the comparable death rates in the same area, in the same months during last year or compared with the death rates in a nearby area, which does not have an obvious food deficit. All excess deaths taking place in a situation of significant under nutrition and serious food insecurity, in the absence of any other plausible cause, may be regarded as hunger related deaths unless proved otherwise.
Body measurements on a sample of adults and children- The observed weight of the child should be compared with the standard weight for his/her age and level of under nutrition can be assessed. This exercise should be done for all the children, or a representative sample of children, below the age of five years in the community. It has been documented that mortality rates among children increase several fold when the weight for age is less than 3SD below the norm.
In case of adults (above the age of 18 years), Body Mass Index should be calculated for a representative sample of persons. The number and percentage of adults with BMI less than 18.5. Mortality rates among adults with BMI below 16 are nearly triple compared to rates for normal adults. Thus in adults a BMI of 16 should be used as a cut off point to identify starvation.
Dietary survey to assess adequacy of food intake in a sample of the population; any food intake in an adult that is sustainedly lower than 850 Kcal per day would be incompatible with life in due course and is an indication of starvation.
Assessment of deterioration in food security in the community- From the point of view of Food security, collecting information about PDS, Mid-day meal scheme and ICDS should be a priority. Lack of income leading to inability to access food should be documented. Consumption of unusual items or ‘famine foods’ should be noted,
Report: Two-day state level workshop on ‘Right to Food’
17 – 18 September 2005, Nagpur.