Briefing on the Bihar Child Support Programme, India

Summary of Field Exchange 51 article by Oxford Policy Management (OPM), India

In recent years there has been immense interest in Bihar, India, in combating child malnutrition. Child malnutrition rates in the state have declined over the past decade but remain high in absolute terms. A survey conducted in 2014 found that 40.3% of children under five were underweight, 52% were stunted and 19.2% were wasted. In Bihar, and across India, Conditional Cash Transfers (CCTs) have been suggested as a potential way to address this problem. There is limited evidence so far of the impact of CCTs on nutrition outcomes.

The Bihar Child Support Programme (BCSP) is a pilot scheme in 261 centres that aims to contribute to the evidence base by testing whether a CCT aimed at pregnant women and mothers of young children can help improve child nutrition. Women are registered at the end of the first trimester (three months) of pregnancy and are eligible to receive 250 rupees (US $3.75) per month until their child is three years old if certain conditions are met. There is also a set of bonuses when a child turns two and three years old if a mother has not become pregnant again and if a child is not underweight. In total, a mother can receive up to 15,500 rupees (US$235), conditional on meeting all conditions throughout the duration of her programme enrolment.

The results so far show that, by the end of November 2015, a total of 7,504 women were registered for the programme, 74% of whom met their conditions and received payment. In addition:

• There has been a steady increase in the number of village health days across the programme area;
• The attendance of nurse midwives, other staff and stock availability has improved considerably and;
• This has translated into increased attendance, higher rates of pregnancy weight-gain monitoring, child-growth monitoring and greater receipt of iron and folic acid tablets by pregnant women.

The impact evaluation report will be finalised in 2016 and summarised in a future edition of Field Exchange. This will inform any decision to scale up and contribute to learning for other similar schemes.