Early Childhood Health and Development in India: A Review of the Evidence and Recommendations for the Future

This paper documents temporal trends and interstate and intrastate disparities in child health and cognitive ability in India, and reviews the theoretical and empirical literature on policy interventions that may help ameliorate these gaps. We show that despite rapid improvements in early childhood health across much of India over the past three decades, many areas still experience persistently high rates of infant mortality, low rates of child immunization, and low levels of child academic achievement. We outline a series of interventions with a strong theoretical and empirical evidence base for improving physical and cognitive development of young children in these areas, including improved nutrition and sanitation, parental stimulation, and caretaker focus on cognitive and emotional development of the child. We then describe various challenges that must be overcome before these interventions can be carried out successfully, as other market failures and issues of state capacity are often present. We conclude by recommending that as India scales up programs aimed at early childhood health and development, it must (a) collect extensive data to understand where programs should be deployed in order to maximize their impact and (b) perform rigorous program evaluations to ensure that interventions which have been shown to work in more favorable settings are also successful in the Indian context.