Impact of Mobile Monitoring on Nutritional Delivery

Client: Department of Social Welfare, Government of Bihar
Partners: International Initiative for Impact Evaluation, DFID, International Growth Centre
Location: Bihar, India
Sector: Governance, health
Dates of service: July 2012 – June 2016
IDinsight services: Policy design support (monitoring system), diagnostic study
IDinsight contacts: Ronald Abraham, Clément Bisserbe
Additional resources: IDinsight baseline study, Bihar’s malnutrition crisis and potential solutions

The Problem

India is home to the largest number of chronically undernourished children in the world.  A significant proportion of that malnutrition burden is borne by Bihar, among India’s poorest states.

Bihar’s Department of Social Welfare (DoSW), with the support of the central government, invests over $250 million annually in the Integrated Child Development Services (ICDS) scheme. ICDS aims to improve the nutritional and health status of young children and mothers through a number of services, one of which is the Supplementary Nutrition Programme (SNP). SNP provides a daily hot meal for pre-school children (aged 3 – 6 years) and take-home rations for children (aged 6 months – 3 years) and pregnant/lactating mothers.

However, poor implementation quality and the lack of accountability structures and monitoring mechanisms result in significant gaps in the delivery of ICDS services and allow a significant proportion of allocated funds to be pilfered.

Evidence Needs

DoSW received support from the UK Department of International Development (DFID) and the Bihar Technical Assistance and Support Team to pilot an Integrated Performance Management System (IPMS). This system uses mobile technology to facilitate bottom-up and top-down monitoring to improve implementation quality. In addition, it supports frontline ICDS workers to regularly interact with mothers to promote appropriate antenatal and postnatal health practices.

IDinsight Service

DoSW appointed IDinsight to evaluate the impact of various components of IPMS across four selected districts through a randomized controlled trial (RCT), and recommend whether to scale IPMS across all 38 districts in Bihar.

IDinsight conducted a quantitative assessment of ICDS nutrition service delivery in Bihar, provided an initial design of IPMS for field-testing and evaluation, developed recommendations on how to update ICDS’ pricing policy for food rations, and conducted a baseline survey as part of the RCT. However, due to severe delays in the implementation of IPMS and multiple leadership transitions in the DoSW, IDinsight was not able to complete the remainder of the RCT.