New Delhi, Feb 26 (IANS): Low-cost investments in maternal nutrition and sanitation programmes can help India exploit its demographic dividend, says the Economic Survey for 2015-16 released on Friday.

The survey, tabled in parliament by Finance Minister Arun Jaitley, stressed that relatively low-cost maternal and early life health and nutrition programmes offer very high returns on investments.

"Investments in maternal nutrition and sanitation and enhancing their effectiveness by changing social norms can help India exploit its demographic dividend," the survey said.

The survey pointed out that early life conditions affect cognitive development in the unborn child.

"A healthy mother is more likely to give birth to a healthy baby. Further, returns on human capital investments vary with the age of the child, being highest for programmes that target young children and in-utero health. Programmes targeting younger children are also relatively cheaper investments."

"Early-life investments are thus a real opportunity for fiscal and capacity constrained governments."

The survey identifies neo-natal mortality as an important indicator of in-utero nutrition.

"Out of all infant deaths in India, 70 percent are in the first month. A leading cause is low birth weight. Underweight women at the beginning of their pregnancy are far more likely to have low birth weight babies," the survey said.

As many as 42.2 percent Indian women are underweight at the beginning of pregnancy in contrast to 35 percent non-pregnant women of child-bearing age who are underweight.

The survey thus highlights that pregnant women are more likely to be underweight. Additionally, Indian women do not gain enough weight during pregnancy.

"Women in India gain seven kg during pregnancy compared with WHO-recommended 12.5-18 kg," the survey said.

The survey also said that another reason for poor maternal health was "social norms" that accord low status to young women in the household.

"This results in stark nutritional differential within households."

"Investing in maternal health could become a top policy priority of the government. The National Food Security Act, 2013, legislating a universal cash entitlement of at least Rs.6,000 for pregnant women is a promising opportunity to improve nutrition during pregnancy. 

The survey recommended pairing cash transfers with education about pregnancy weight gain.

It also said that breast-feeding illustrates how some investments by the state can lead to tangible changes in social norms in a relatively short period of time.

As per the survey, programmes like 'Janani Suraksha Yojana' and other schemes under the Integrated Child Development Scheme delivered via anganwadi programme has increased the proportion of breast-feeding mothers to 62 percent.

The survey said creating a "nudge unit" within the government is a useful way of changing norms.

Coming on the physical development of children, the survey said height-age parameters for children in both rural and urban areas have shown improvement.

The children surveyed during the Regional School Choice Office 2013-14 round are on average taller than those surveyed during National Family Health Survey 2005-06.

However, there is a persistent rural-urban height gap and overall India remains a negative outlier with children being on an average two standard deviation shorter than the healthy average.