the sum of the effects
of the recipe treatment and the
incentive treatment and we can
that the fourth group was the control
group where we just follow the kids over
grow and what we
found was very insightful because the
recipe treatment had no signific ific
effect the incentive scheme alone had no
effect and these were precisely
estimated zero
effects but the combined treatment
actually led to a significant drop in
malnutrition which was about 4
percentage points over a
quarter once we discontinued the incentive
incentive
scheme and weighed these kids a year
later they had the the gains that that
they had accumulated initially those
gains had persisted over a
year then we delved into why this
happened what were the mechanisms
driving this increase in weight for age
malnutrition a team of enumerators had
not only weighed these kids but they had
gone to the mothers and interviewed them
both before the treat treat M and after
the treatment at end
line what we found was that workers had
started making more home visits when
incentivized and when they went to the
homes they gave specific nutritional
advice to the mothers when the mothers
had recipe
books so the communication was much more
effective when the mothers had the
recipe books at home and the workers
when the workers were incentive
vised so this
communication Effectiveness actually
drove the complimentarity in Improvement
an improvement of
Weights in turn we also asked mothers
about the diet that they were giving to their
their
kids and we found that mothers improved
children that experiment was carried out
in 2010 since then I've carried out a
similar EXP experiment in Kolkata among
209 daycare
20145 um in 165 daycare
centers in both of these experiments we
have been able to
corroborate a decline in malnutrition of
roughly the same
magnitude every
quarter where workers got
performance-based pay and mothers got information
information
so this has been replicated over and
over again what we've also found is that
just increasing the wage without
conditioning it on the weight gain of
the kids is not as effective so just
increasing the wages as a fixed lump sum
amount is not as effective we found that
making workers compete against one
another is not as effective as just
you might think that after giving it
once if you give it if you implement
this incentive scheme again it would
have no effect but a renewal of
incentives also leads to a decline in
malnutrition of about 4 percentage
points finally withdrawal of incentives
did not crowd out intrinsic motivation
of workers it did not reverse the gains
that the that the children had
accumulated when the incentives were in
place and the main main channel that was
driving this was Mother worker
communication and we in a recent uh
paper I also
find that worker attendance went up so
um enumerators went in randomly and saw
uh whether the workers were present in
their classroom or not and they they
were more likely to be present when they were
were
incentivized now different contexts will
involve different
strategies what we can do is try and experiment
experiment
and sometimes experiments are going to
be successful and when they are
successful in the realm of Early
Childhood nutrition the benefit cost
ratios can be really really
high so think about what happens when a
child is no longer undernourished not
only is that child less likely to die
because of diseases such as diarrhea and
pneumonia but that child is also more
likely to come to
school the child is more likely to have
high higher grades in school to get more
schooling to have higher labor
productivity and eventually higher wages
economists can back out the lifetime
increase in wages and say that's the
benefit of not being undernourished the
benefit cost ratio estimate of the
combined treatment was close to 16 which
means that if you spend a dollar today
on implementing the combined treatment
over a long enough period you're
actually going to get $16 back so it's
in the interests of governments and NOS
and communities to actually
Implement policies that have high
ratios finally Improvement in child
health is just the first step towards
kids realizing their potential and
leading fulfilling lives thank you
Click on any text or timestamp to jump to that moment in the video
Share:
Most transcripts ready in under 5 seconds
One-Click Copy125+ LanguagesSearch ContentJump to Timestamps
Paste YouTube URL
Enter any YouTube video link to get the full transcript
Transcript Extraction Form
Most transcripts ready in under 5 seconds
Get Our Chrome Extension
Get transcripts instantly without leaving YouTube. Install our Chrome extension for one-click access to any video's transcript directly on the watch page.
