ICDS : Rs. 6/day to address severe malnutrition?

Children in the age group 0–6 years constitute more than 13% of the population of India. Ministry of Women Child Development is implementing various schemes for survival, development and protection of children. The Integrated Child Development Services (ICDS) Scheme is one of the flagship programs of the Government of India and represents one of the world's largest programs for Early Childhood Development.

Revised Supplementary Nutrition Norms

Provision of supplementary nutrition under ICDS is primarily designed to bridge the gap between the Recommended Dietary Allowance (RDA) and the Average Daily Intake (ADI). On an average, the effort is to provide daily nutritional supplements to the extent indicated here in this chart.

I am still thinking how can a child between age group 6 month to 72 months suppose to address severe malnourished state with Rs. 6 per day? 

His nutrition needs can only be met by a variety of quality foods which includes Cereal and grains, rice, milk, seasonal fruits, vegetable soups etc. With due respect to government efforts and ICSD scheme, common sense tells me that its not possible.  

Grandma technique to control blood sugar

Finally it happened to me as well. I must say Diabetes is an interesting phenomenon in your life. The day you know you are diabetic or prone to high blood sugar, your life changes. The doctors start discussing side effects of high blood sugar levels and that’s when you realize, you are in trouble.

There are several factors which could be root cause for high blood sugar levels which includes stress levels, unhealthy diet, alcohol and smoking and also family history.  I am not the expert in blood sugar control however I did ponder on various articles, books and journals to understand what goes in increasing the blood sugar levels and how can I control it.  The fact is each person is different, have different tendencies and provide different response to any activity. So you need to experiment with yourself to understand how your body responds to food intake, exercise and medicines.

Scientifically, sugar travels in your blood as glucose, an important energy supply for your cells. Insulin is a hormone that helps move glucose from your blood into your cells. When body either fails to produce insulin or reacts abnormally to insulin that is present, the cells are unable to use glucose and levels of glucose in your blood become too high. If this condition becomes severe, diabetes may result.

I have a strong family history with regards to diabetes. So I knew since beginning its goanna hit me someday and it did. I began taking precautions the day i realized some consistent reading of above normal level blood sugar. Thankfully I am at the initial stages and can use preventive techniques. There is no substitute to exercise, minimum 45 minutes of exercise every day is necessary. Stay active and you will see the difference. Apart from exercise I am seeing good benefits including Fenugreek seeds in my diet on regular basis.

Fenugreek is a food and a spice commonly eaten in many parts of the world including India. Fenugreek is used for centuries by practitioners of Ayurveda and Traditional Chinese Medicine. It contains several biologically active components that may help lower blood sugar. It’s proved by several research practitioners that it does help in both the types of diabetes Type I and Type II.  

There are other herbs like Cinnamon and bitter melon can help you to control the blood sugar apart from your regular medicine prescribed by doctor.

In case someone in interested in going through research indicators, I found this document quite informative http://www.diabetes.org.in/journal/1992_april-june/article4.pdf 

Cost of Malnutrition to the Nation

I am moved by the report on malnutrition in India. I bumped onto very informative article and presentations from Dr. Veena Rao, Former Secretary to Govt of India with Domain expertise on Malnutrition. I thought will bring some insights into this subject. 

Interesting finding is that relatively small number of states, districts, and villages account for a large share of the burden – 5 states and 50 percent of villages account for about 80% of the malnutrition cases.

According to World Bank - The prevalence of child undernutrition in India is among the highest in the world; nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth.

Yes, this is eye opening that Malnutrition negatively impacts the GDP as it reduces physical/ cognitive growth of an individual by impacting the productivity (earnings of individuals) thus results in economic loss to the nation.

Malnutrition lowers the resistance of the body to infections and capacity to recover from illness and adds to the health costs of the nation. Protein Calorie Intake, Micronutrient Intake, Infections and illness, Nature of Occupation determine working capacity and income generation capacity

According to her research 4% of GDP is lost on account of malnutrition and its various types of manifestations. How? 

• Total no. of households in India= 193,579,954 (Census of India 2001)

• 30% of households =58,073986 consume less than 70% of energy requirements (NNMB Repeat Surveys in 1988-90 and 1996-97)

• Norm level of calorie intake: 2700Kcal

o Actual Calorie Intake: 1890 Kcal (70% of 2700Kcal)

• Energy required for Basal Metabolic Rate (BMR): 1515 Kcal

• Calorie left for productive work: 375 Kcal (1890 Kcal- 1515 Kcal)

• Heavy work requires 219 Kcal per hour.

• Moderate work requires 122 Kcal per hour.

• Work hour lost per day per person due to inadequate calorie consumption: 4 hours of moderate work and 7.5 hours of heavy work

• Calculated on the formula:

Ea X Total No. of days in year (365)

Er X Total No. of working days in year (250)

Ea: is the Energy available for work: 375 Kcal

Er: is the energy required for a particular work: 219 Kcal for heavy work and 122 Kcal for moderate.

• Assuming average household has 5 Consumer Units,(NSS in Nutritional Intake in India, 50th Round,  July 1993: June 1994) then total no. of population consuming less than norm level for calorie intake= 290,369,930

• 55% of Adults= 159,703,461.

• Based on actual average wage of Rs. 60/- per man per day of 8 hours, per hour earning =  Rs. 7.50/- 

• Loss of total money due to low productivity due to inadequate calorie consumption = Rs. 30/- approx. per day per person.

• Total money lost by entire adult population per day= Rs. 4,791,103,830.

• Assuming total of 250 working days, total money lost in a year = Rs. 1,197,775,957,500 = US$ 29,944,398,937 approx. (1 US$= Rs. 40/-) = Approx. US $ 29 Billion

• Total GDP for year 2006-07 = Rs. 28481.57 billion, or US$ 712 billion  

GDP loss = 4% GDP

Child Undernutrition in India

I am moved by the report on malnutrition in India. I thought will bring some insights into this subject. Interesting finding is that relatively small number of states, districts, and villages account for a large share of the burden – 5 states and 50 percent of villages account for about 80% of the malnutrition cases. 

According to World Bank - The prevalence of child undernutrition in India is among the highest in the world; nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth.

The existing response to malnutrition in India has been skewed towards food-based interventions and has placed little emphasis on schemes addressing the other determinants of malnutrition.

India’s main early child development intervention, the Integrated Child Development Services program (ICDS), scheme was launched in 1975 with the following objectives of improving the nutritional and health status of children in the age-group 0-6 years. However, it has not yet succeeded in making a significant dent in child malnutrition. 

This is mostly due to the priority that the program has placed on food supplementation rather than on nutrition and health education interventions, and because of the fact that the program targets children mostly after the age of three when malnutrition has already set in.
 ICDS program appears to be well-designed and well-placed to address the multidimensional causes of malnutrition in India. However, there are several mismatches between the program’s design and its actual implementation that prevent it from reaching its potential. 

http://siteresources.worldbank.org/SOUTHASIAEXT/Resources/223546-1147272668285/undernourished_executive_summary.pdf


   

Global Hunger Index (GHI) and India

Global Hunger Index (GHI) and India

The Global Hunger Index (GHI) is designed to comprehensively measure and track hunger globally and by country and region. GHI Index is used to understand the countries hunger situation. The index is is created by IFPRI (The International Food Policy Research). IFPRI is founded in 1970, an agricultural research center, to improve the understanding of national agricultural and food policies to promote the adoption of innovations in agricultural technology.

GHI index raises awareness of regional and country difference hunger, show progress over time and help learn the success and failure in hunger reduction. The index is updated each year which highlights successes and failures in hunger reduction and provides insights into the drivers of hunger.  GHI takes into consideration equally weighted indicators in one index number on Undernourishment, Child Underweight and Child Mortality

India is ranked 2nd in the world number of children suffering from malnutrition.  The prevalence of underweight children in India is among the highest in the world. Every day, 1,000 Indian children die because of diarrhea alone. According to the 1991 census of India, it has around 150 million children, constituting 17.5% of India's population, who are below the age of 6 years. (Source: Wiki).

India Indicators from GHI 2012

·         Prevalence of undernourishment in population (%): Ranked 19th as per year 2006-08 data

·         Prevalence of underweight in children under-five years (%): 43% as per year 2005-10 data

·         Under-five  Mortality rate (%):  43.5% as per year 2005-10 data (an increase in 1% over previous indicators of year 1999-2003)

Source: http://www.slideshare.net/ifpri/2012-global-hunger-index

Looking at indicators, needless to say, India falls under the top 23 alarming nations category.  

India’s latest GHI score is based partly on outdated data except child mortality data from 2010. India’s latest available nationally representative data on child underweight were collected in 2005–06.

Government of India has failed to monitor national trends in child under-nutrition for more than six years now so we would not know any progress or failure happened in last six years.

Over all Rank 65th across world (GHI takes into consideration equally weighted indicators in one index number on Undernourishment, Child Underweight and Child Mortality)

India has lagged behind in improving its GHI score despite strong economic growth. After a small increase between 1996 and 2001, India’s GHI score fell only slightly, and the latest GHI returned to about the 1996 level, as the above graph shows. This stagnation in GHI scores occurred during a period when India’s gross national income (GNI) per capita almost doubled, rising from about 1,460 to 2,850 constant 2005 international dollars between 1995–97 and 2008–10 (World Bank 2012).

Japan Diary – The food conundrum

Japan Diary – The food conundrum

Indians are foodie by default. It’s rare to find an Indian who doesn’t love the food. The availability of information, travel, cookery shows on various channels have exposed us to delicious and mouthwatering dishes prepared in variety of cuisines. Most of us have problem with food when we go abroad. If the destination is USA or Asia pacific you do have a chance of finding Indian restaurant or locating some edible food. If its china or Japan…..just have fun.

Since Japanese speaks English, it’s easy to communicate at restaurant and get what you want. Hey, wait I am just kiddingJ.  That’s not the case. Japanese shy away from people who speak English. That’s the worse part. Imagine standing at the restaurant counter and trying to communicate what you want when the other person doesn’t understand at all. Only the American retail chains like MacDonald’s and KFC where you can find young people exposed to some English education at schools.

Indian Vegetarians (the real the hardcore the total vegetarians) have tough time to find edible food among the meat and sea foods serving restaurants. The menu will be in Japanese so there is no way to decipher the ingredients. Take a look at this picture and check what you can possibly order? 

Japan Diary – What’s missing in Tokyo Tower?

Japan Diary – What’s missing in Tokyo Tower?

These views are completely from tourist point of view and has no intention of devaluing Japanese technology or architecture.

During my Japan tour, my friend had organized a quick visit to Tokyo Tower on one of the evening. I appreciate his efforts and time considering he would have visited the place earlier.   

I enjoyed the day roaming around Eifel Tower at Paris the earlier spring. The whole day I strolled through the surrounding area, ate some good food, sipped great coffee. For the same reason, I was excited to see this replica or inspirational version of Eifel Tower.  

The Tokyo Tower does resemble to Eifel in some way. The beautiful structure is erected on probably 1/5^th of the place that of Eifel Tower. It’s definitely a great example of structural engineering. From the top through ‘look down window’, Tokyo city surrounding looks amazingly beautiful.   

Tokyo tower is primarily built for observation and communication. One of the revenue sources for tower is tourist. What’s missing in Tokyo Tower is the grace and elegance, peaceful and loving natural beauty, the coffee shops and great restaurants, gardens where you can spend almost entire day and most important ‘love in the air’ which is very much prevalent in Paris.  

View from Tower

The view from 'look down window'. 

Japan Diary – The Marriage

Japan Diary – The Marriage

According to Ministry of Health, Labor, and Welfare, approximately 1 million kids were born in year 2011 which is lowest in last five decades.

In 2011, the total number of marriages that took place was 661,895 and the numbers of divorces were 235,719. The divorce rate in Japan would be approx. 30%.

Knowing the situation in advance, since year 2001, Government has been putting effort to encourage Japanese women to get married and deliver babies to address the birthrate issue of country. 

The problem revolves around marriage and giving birth. Most importantly marriages seem to be the critical issue in Japan. Does that mean Japanese women aren't interested in getting married? Or they have become career oriented, may be insecure and not indulging in giving births?

The answer lies in the history of Japan and several paradigm changes in the economy and culture. Traditionally Japanese women need to act as subordinates to men; she needs to fully devote herself to the needs of her husband (that makes it second to men).  With the change in overall economy, education and global reach women have evolved and the situation has changed. Japanese women are now educated, strong, self-sustained and no longer need to play a supporting role. However I believe average Japanese men are traditional, and find difficult in accepting such massive change and still believe in old school thoughts about role of wife. This makes the situation complicated and difficult for marriages to sustain.

One more important dimension is Japan being worlds thirst largest economy having easy access to USA, UK and other European countries.  Large numbers of Japanese women are looking abroad for love/marriage will bring them the qualities in a partner that seems rare at home. The evolved thought process of Western men appeal to them as they are more appreciative, and seek reasonable between personal and professional life.  Tokyo and some other cities are full of dating agencies to help women find a suitable western partner.  That reminds me of such agencies in Gujarat which helps abroad settled Gujju men to locate suitable, cultural traditional Gujju wife. 

The Seinfeld

The Seinfeld

Sitcoms are good stress busters. All you need to do is to choose from the large number of sitcoms created by different production houses. We must thank NBC (American National Broadcasting Company) for creating ‘The Seinfeld’.  Seinfeld was the pioneer of the sitcoms and the nine seasons lasting July 5, 1989, to May 14, 1998 was kind of humorous revolution.

The success of this successful sitcom goes everyone who is part of the Seinfeld.  Strong consistent characters, simple situations and effortless delivery of jokes (involved in day to day life) make it humorously engaging. I am addicted to Seinfeld, its must watch for me. It’s a great stress buster and you just can’t watch once.

The cast couldn't be more perfect.  The cast includes Jerry Seinfeld who has played himself (as small scale celebrity stand-up comedian), George Costanza who is a cheapo, annoying, rarely honest and jealous best friend of Jerry.  Elaine Benes as Jerry's ex-girlfriend and Cosmo Kramer who is Jerry's "Crack neighbor".

I like the way characters unfold themselves from first episode. It takes 4/5 episodes to build the momentum but after that it’s a roller coaster ride. The punches are unforgettable and become part of your life. For example

·         George to Jerry “just remember, it's not a lie if you believe it”

·         George to his boss on getting fired “Well, you didn't have to say it like that”

·         Jerry to his girlfriend” I'm a man who respects a good coma”

·        Cosmo Kramer: I'm at the corner of 1st and 1st... How can the same street intersect with itself? It must be at the nexus of the universe.

There are countless punches which can make you burst into laughter. So in case you haven’t heard/watch ‘The Seinfeld’ just go for it, the laughter is guaranteed.  

Mumbai Marathon

 Marathon

These days, especially in metros and towns, everyone knows about the long distance running event called Marathon.  You will know from newspapers and TV channels covering the celebrities encouraging people to participate and run for a cause. You will get to hear from office colleagues and friends who are probably planning for ‘dream run’. I first noticed this event 2004 on hoardings and banners placed across on western express highway in Mumbai. The event was sponsored by Standard Chartered Bank and well covered in the print media.

I initially thought it’s for someone who got plenty of time, someone who already has made fortune and now working towards the health. My belief was largely from my own experience as I was working more than 12 hours a day, travelling by local trains, buses and hardly had any time to think beyond work. I thought it’s an event for companies to sponsor and get noticed (part of the advertisement), celebrities to show their concern for the cause, people to showcase the elite class status (and of course talk about this run in parties).

Over a period of time my views changed when I met some passionate marathon runners. I was totally wrong and in retrospect I think I just didn’t understand the importance of the event. This event could be used by people for various reasons however that doesn’t still takeaway the spirit of the sport.  I realized long distance running is not so easy. To be a runner, you need passion, dedication, and disciple and require reasonable balance between work and personal life. Even though it appears to be group event however when it comes to running, you are on your own.  It’s a competition and you are only competing with yourself. Marathon is like a plan for long distance runners. The plan includes how to pace out, distance vs. speed, when to drink energizers, what to eat etc.  

These days I am running 7 to 8 miles and clocking 25 miles per week. I hope I can make myself capable to run at least 21 kilometers (half marathon) in 2013.