Bharat Rakshak

Shiv, AFAIK the IMR has fallen to 47 now.

Literacy is about 75%.

What is curious is that issue of malnutrition by arm circumference. That so few inferences are being drawn from that is curious.

Sanjay as with many "general rules" in medicine a correlation is discovered between one easily measurable parameter and a more difficult to assess condition and that easy to measure parameter is then used as a substitute for the more difficult to measure one. That means that If someone meets two Pakis who are TFTA and creates a general rule that Pakis are TFTA, anyone who is later found to be TFTA is called "Paki".

In the case of "arm circumference" as a predictor of malnutrition you will have teams of researchers sitting in clinics or going to villages and measuring the arm circumference of children and those measurements are entered into a spreadsheet. Previous research would have shown that if arm circumference is more that X the child is less likely to die from diarrhoea/infections etc, but if the arm circumference is less than Y then the child is more likely to die from those diseases. This is the "clever medical way" of saying "Ah! Plump healthy child" versus "Thin unhealthy child".

Trying to go into more detail/accuracy to detect malnutrition is more difficult. It would require collection and transport of blood samples from children to nearby labs to measure for anaemia and low serum protein levels. At the very least it would require an accurate set of weighing scales. The easiest would be to train a 7th std pass lady as a worker carrying a measuring tape to travel to outlying villages in inaccessible areas and measure arm circumference. No need to carry 4 -5 kg weighing scales, or even 200 syringes, needles and bottles for blood samples requiring separate labelling and far more highly skilled research workers. Hence arm circumference. But the fact remains that it is used because it is easy to be applied to large numbers. It is not necessarily accurate. A lot of children are wrongly diagnosed as malnourished by this method (false positive) and many children declared as well nourished by arm circumference may actually be malnourished (false negative). Not least because there is no clear definition of what is "mid arm circumference" and exactly how tight or how loose the tape measure is held on the arm of a howling, kicking child and you hardly have PhDs doing the measuring.

Typically more detailed research teams would record other things along with arm circumference like, head circumference, literacy of mother, poverty, amount of food available, and community, caste, religion etc.

Putting all these parameters together on a spreadsheet and comparing who has them shows that low arm circumference correlates with malnutrition correlates with poverty correlates with illiteracy correlates with low caste correlates with lack of clean water correlates with low quality food supply correlates with frequent diarrhoeas correlates with infections correlates with high child mortality.

Any single one of these variables can be use as a predictor of any of the others - but since all the others can lead to or hint towards malnutrition and it is difficult to accurately assess any of the others, arm circumference becomes the single focus of predicting that everything else also exists in the population

So the statistics obtained are useful to a lot of people, if you know what I mean - but that does not mean they should not be collected. So once you detect an area where people have children with low arm circumference a lot of people get interested.

Cross Post.. If UP and Bihar and the Gangetic plain from UP all the way to Bengal can become like what the banks of Kaveri, right from Kodagu to Kaveripatnam has become, we would be fine. Panda and it's model can go screw itself. We would be really happy with first world HDI and no poverty.
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Just got back from my son (15 months old) tonsuring / "mundan" ceremony over the weekend yesterday. My dad's ancestral temple is Vaitheeswaran Koil, which is like 15 kms from Mayuvaram (I cannot bring myself to call it Mayiladuthrai, represented by that doofus Mani Shankar Aiyar), which is the area where my dad's forefathers hailed from.

Took the train and got down at Kumbakonam (45 kms away from Mayuvaram) and met my folks who had reached earlier and checked into the hotel. From there we drove down to Gharbha Rakshambal temple, then Uppiliappan Temple, Swami Malai and then drove down to Vaitheeswaran Koil some 65 kms away.

Now, these parts are in the absolute heart of the densely populated (near kerala and higher kind of density, hardly a gap between villages), extremely fertile Kaveri delta lands and had a good look around.

When I look at the photos from my tonsuring ceremony XX years ago (I am just slightly older than Raja Bose, who is over the hill but pretends to be young ) and from what I remember from the visits long long ago, those areas had visible poverty, broken rutted roads, hard manual labor doing the work, and bullocks pulling the plow and women and men harvesting by hand and standing ankle deep in water in sowing season.

Not anymore. The last I went was for my daughter's tonsuring some 6.5 years ago. Then too, the place had become vastly changed, there was even an A/C "deluxe hotel/cottage" kind of thing available (earlier, we used to stay with the priest's family in his house near the temple, now all the streets around the temple, old homes have been pulled down to become "lodges") . But this time, I noticed something radical. I could not see a SINGLE harvest being done manually. I saw dozens of combine harvesters in the winding roads. There was zero poverty, no one looked destitute, few or no beggars compared to what I remember from 25/30 years ago, absolute world of difference. All the houses were pucca, well built, decent sanitation (no more open drains in TN, all underground drainage, massive difference from even a decade ago, and hence far less mosquitoes and foul smell). Places like Kumbakonam, Mayuvaram, Sirghazi etc looked in great shape.

All piss,plogress and plosepelity onree. So basically I would think that in places like those poverty and destitution that one saw some 25 years ago or even as recently as a decade ago has been firmly wiped out, all the HDI indices will he going vertically up and if this continues, those places will start looking chi-chi in another 25 years with very "posh" hotels etc even in places like Vaitheeswaran Koil (there was another one coming up that I saw) and stuff to cater to the folks coming back to their "kul devata" etc.. Think of it , for most folks who trace their roots there places like Swami Malai,Vaitheeswaran Koil are a must go back to and it was great to see that all is well and fine and dandy in those places.

Hmm, so it has taken 60 years since we got rid of the Brits to set things right finally here since the Cholas. But it has been done largely I think.

shiv saar , 400% agree.

My pediatrics prof told us that when she was a ug student there would be 10-15 times as many PEM cases. There were hardly 1-2 PEM cases admitted in the entire hospital (a busy government teaching hospital) at any given time.

In fact in final exams they literally had to look for PEM cases , because the external examiner wanted PEM as one of the long case in the exam . Sometimes residents were asked to look for the case 15 days in advance so that they could be used in the university exam .

The noise about 40 % indians being malnourished sounds beyond preposterous . Those people have perhaps never seen a PEM case in their life .

When I say India is unique, people don't want to believe me. No nation on earth has alowed people of every other country to walk around freely anywhere in the land taking samples and measurements and allowed them to publish whatever conclusion they may reach in the name of research. The numbers are so huge that researchers really cannot do anything but make statistical guesses from faulty measuring "instrument' like a measuring tape wrapped around the arm of a screaming child. You make it a bit tight and the child becomes malnourished. You make it loose and the child is well nourished. You have to measure 100,000 accurately to extrapolate to 100 million children. But you can't do that. So you measure 1000 and extrapolate to 100 million.

After all even measuring 1000 isn't easy. If there are 10 infants in a village, you need to visit 100 villages before you get 1000. Typically you cover 1 village a day (to get other data as well). Check the effort and funds a "researcher" in nutrition would require to take 100,000 measurements. So they will measure the kids who come to hospital as a representative sample. But the kids who come to hospital are sick, so you are getting a biased sample. No one is interested in critical details such as these.

>> So they will measure the kids who come to hospital as a representative sample. But the kids who come to hospital are sick, so you are getting a biased sample. No one is interested in critical details such as these.

Even if the sample is taken from a teaching hospital , where the poorest of the poor come ,the data they are giving is absurdly high. If the data was properly taken mid arm circumference has a decent sensitivity and specificity . But it is operator dependant . Most of the studies that appear seem to be out-rightly dishonest and poorly designed.

http://www.naandi.org/CP/HungamaBKDec11LR.pdf

Above is a much quoted report . Does not even look like a scientific paper. Flashy pictures and graphs are littered in it . Design methodology is poorly explained . When they use Mid arm circumference as a criterion , malnutrition is quite low . But when they use height/age or weight/height 40% population is stunted or wasted . That does not make sense .

Even though I respect the trusties ot the naandi foundation , (they include people like Anand Mahindra) I have a feeling that the above report did not have sincere intentions .

The study is done is poorest 'focus' villages .


There are some good points about the report however. Like it covers percentage babies , breast fed after delivery , household ownership of cell phones etc.

One conclusion I draw from above , is that wherever malnutrition has a higher prevalence social factors are more important than economic ones .For instance , household ownership of cell phones is greater that 60% even in the worst villages . But they have higher malnutrition. In these villages breast feeding is initiated later than it should .

source : http://www.skyscrapercity.com/showpost. ... count=1187

gakakkad wrote:One conclusion I draw from above , is that wherever malnutrition has a higher prevalence social factors are more important than economic ones .For instance , household ownership of cell phones is greater that 60% even in the worst villages . But they have higher malnutrition. In these villages breast feeding is initiated later than it should .

This is absolutely correct on the ground. And has been pointed out numerous times here but try to get these worthies to admit this as being the problem. They want more money, more programs and more outreach what ever that means. They timidly reach the conclusion that mothers need to be 'empowered' without identifying how they are dis-empowered. No addressing of why society is organized in this manner. What is the source of this lack of power.

There are large communities within India, with very low socio-economic status, that have virtually eliminated illiteracy, mal-nutrition and unwanted pregnancies. How did they do it?
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RahulM,

Were you trying to say something. I couldn't pick up any unusual data in that chart.

Other than Manipur's infant mortality number. Wow. How did they do it?

just data mining saar ji. manipur's relatively high edu levels help.

Some glaring results from the above data :
1) AP no better than Bihar !
2) Goa and Kerala with all industrial backwardness way above others.
3) Chandigarh with all high per capita and education not even close to Goa.
4) Punjab and Bengal similar numbers, despite one being commie for 3 decades and other capitalist !
5) Manipur doing really well when compared to Sikkim !

So what is common between Manipur, Goa and Kerala ? More matriarchal tribes ?

Bade wrote:Some glaring results from the above data :
2) Goa and Kerala with all industrial backwardness way above others.

Services trumped manufacturing in these two states. So they are not the economic backwaters (living with "remittances") as is the general wisdom.

Statewise District Domestic Product (DDP) Data
http://planningcommission.nic.in/plans/ ... hdbody.htm