Siblings of children who have died of suspected malnutrition can be assessed. Their anthropometry may show poor nutritional status and this would be supportive evidence
Access ICDS records / records from other sources for weight of deceased child before death if possible.
High mortality for minor infections (e.g. diarrhoea, measles) is itself indicating that the underlying cause of death is malnutrition. We need to compare mortality rate due to the infection in the sample community with ‘standard’ mortality rates for that illness. If say the case fatality rate for measles in a community is 20% compared to the known case fatality rate of 2%, then the ‘measles deaths’ in the community are actually malnutrition deaths in which the terminal event is the measles.
Keeping these broad criteria in mind, the following activities would be needed to carried out for the investigation –
Initial contact with the community, coming to know about the villages affected and anecdotal reports of starvation deaths
Selection of village(s) / hamlet(s) to be taken up for study
Assessment of death rates in these communities during specific recent period
Anthropometric measurements on a sample of adults and children
Dietary survey to assess adequacy of food intake in sample families (can be combined with anthropometric survey)
Assessment of any deteoration in food security in the community, based on data about off take from PDS etc.
Assessing ICDS weight-for-age records for recently deceased children if available
Report – Two-days workshop on Right to Food
17 and 18 September 2005, Nagpur