There is considerable global evidence on the effectiveness of cash transfers in improving health and nutrition outcomes; however, the evidence from South Asia, particularly India, is limited. In the ...context of India where more than a third of children are undernourished, and where there is considerable under-utilization of health and nutrition interventions, it is opportune to investigate the impact of cash transfer programs on the use of interventions. We study one conditional cash transfer program, Mamata scheme, implemented in the state of Odisha, in India that targeted pregnant and lactating women. Using survey data on 1161 households from three districts in the state of Odisha, we examine the effect of the scheme on eight outcomes: 1) pregnancy registration; 2) receipt of antenatal services; 3) receipt of iron and folic acid (IFA) tablets; 4) exposure to counseling during pregnancy; 5) exposure to postnatal counseling; 6) exclusive breastfeeding; 7) full immunization; and 8) household food security. We conduct regression analyses and correct for endogeneity using nearest-neighbor matching and inverse-probability weighting models. We find that the receipt of payments from the Mamata scheme is associated with a 5 percentage point (pp) increase in the likelihood of receiving antenatal services, a 10 pp increase in the likelihood of receiving IFA tablets, and a decline of 0.84 on the Household Food Insecurity Access Scale. These results provide the first quantitative estimates of effects associated with the Mamata scheme, which can inform the design of government policies related to conditional cash transfers.
Women play important roles at different nodes of both agricultural and off-farm value chains, but in many countries their contributions are either underestimated or limited by prevailing societal ...norms or gender-specific barriers. We use primary data collected in Asia (Bangladesh, Philippines) and Africa (Benin, Malawi) to examine the relationships between women’s empowerment, gender equality, and participation in a variety of local agricultural value chains that comprise the food system. We find that the value chain and the specific node of engagement matter, as do other individual and household characteristics, but in different ways depending on country context. Entrepreneurship—often engaged in by wealthier households with greater ability to take risks—is not necessarily empowering for women; nor is household wealth, as proxied by their asset ownership. Increased involvement in the market is not necessarily correlated with greater gender equality. Education is positively correlated with higher empowerment of both men and women, but the strength of this association varies. Training and extension services are generally positively associated with empowerment but could also exacerbate the inequality in empowerment between men and women in the same household. All in all, culture and context determine whether participation in value chains—and which node of the value chain—is empowering. In designing food systems interventions, care should be taken to consider the social and cultural contexts in which these food systems operate, so that interventions do not exacerbate existing gender inequalities.
•Limited research focussing on the affordability of diets in India.•We model the least-cost means of meeting national dietary guidelines.•We assess the affordability of this least-cost diet against ...wage data.•Diets are highly unaffordable, especially for women.•Greater focus needed on enhancing affordability of nutritious food groups.
In 2015–16 some 38% of preschool children in India were stunted, 21% wasted, and more than half of Indian mothers and young children were anemic. Though widely studied, surprisingly little research on malnutrition in India explores the role of diets, particularly the affordability of nutritious diets given low wages and the significant structural problems facing India’s agricultural sector. To explore this we used nationally representative rural price and wage data to estimate the least cost means of satisfying India’s national dietary guidelines, referred to as the Cost of a Recommended Diet (CoRD), and assessed the affordability of this diet relative to male and female wages for unskilled laborers. Although we find that dietary costs have increased substantially for both men and women, rural wage rates increased more rapidly, implying that nutritious diets became substantially more affordable over time. However, in absolute terms nutritious diets in 2011 were still expensive relative to unskilled wages, constituting approximately 80–90% of female and 50–60% of male daily wages. Overall, we estimate that 63–76% of the rural poor could not afford a recommended diet in 2011. Achieving nutritional security in India requires a much more holistic focus on improving the affordability of the full range of nutritious food groups (not just cereals), a reappraisal of social protection schemes in light of the cost of more complete nutrition, ensuring that economic growth results in sustained income growth for the poor, and more timely and transparent monitoring of food prices, incomes and dietary costs.
•We study the impacts of women’s Self-help group membership on women’s and men’s empowerment.•We measure empowerment using two alternate indices: the A-WEAI and the Pro-WEAI.•We find that SHG ...membership has a significant positive impact on aggregate measures of women’s empowerment.•We also find that SHG membership reduces the gap between men’s and women’s empowerment scores.•The impacts are driven by increase in control over income, decisionmaking over credit, and active involvement in groups.
Women’s groups are important rural social and financial institutions in South Asia. In India, a large majority of women’s groups programs are implemented through self-help groups (SHGs). Originally designed as savings and credit groups, the role of SHGs has expanded to include creating health and nutrition awareness, improving governance, and addressing social issues related to gender- and caste-based discrimination. This paper uses panel data from 1470 rural Indian women from five states to study the impact of SHG membership on women’s empowerment in agriculture, using the project-level Women’s Empowerment in Agriculture Index (pro-WEAI) and the abbreviated Women’s Empowerment in Agriculture Index (A-WEAI). Because SHG membership was not randomized and women who self-select to be SHG members may be systematically different from non-members, we employ nearest neighbor matching methods to attribute the impact of SHG membership on women’s empowerment in agriculture and intrahousehold inequality.
Our findings suggest that SHG membership has a significant positive impact on aggregate measures of women’s empowerment and reduces the gap between men’s and women’s empowerment scores. This improvement in aggregate empowerment is driven by improvements in women’s scores, not a deterioration in men’s. Greater control over income, greater decisionmaking over credit, and (somewhat mechanistically, given the treatment) greater and more active involvement in groups within the community lead to improvements in women’s scores. However, impacts on other areas of empowerment are limited. The insignificant impacts on attitudes towards domestic violence and respect within the household suggest that women’s groups alone may be insufficient to change deep-seated gender norms that disempower women. Our results have implications for the design and scale-up of women’s group-based programs in South Asia, including the possibility that involving men is needed to change gender norms.
•Many development interventions rely on last-mile agents for information delivery.•The ethnicities of beneficiaries or agents could affect intervention effectiveness.•We test this using a field ...experiment with women’s groups in India.•Agents deliver information and elicit willingness to contribute to club good.•Ethnicity matters for information retention and individual contributions.
Development programs often rely on locally hired agents for service delivery, especially for interventions promoting agricultural practices, health, and nutrition. These agents are key to reaching underserved communities, especially women, with information and services around recommended practices. However, where societies are socially stratified, differences in ethnic identities between agents and beneficiaries may impact the effectiveness of information and service delivery and the uptake of recommended behaviors. We explore the salience of shared ethnic identity between agents and beneficiaries in promoting collective action using a field experiment with women’s self-help groups (SHGs) in India. We cross-randomize an information treatment and a group-agent shared ethnicity treatment at the SHG level. We measure impacts on individual group member information retention and willingness to contribute to a group-owned kitchen garden that could improve access to a diverse and nutritious diet. We find information retention is better when the group is matched with an agent lower in the ethnic hierarchy, but that agents higher in the hierarchy elicit greater individual contributions to the group-owned kitchen garden. We suggest some hypotheses for these seemingly contradictory results. Other characteristics like education, group cohesion and perceived agent ability also matter in changing knowledge and contribution. Our findings have important implications for effective program design and implementation, suggesting that implementers need to consider factors beyond the information content, target group and pedagogical mode of delivery for their strategies to be transformative.
•High-frequency indicators of food affordability are unavailable in LMICs.•Agencies invested in food price data after 2008, but not income or wage data.•We propose real wages of unskilled workers as ...a cheap and accurate income proxy.•We show that real food wages declined by 20–30 % in well-known food crises in 2022.•We outline strengths, limitations and scope for improved measurement of real wages.
The affordability of nutritious food for “all people, at all times” is a critically important dimension of food security. Yet surprisingly, timely high-frequency indicators of food affordability are rarely collected in any systematic fashion despite price volatility emerging as major source of food insecurity in the 21st Century. The 2008 global food crisis prompted international agencies to invest heavily in monitoring domestic food prices in low and middle income countries (LMICs). However, food price monitoring is not sufficient for measuring changes in diet affordability; for that, one must also measure changes either in income or in an income proxy. We propose using the wages of unskilled workers as a cheap and sufficiently accurate income proxy, especially for the urban and rural non-farm poor. We first outline alternative measures of “food wage” indices, defined as wages deflated either by consumer food price indices or novel healthy diet cost indices. We then discuss the conceptual strengths and limitations of food wages. Finally, we examine patterns and trends in different types of real food wage series during well-known food price crises in Ethiopia (2008, 2011 and 2022), Sri Lanka (2022) and Myanmar (2022). In all these instances, food wages declined by 20–30%, often in the space of a few months. In Myanmar, the decline in real wages during 2022 closely matches declines in household disposable income. We strongly advocate tracking the wages of the poor as a timely, accurate and cost-effective means of monitoring food affordability for important segments of the world’s poor.
To investigate coverage and equity of India's Integrated Child Development Services programme across the continuum of care from pregnancy to early childhood, before and after the programme was ...expanded to provide universal access.
The programme offers nutrition and health services to pregnant and lactating mothers and young children. We used data from nationally representative surveys in 2005-2006 and 2015-2016, including 36 850 mother-child pairs in 2006 and 190 804 in 2016. We assessed changes in the equity of use of programme services by socioeconomic quintile, caste, education and rural or urban residence. We used regression models to investigate the determinants of programme use.
The mean proportion of respondents using programme services increased between 2006 and 2016, from 9.6% to 37.9% for supplementary food, 3.2% to 21.0% for health and nutrition education, 4.5% to 28% for health check-ups and 10.4% to 24.2% for child-specific services (e.g. immunization, growth monitoring). Wealth, maternal education and caste showed the largest positive associations with use of services. However, expansion in service use varied at the sub-national level. Although overall use had improved and reached marginalized groups such as disadvantaged castes and tribes, the poorest quintiles of the population were still left behind, especially in the largest states that carry the highest burden of undernutrition.
India's policy reforms have increased coverage of the programme at the national level, including for marginalized groups. With further scaling-up, the programme needs to focus on reaching households from the lowest socioeconomic strata and women with low schooling levels.
•Our paper explores the link between women's self-help groups and public entitlements.•It further examines the effect of SHG membership on social networks and mobility.•Empirical strategy employs ...matching methods to correct endogeneity of SHG membership.•Using data from rural India, we find that SHG members are more politically engaged.•SHG members are more likely to know of certain public entitlements than non-members.•SHG members are also more likely to avail of these public entitlement schemes.•SHG members also have wider social networks and greater mobility than non-members.
Women’s self-help groups (SHGs) have increasingly been used as a vehicle for social, political, and economic empowerment as well as a platform for service delivery. Although a growing body of literature shows evidence of positive impacts of SHGs on various measures of empowerment, our understanding of ways in which SHGs improve awareness and use of public services is limited. To fill this knowledge gap, this paper first examines how SHG membership is associated with political participation, awareness, and use of government entitlement schemes. It further examines the effect of SHG membership on various measures of social networks and mobility. Using data collected in 2015 across five Indian states and matching methods to correct for endogeneity of SHG membership, we find that SHG members are more politically engaged. We also find that SHG members are not only more likely to know of certain public entitlements than non-members, they are significantly more likely to avail of a greater number of public entitlement schemes. Additionally, SHG members have wider social networks and greater mobility as compared to non-members. Our results suggest that SHGs have the potential to increase their members’ ability to hold public entities accountable and demand what is rightfully theirs. An important insight, however, is that the SHGs themselves cannot be expected to increase knowledge of public entitlement schemes in absence of a deliberate effort to do so by an external agency.
Effective agricultural extension is key to improving productivity, increasing farmers’ access to information, and promoting more diverse sets of crops and improved methods of cultivation. In India, ...however, the coverage of agricultural extension workers and the relevance of extension advice is poor. We investigate whether a women's self‐help group (SHG) platform could be an effective way of improving access to information, women's empowerment in agriculture, agricultural practices, and production diversity. We use cross‐sectional data on close to 1,000 women from five states in India and employ nearest‐neighbor matching models to match SHG and non‐SHG women along a range of observed characteristics. We find that participation in an SHG increases women's access to information and their participation in some agricultural decisions, but has limited impact on agricultural practices or outcomes, possibly due to financial constraints, social norms, and women's domestic responsibilities. SHGs need to go beyond provision of information to changing the dynamics around women's participation in agriculture to effectively translate knowledge into practice.
•We study a cluster-randomized health and nutrition intervention delivered through self-help groups (SHGs) in Bihar.•The intervention was two-pronged, with a behavior change and a convergence ...component.•We find few impacts on women or children’s anthropometry but large significant impacts on their dietary diversity.•We investigate multiple pathways to impact and compare the cost of this intervention to similar programs.•Despite potential of SHGs, information-only interventions in resource-constrained settings will likely have limited impact.
India accounts for a large proportion of the global prevalence of maternal and child undernutrition, and recent trends have renewed the call for large-scale concerted efforts to improve outcomes. With their reach to millions of rural Indian women, self-help groups (SHGs) offer a possible solution. We provide evidence from a cluster-randomized controlled trial in the state of Bihar of the impact of a health and nutrition intervention that provided behavior change communication to SHG members and worked to strengthen utilization of services. Over the course of 2.5 years, the intervention resulted in a 7% increase in the number of food groups consumed by children and a 30% increase in the proportion of women achieving minimum dietary diversity but had no impact on women’s body mass index or child underweight and wasting. Both knowledge and adoption of key behaviors along the impact pathway improved as a result of the treatment. SHGs certainly have the potential to effect social change and accelerate improvements in maternal and child health and nutrition outcomes, but in resource-constrained settings such as these, information-only interventions delivered through these platforms will likely have limited impact.
PDF
