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Williams College

Publication Date

Spring 2017

Program Name

India: Public Health, Policy Advocacy, and Community


Indian children have long suffered from some of the world’s worst rates of malnutrition. However, there is an evident mismatch between the macro proliferation of India’s intergenerational cycle of malnutrition and the micro ways in which it is often approached, as established views that place blame on mothers for the poor health status of their children have systematically removed blame from underlying structural determinants of health such as government policies, social inequalities, and economic conditions. Taking a mother-centric approach, this study examines the links between childcare practices and maternal decisionmaking in the context of Dharamshala, Kangra District, Himachal Pradesh. Interviews were conducted with mothers in rural Dharamshala to gain a complete understanding of their childcare decision-making in their respective contexts, as well as with frontline Anganwadi workers, health workers, and staff members of an NGO working for women’s well being in the area. Results indicate that child health outcomes are profoundly impacted by restraints and responsibilities placed on mothers in the rural, agrarian context, and that the provision of affordable and accessible childcare services through the Integrated Child Development Services program and at government-managed worksites is critical to lessening this burden and successfully ameliorating child health inequalities.


Asian Studies | Community Health and Preventive Medicine | Economics | Family, Life Course, and Society | Income Distribution | Inequality and Stratification | Maternal and Child Health | Political Economy | Public Health | Public Health Education and Promotion | Women's Health | Work, Economy and Organizations



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