How to monitor hunger deaths – Dr. C S Kapse2
To establish adult starvation deaths in a particular community, following criteria is suggested –
Documentation of recent increased deaths rates (monthly, tri-monthly), in the community compared to state averages
Anthropometric indicators below state averages
No mass disasters or other accidents
Reduced food off take from PDS and other indicators of reduces food security like eating unusual foods, increased indebtedness, large-scale out migration for work etc.
Sample dietary histories to assess daily calorie intake, shoe starvation diets (<850 Kcal per day in adults)
Verbal autopsies reveal at least a few deaths in which starvation is an underlying cause of death (irrespective of immediate cause, which may often be infections)
Verbal autopsies should be used only in conjunction with the first five criteria, to document specific starvation deaths. Individual starvation deaths are only extreme examples of the severe nutritional deprivation being suffered by the entire community, and should always be presented in the larger context of community starvation
For children, following criteria may tentatively used to establish malnutrition deaths –
Increased death rates among under-five children compared to state U5MR (under 5 years mortality ratio). An exercise must be done to calculate age specific death rates, and compare this with state average to define increase death rates.
2 Based upon notes provided by the speaker
Report – Two-days workshop on Right to Food
17 and 18 September 2005, Nagpur