Why babies are born small in Uttar Pradesh, and how to save their lives | Dean Spears

In today’s episode, host Luisa Rodriguez speaks to Dean Spears — associate professor of economics at the University of Texas at Austin and founding director of r.i.c.e. — about his experience implementing a surprisingly low-tech but highly cost-effective kangaroo mother care programme in Uttar Pradesh, India to save the lives of vulnerable newborn infants.

They cover:
• The shockingly high neonatal mortality rates in Uttar Pradesh, India, and how social inequality and gender dynamics contribute to poor health outcomes for both mothers and babies.
• The remarkable benefits for vulnerable newborns that come from skin-to-skin contact and breastfeeding support.
• The challenges and opportunities that come with working with a government hospital to implement new, evidence-based programmes.
• How the currently small programme might be scaled up to save more newborns’ lives in other regions of Uttar Pradesh and beyond.
• How targeted health interventions stack up against direct cash transfers.
• Plus, a sneak peak into Dean’s new book, which explores the looming global population peak that’s expected around 2080, and the consequences of global depopulation.
• And much more.

In this episode:
• Luisa's intro [00:00:00]
• Why is low birthweight a major problem in Uttar Pradesh? [00:02:45]
• Neonatal mortality and maternal health in Uttar Pradesh [00:06:10]
• Kangaroo mother care [00:12:08]
• What would happen without this intervention? [00:16:07]
• Evidence of KMC’s effectiveness [00:18:15]
• Longer-term outcomes [00:32:14]
• GiveWell’s support and implementation challenges [00:41:13]
• How can KMC be so cost effective? [00:52:38]
• Programme evaluation [00:57:21]
• Is KMC is better than direct cash transfers? [00:59:12]
• Expanding the programme and what skills are needed [01:01:29]
• Fertility and population decline [01:07:28]
• What advice Dean would give his younger self [01:16:09]

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_The 80,000 Hours Podcast_ features unusually in-depth conversations about the world’s most pressing problems and what you can do to solve them.

Learn more, read the summary and find the full transcript on the 80,000 Hours website:
https://80000hours.org/podcast/episodes/dean-spears-neonatal-mortality-kangaroo-mother-care

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