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This week’s Foreign Policy featured an excellent article by Dr. Purnima Menon on malnutrition in India. Given my frustrations, voiced in an earlier blog about the usual finger-pointing at cultural practices, I was heartened to see that Dr. Menon’s analysis took a more structural approach and argued for real social change over ‘more blind handouts’. What does Dr. Menon think is the way forward?

• Social and governance change over more food handout programmes

Recently there has been much debate about various food distribution schemes- should they be expanded, re-targeted, pulled-back. And while these are important short-term solutions, they are unlikely to solve endemic malnutrition in India. When malnutrition rates are estimated at 40% for children, bigger thinking is needed. And as Dr. Menon argues, malnutrition in India is “a story of poor planning, social exclusion, gender inequality, and above all, a government that’s failing to translate new capital into broad prosperity for its people.”

• Strengthen women’s control over family resources

For the past 20 years we have known that women are the key to child nutrition. When women control family resources they tend to spend it on health-seeking behaviours for children unlike men who might spend it on individual consumption. This is why conditional cash transfer programmes like Oportunidades give the bimonthly cash transfers to women. Alcohol is a major leakage of household income- but also high consumption results in domestic violence. And as IFPRI research in Bangladesh shows, women who condone domestic violence have children who are more undernourished than those who do not condone violence.

• Better evaluation of what works and what doesn’t

This is the repeated call in development circles- why don’t we invest in better understanding the impact of interventions? There are large steps being taken by groups such as IHME and 3IE, but when will evaluation become an integral part of every project?

• The Media must be a partner

Dr. Menon points to the key role of the media in shaping social norms about what is acceptable and unacceptable behaviour. For example, a long-running TV serial, Balika Vadhu (Child Bride), tackles issues of child marriage and ostracism of widows by showing the daily struggles and stories of a girl married as a child and another married early and widowed at age 16. The show is among the top 10 most-watched soap operas in India. How can the government partner with the media, and with marketing companies, to better understand how to shape aspirations and norms?

• Good Governance

This is the gap between the progressive rhetoric on paper, and high-level governmental committees on malnutrition, and the reality of implementation where poor planning and corruption erode even the best of intentions. What kind of accountability structures can be put in place?

It is great to see Dr. Menon, a renowned and world expert on malnutrition in India, pushing a progressive agenda of change. This is an ambitious agenda- but is there a problem more salient than the next generation growing up stunted and deprived? Other countries such as Brazil, Mexico, and China have made enormous gains in this area- so what is holding back India? Yes, it will take time but as was said years ago, “A journey of a thousand miles begins with a single step.” My idealism continues.

Devi Sridhar