Wednesday, September 9, 2009

Second day at the child nutrition conference

Started the day listening to an excellent presentation on organizational change. It was presented by a professor of social work who did not use an organizational framework but who made several comments very relevant to economics. In particular, economists (with our sense of rationality of resource allocation) are relatively favorably predisposed toward evidence-based policy and evidence-based practice. The presenter pointed out that the whole movement toward evidence-based anything assumes that there is some rationality and that systems are relatively stable. That can work for biology. It can work for mechanical systems. It rarely works for human systems. We can try to predict how changes in the environment will affect the changes in our interpretation of past evidence but that is not always easy.

Second was on self-efficacy and breastfeeding. The important things here are that health care professionals need to be trained to feel their own-self efficacy with respect to helping moms as well as moms needing to gain self-efficacy. That affects people’s ability to reach their goals (as an economist I would call it productivity). And, all learning—and ultimately all decisions—occur in a social context which shapes people’s perceptions and constraints. Again, all a part of the economic decision making.

Third session focused on training for health visitors and nursery nurses—two types of health care providers my American colleagues will not ever recognize. Key result—if everyone (providers, managers, and mothers) gains knowledge then the outcomes are likely to improve as everyone has better information and resources.

Fourth session was more about evidence. In this session a key finding was that group interventions work better for narrowly targeted rather than broadly targeted groups. This really should be no surprise. It reflects, I think that messages work better when they are for people who have similar information and face similar constraints. One-size-fits-all information sharing is not likely to be a winner.

Other sessions of the day—several have focused on the information that mother’s have available for making decision and how those decisions affect themselves and their families. A key perception is that breastfeeding keeps the father away from the child. While our culture seems to believe that the only way to bond is through feeding, there are so many things that a father can do for the combined well being of the mother and child and there are so many hours of the day that the baby is not feeding that a father should not feel excluded by the mother breastfeeding. Last session of the day talked all about all the things that dads can do. Great day.

One goal for tomorrow is to show that economists really are not so different in the way that we think about the world.

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