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One of the most recognized emojis by our respondents was the "Hands Praying. How is unemployment measured for states and local areas? Retrieved February 10, Annals of Human Biology. Plausibility of the link is very strong here. Recall techniques, on the contrary, can easily be applied to a large sample, obviously with a smaller confidence interval. A Review of Human and Animal Studies".

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Proposed working definition of an older person in Africa for the MDS Project

This causes an increase in variance and implies that larger samples will be needed in order to assess correctly the level of the indicator and its variations over time.

Subjectivity bias is a frequent risk with indicators deriving from qualitative surveys, as they describe behaviours or opinions of households, for example, since the personality or technique of the person conducting the survey may influence the nature of responses. Moreover, respondents to a questionnaire or subjects under observation can modify their responses or behaviour in a normative way.

People who are overweight, for example, often minimise their actual food intake when interviewed for a food consumption survey. Reproducibility guarantees that an indicator can be measured at repeated intervals in a comparable manner - a quality which is crucial when using the indicator to assess and monitor the situation.

A complementary characteristic is specificity, which refers to the ability to identify those not affected by the risk or characteristic. Sensitivity is measured in practice by the ratio of the number of individuals identified by the indicator as being at risk or as having the characteristic to the number of individuals who are actually at risk or have the characteristic. Specificity is the ratio of the number of individuals not identified by the indicator to the number of individuals who are actually not at risk or do not possess the characteristic.

Sensitivity thus gives an idea of the degree of correct or misclassification linked to the use of an indicator. Not all indicators lend themselves to an assessment of sensitivity. Sensitivity applies essentially to indicators with cut-off values. Moreover, sensitivity is measured with respect to a given goal; sensitivity of an indicator such as weight-for-height at a given cut-off value will not be the same, depending on whether the goal is to identify children who are wasted or those who are at risk of dying in coming months.

Data for quick computation of these parameters sensitivity, specificity are not always available, so in practice, reference is made to existing data from the literature to find those closest to the chosen cut-off values and expected prevalences. One particular aspect of sensitivity is the ability of an indicator to measure change, not in order to identify or target a particular category of individuals as previously but to detect the smallest possible change in the phenomenon described, in a significant way.

While sensitivity, in general, is important when establishing a baseline, and for defining the target groups to which the activities will be directed, this ability for measuring change is crucial for assessing or monitoring trends, in particular to detect changes in the situation during implementation of the programme.

However, it is relatively inert when assessing small progressive changes in nutritional status over time, and the weight-for-height indicator will be preferred in this case, since it is more sensitive to change. Also, urinary iodine will respond to introduction of salt iodization in a region quicker than prevalence of goitre, which will decline only slowly.

In addition to these inherent characteristics of indicators, their operational value should be examined; it will be essential when the choice of indicators is made, especially in terms of speed and cost of collecting data for producing these indicators. It represents the practical possibility of making available the indicator in question.

It implies the feasibility of collecting the corresponding data by whatever means. There are indicators described as "ideal" which nobody is in practice able to collect. As a result of major international conferences and of programmes that have followed them during the last two decades, many of the required indicators are already systematically and regularly collected within the framework of such programmes and are thus very easily available.

It affects use of the indicator not only at the descriptive stage, but also when monitoring the situation. An indication of the quality of the measurements, of sampling and of the confidence interval of the result is essential here to assess dependability. Occasionally, it has been observed that the number of malnourished children estimated by nutritional surveys carried out by various organizations on identical populations and during the same periods, differed substantially; using the results for targeting purposes or for monitoring the situation is ruled out in this case.

The reason was usually the lack of precision of the anthropometric measurements or of the definition of age, and occasionally a sampling problem. Data on food consumption obtained by weighing food are more precise than those obtained with the "recall" technique, although the former implies technical constraints and can therefore only apply to small samples, so that there is a broad confidence interval in the results.

Recall techniques, on the contrary, can easily be applied to a large sample, obviously with a smaller confidence interval.

The various available data must therefore be carefully examined before using them for monitoring purposes, and a choice will sometimes be made between data collected with a higher level of accuracy but lower power at the level of the target population, or the opposite. On this depends, in part, the speed and frequency with which the indicator can be regularly measured.

When the data necessary for the construction of the indicator need to be collected specifically for evaluation or monitoring, cost should be considered; it depends on the difficulty and sophistication of the measurements, the accessibility of the objects or people to be measured, the frequency of collection and the complexity of the analysis subsequently.

The cost of non-collection may be measured, in the case of a food subsidy programme, for example, by the difference between the cost of the programme if it is carried out without particular targeting, in the absence of any indicator allowing targeting, and the cost of the programme for the target population, plus the cost of targeting, if the programme is to be directed at a high risk group only.

Nevertheless, information on the cost of collecting an indicator for each situation is seldom available. It is difficult to measure, and estimates are generally based on the cost of different types of survey within the country, taking account of the fact that several indicators are collected at the same time.

Indicators can be categorized schematically in the following way according to the level at which they are produced or made available:. They include both indicators regarding the implementation of services as well as indicators regarding the situation or the impact of actions under way.

It is generally easy to obtain them from the departments concerned, which usually have time series that are very useful in distinguishing medium- and long-term trends. Even so, it is not always possible to cross-tabulate these indicators, since they do not necessarily come from the same databases and are accessible only in a relatively aggregated form.

It is also difficult to verify the quality of the original data. Lastly, even if the data are collected on a frequent basis monthly reports, for example , recovery and analysis may take too long. Such data tend not to be immediately accessible except in summary form, although it is easy to organize new analyses with the departments in charge of them. These data allow statistical cross-tabulation to be made between the many variables collected simultaneously on the sample. Although carried out at best at very long intervals, they can be updated with reasonable projections, especially if information on trends in the fields of interest, based on routinely collected data, are also available.

These data are often kept together in national statistical offices. They consist of a regular collection of information based on a small number of selected indicators. The system varies by country, those that perform best are based on an explicit conceptual framework and are linked to a clear decision-making mechanism. They can represent a sound basis for central monitoring. A particular category is derived from surveys conducted by international bodies for various purposes: These cross-sectional surveys are conducted directly at household level on samples which are representative at national level but of variable size; they include a wide variety of indicators in number, goals and qualities and are now frequently repeated.

Although conducted peripherally, they are generally available and used centrally. These sources, which are in principle fairly reliable, benefit from an advanced level of analysis allowing causal inference to be derived of relationships among various household indicators, and with individual indicators, such as nutritional status. They represent a precious source when establishing a baseline and when analysing causes prior to launching an intervention. These are constructed primarily on the basis of routinely collected data from local government offices, community-based authorities.

They are usually passed on as indicators or raw data to the central level, and then sent back to the decentralized levels, with varying degree of regularity, after analysis. They are often disaggregated by district or locality, but are not always representative, since they often refer only to users of the services under consideration. They are generally grouped together at the central administrations of regions or administrative centres. The indicators relate primarily to activities that lend themselves to regular observation, either because they record activities indicators of operation or delivery of services or because they are necessary for decision-making crop forecasts, unemployment rates or for monitoring purposes market prices of staples, number of cases of diseases, etc.

They do not necessarily include indicators of the causes of the phenomena recorded and are not in principle qualitative indicators.

Indicators collected at decentralized levels should meet both the needs of users on these levels and also those of users on the central level for the implementation and monitoring of programmes. If these regularly compiled indicators do not have any real use at the local level and are intended only for the national central level, there is a danger that their quality will drop over time, for lack of sufficient motivation of those responsible for collection and transmission - and gaps are therefore often found in available data sets.

Nevertheless, they are invaluable in giving a clear picture of the situation on the regional or district level, together with medium-term trends. Generally speaking, their limitation is the low level of integration of data from different sectors. A certain number of indicators, particularly those concerning the life of communities or households and not touching on the activities of the various government departments, are not routinely collected by such departments and are in any case not handed on to the regional or central offices.

They are sometimes collected at irregular intervals by local authorities, but most often by non-governmental organizations for specific purposes connected with their spheres of activity - health, hygiene, welfare, agricultural extension, etc. Analytical capabilities are often lacking at this level, and the available raw data may not have led to the production of useful indicators. Action therefore should be taken to enhance analytical capacities or else sample surveys will have to be carried out periodically on these data in order to produce indicators.

A sound knowledge of local records and their quality is needed to avoid wasting time. New collection procedures often have to be introduced for use by local units, while being careful not to overload them or divert them from their own work. Otherwise a specific collection has to be carried out by surveying village communities targeted for analysis or intervention. These surveys are vital for a knowledge of the situation and behaviours of individuals and households and an evaluation of their relationship with the policies introduced.

In general, they offer an integrated view of the issues concerned. They may have the aim of supplying elements concerning the local situation and local analysis, in order to confirm the consensus of the population and of those in charge as to the situation and interventions to be carried out, and also to allow an evaluation of the impact of such interventions.

The participatory aspect should be emphasized rather than the precision or sophistication of data. An FAO work on participatory projects illustrates issues of evaluation, and especially the choice of indicators in the context of such projects FAO If data already collected are used or if a new survey is carried out for use on a higher level, the size and representativeness of the sample must be checked, and it must be ensured that the data can be linked to a more general set on the basis of common indicators collected under the same conditions method, period, etc.

Verification of the quality of the data is crucial. Before undertaking a specific data collection, a list of indicators and of corresponding raw data should be developed which can be used by services at all levels; it is not unusual to find that surveys could have been avoided by a better knowledge of the data available from different sources.

To track down these useful sources and judge the quality of the data available and their level of aggregation, a good understanding is needed of the goals and procedures of the underlying information system. The country had set up a monthly national information system on production estimates for 35 crops, covering information on crop intentions, areas actually planted, crop yields and quantities harvested in each state.

The information was obtained during monthly meetings of experts at various levels - local, regional and national. The information was then put together at the state level, and then at the national level, reviewed by a national committee of experts, and sent on to the central statistics office.

The different levels thus had some rich information at their disposal, coming from a range of local-level sources.

Although it was certainly fairly reliable, being confirmed by a large number of stakeholders and experts, its precision could not be defined, in view of its diversity. The usefulness of such data varies depending on information needs and thus on the quality of the data required. Data concentrated at the central level are probably useful primarily for analysing trends. On the other hand, apart from the figures, more general information on production systems exists at local level, and this can be useful for identifying relevant indicators of causes, or for simplifying monitoring of the situation.

We have seen that there is a great number of indicators which differ widely in quality; the availability of corresponding data is variable, and any active collection will be subject to constraints. Therefore the choice of indicators must be restricted to the real needs of decision makers or programme planners. This implies that a method is needed for guiding the choice. The main elements that will guide choice are: Any intervention is based on an analysis of the situation, an understanding of the factors that determine this situation, and the formulation of hypotheses regarding programmes able to improve the situation.

A general framework was presented earlier see Figure , representing a holistic model of causes of malnutrition and mortality, which was endorsed by most international organizations and nutrition planners. However, the convenient classification that it implies, for instance into levels of immediate, underlying or basic causes needs to be operationalized through further elaboration in context.

The benefit of constructing such a framework, over and above the complete review of the chain of events which determine the nutritional situation, is to allow the expression, in measurable terms, of general concepts which, because of their complexity, are not always well defined.

For example, it is not enough to refer to "food security"; one should state which of the existing definitions is to be used, on which dimensions of food security the focus is placed and the corresponding indicators.

The use of conceptual frameworks when implementing programmes or planning food and nutrition is not new. Many examples have been developed, focusing on different aspects. The concept of food security is generally perceived as that of sufficient availability of food for all. However, several dozen different definitions have been proposed over these last 15 years! This concept may, for example, comprise different aspects depending on the level being related to: In the first case, analysis will focus on agricultural production, and in the second the emphasis will be on improving the resources of those who lack access to a correct diet.

This preliminary brainstorming exercise will allow a better definition of the perceived chain of causes production shortfall, excessive market prices, defective marketing infrastructures, low minimum wage, low level of education, etc. It will then be easier to consider potential indicators of the situation and its causes, or potential indicators of programme impact. Obviously it is not so much the final diagram which is of importance as the process through which it was developed.

Insofar as the relations between all the links of the chain of events or flow data, depending on the type of representation have been discussed step by step and argued with supporting facts, the framework will be adapted to the local situation and will become operational. Methodologies have been developed for making this process effective in the context of planning, for example with the method of "planning by objectives" see ZOPP , which comprises several phases: During this planning process, all programme activities, corresponding partners, necessary inputs and resulting outputs as well as indicators for both monitoring implementation and evaluating impact of the programme will be successively identified.

The method acts as a guide for team work, encouraging intersectoral analysis and offering a simplified picture of the situation, so that the results of discussions are clear to all in the team.

Let us again take the example of a problem of food security. It can be broken down into three determining sectors: A series of structural elements can be defined for each sector: These elements affect both production levels and operation of markets. A certain number of macro-economic or specific policies will affect one or all the elements in this block. Each block can be considered in a similar way, and this will provide the groundwork for a theoretical model of how the system works see C.

The final steps in order to operationalize the model are i that of defining indicators that will, in the specific context of the country, reflect the key elements of the system, and ii , once policies and programmes have been chosen, that of identifying which of these indicators are useful for monitoring trends and evaluating programme impact. This will be the basis for an information system reflecting the overall framework of the programme and how it should work.

Another method has been proposed by researchers from the Institute of Tropical Medicine in Antwerp based on their field experience in collaboration with different partners Lefèvre et al. Basically, it stresses the participatory aspect, with the aim of obtaining a true consensus on the local situation, the rationality of interventions in view of the situation, and the choice of indicators. It includes first a phase in which a causal framework is developed with the aim of providing an understanding of the mechanisms leading to undernutrition in the context under consideration.

The framework is constructed in the form of a schematic, hierarchized diagram of causal hypotheses formulated after discussions among all stakeholders. Biomaker Household Mans Womans. Key Findings Report The survey is based on a sample of households which is representative at the National and State levels.

For the first time, NFHS-3 also provides information on men and unmarried women. In addition, HIV prevalence is measured at the national level and for selected states. These Fact Sheets presents provisional information on key indicators and trends at the national level. State Reports of the following States have been released and key findings disseminated in their respective State capitals. The Seminar Presentations of the key findings for different states are also available online.

A quarter of India's population lives below what has been termed a 'starvation line'. Why have foodgrain and calorieconsumption actually fallen in the last 15 years of structural adjustment? Why have foodgrain and calorie consumption actually fallen in the last 15 years of structural.

The World Bank Keywords: Drawing on qualitative studies and quantitative evidence from large household surveys, this book explores the dimensions of child undernutrition in India and examines the effectiveness of the Integrated Child Development Services ICDS program, India's main early child development intervention, in addressing it.

Although levels of undernutrition in India declined modestly during the s, the reductions lagged behind those achieved by other countries with similar economic growth. Nutritional inequalities across different states and socioeconomic and demographic groups remain large. Although the ICDS program appears to be well-designed and well-placed to address the multi-dimensional causes of malnutrition in India, several problems exist that prevent it from reaching its potential.

The book concludes with a discussion of a number of concrete actions that can be taken to bridge the gap between the policy intentions of ICDS and its actual implementation. Each country profile is structured under the following sub-headings: Population Consumer segmentation Households Household segmentation Labour Income Consumer expenditures Food and non-alcoholic beverages Alcoholic beverages and tobacco Clothing and footwear Housing Household goods and services Transport Communications Leisure and recreation Education Hotels and catering Miscellaneous goods and services The information in this report was gathered from a wide range of sources, starting with national statistics offices.

This information was cross-checked for consistency, probability and mathematical accuracy. Secondly, we sought to fill in the gaps in the official national statistics by using private-sector surveys and official pan-regional and global sources. Furthermore, Euromonitor International has carried out an extensive amount of modelling in order to come up with interesting data sets to complement the national standards available. The wide range of sources used in the compilation of this report means that there are occasional discrepancies in the data, which we were not able to reconcile in every instance.

Even when the data is produced by the same national statistical office on a specific parameter, like the total Population in a particular year, discrepancies can occur depending on whether it was derived from a survey, a national census or a projection and whether the data is based on mid-year or January figures.

For slow trends where it is interesting to look at a long period as well as projections, data is presented for , , , , and Fast-moving trends are illustrated with data sets relating to , , , and Initiation of Breastfeeding by Breast Crawl visit breastcrawl. Every newborn, when placed on the mother's abdomen, soon after birth, has the ability to find its mother's breast all on its own and to decide when to take the first breastfeed. This is called the "Breast Crawl".

This method is evidence based and has been field tested by us. A documentary on the "Breast Crawl" has been prepared for training, advocacy and for wider dissemination.

The video has created a very high level of sensitivity among all the levels of functionaries and was officially endorsed by senior policy makers as the right approach for initiating breastfeeding. This dossier provides the background and a scientific overview to the documentary. We are sure that this documentary and dossier will greatly help similar initiatives worldwide.

It is our strong desire that this information helps every mother and baby to experience the miracle of Breast Crawl. This can be achieved by training all health care providers to initiate breastfeeding, by Breast Crawl, to give infants the best start in life.

And yet, so many of them die. To lose a newborn life like this is heartbreaking. Especially when we know that such tragedies can be prevented. We strongly believe that if a mother's health is attended to, if she receives basic nutrition, health care and education in her formative years as well as during pregnancy, then newborn babies would not have to die.

WHO is providing technical support to the national scale up of counselling and testing services including monitoring and evaluation of the programme. Operational guidelines for ICTC Several informative and low-priced books and journals are brought out by the Institute in English as well as in some regional languages. These publications contain the quintessence of Institute's research endeavors over the years. To popularise these publications among people, a short write-up describing the essential features of these publications is given below.

It contains a simple account of current concepts of nutrition science, nutritional chemistry of major food groups and nutritional deficiency diseases.

In addition, the book incorporates latest information on nutritional requirement and recommended dietary allowances and on the guidelines for formulating healthy, balanced diets. This book is a must for all those who wish to know more about nutritive value of foods including students, medical and health professionals, planners as well as general public.

Nationwide surveys have revealed a wide prevalence of malnutrition among mothers and children, mainly belonging to the underprivileged sections of society.

The book discusses in-depth the nutritional needs of pregnant and lactating mothers, infants and pre-school aged children. Several types of low-cost nutritious recipes are described in the book after thoroughly testing these foods in the community for acceptability and tolerance.

It is hoped that this low priced informative book will serve the dual purpose of training the health personnel and educating the average Indian housewife in ensuring better health for herself and her child.

This book contains such updated information on the protein energy requirements, definition of quantum and type of fat intakes and other related themes.

In addition, ADA for some other nutrients like fat-soluble vitamins, trace elements and electrolytes are also listed. The book is a good reference guide especially for policy makers and researchers. The details pertaining to cooking methods and nutritive value of these recipes will help housewives to plan healthy menus for the family and also assist in formulating nutritious school lunches and community feeding programmes.

Hostels, restaurants and cafeterias can take a few dietary tips from this book. This booklet discusses the principles governing the formulation of these recipes and lists out several food supplements for infants and young children.

Most of these recipes are based on coarse cereals, legumes and other locally available foods. This low priced booklet will help mothers to plan healthy diets for their children in the most economical way. Ingredients used in the preparation of these recipes are inexpensive and method of cooking described is simple. These two low priced booklets will help in strengthening the school meal programmes operational in some parts of the country.

Though a variety of fruits are grown and consumed in the country, the prevalence of micronutrient malnutrition is alarmingly high among people. This book contains wealth of information on the nutritional aspects of several popular fruits including amla, papaya, guava, sapota, seetaphal and many others.

A section of the book has been devoted to a range of lip smacking fruit-based recipes. It is always a challenge to make recipes both nutritious as well as tasty. This book provides information on different methods of cooking and on protein, carbohydrate, fat and mineral contents of each of these recipes. A glossary of terms commonly used in food preparations is also presented. The book helps the research workers too in the calculation of the nutrient content of diets of people.

Their number keeps steadily increasing as a direct consequence of increased life expectancy. Health and nutritional problems also affect the lives of the elderly. This booklet provides information on several Easy-to-cook and Ready-to-eat nutritional recipes, which require minimum cooking time.

The booklet also contains information on the nature of ageing process, nutrient requirement and dietary sources of nutrients.

This beautifully illustrated book educates general public on various aspects of diabetes including its types, symptoms, risk factors, diagnosis, prevention and dietary management. All you wanted to know about food exchange system, glycemic index, model diets, exercise regimen, insulin and other oral drugs, use of alcohol and artificial sweetners and therapeutic effect of fenugreek methi seeds are found in this book which is an information storehouse on diabetes.

This book provides in-depth information on several factors relating to heart health. Structure and function of heart, types of heart diseases, dietary and non-dietary prescription for a healthy heart, nutritive value some commonly eaten foods, heart-healthy recipes are some major aspects covered in this well illustrated book.

This book written in simple, non-technical style is highly recommended for both the students of food and nutrition as well as the general public. The nutrition knowledge imparted through this book aims to promote the concept of balanced diet and positive lifestyles right from infancy to old age.

The book educates the common man to meet his nutritional needs through the judicious use of locally available, low-cost nutritious foods and informs about the deleterious effects of high calorie and cholesterol rich foods on one's health. Students of nutrition and medical sciences, health personnel, policy makers and researchers will find this manual extremely informative and useful. Postage will be payable in addition to the price indicated.

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