out the family’s pulse
Check out the family’s pulse
The National Family Health Survey 2005-06 has many firsts to it. For the first time, the survey has zeroed in on spousal violence, HIV prevalence and violence against unmarried women, says Kajal Basu
The third National Family Health Survey (NFHS-3) — due to be out in by the first quarter of 2007 — has already had a dry run. Provisional data from five states — Orissa, Maharashtra, Chhattisgarh, Gujarat and Punjab — is in, and the data from seven more is due by early 2007.
While the survey is not big enough to cull district and village level data, and the union territories were not included, it did cover all 29 states and was buttressed by more than 30 organisations involved in it. The approximate sample sizes for interview at the national level are 1,10,000 ever-married women (i.e. women who have been married at any point in their lives), 33,000 never-married women and 78,000 men.
The complete survey — for which fieldwork was conducted between December 2005 and August 2006 — will have extensive data on women’s empowerment and the minutiae of domestic violence. For the first time since the NFHS began in 1992-93, it will also be possible to extrapolate information on violence against non-married women. Non-married women and men have been included for the first time.
These surveys are conducted under the stewardship of the Ministry of Health and Family Welfare. The International Institute for Population Studies, which was the nodal agency for the first and second survey, is also the nodal agency for this third survey. ORC Macro of the US — which implements Measure DHS (demographic and health surveys), the most widely accepted source of health and population data in the developing world — provided technical assistance to the survey.
Of as much pertinence as health information related to women is that HIV prevalence is being measured for the first time. Of course, the 112,000 tests conducted might seem a drop in the bucket (given that the government accepts that 5.2 million are living with HIV/AIDS in the country). Said Laurie Liskin, ORC Macro’s Senior Advisor for Communication, "In every country we’ve surveyed, being surveyed doesn’t translate into HIV testing."
Then, again, for this survey, one in six households inhaled deep and went in for blood testing anyway. More than 200,000 anaemia tests were carried out on women aged 15-49, men aged 15-54 and children under five years using a small, hand-held, ‘field-friendly’ device. It was battery-operated and required no refrigeration — the one aspect that nearly proved fatal for India’s pulse polio programme. It was also non-intrusive, needed only a small drop of blood for analysis and came up with results within a minute.
In all categories of gender indicators in the five states whose results are out, the statistics on women were indicative of social infirmity: Body mass index (BMI) was low, ranging from 41 per cent of the women in Orissa and Chhattisgarh (compared to 32 per cent for men) to the relative ‘normalcy’ of 14 per cent of the women in Punjab (compared to 12 per cent in men). The only consolation was that, relative to the second survey, the BMI normalised by an average of seven per cent in the said states.
Most parameters, in fact, show an improvement over the previous surveys, says Fred Arnold, Vice-President, ORC Macro, "Child marriage, for instance, declined drastically from the first to the third survey. It’s very rare, nationally." The improvement is entirely relative, though: anaemia among women is still endemic, ranging from a ‘low’ of 38 per cent in Punjab to a ‘high’ of 63 per cent in Orissa; the percentage of ever-married women who have experienced spousal violence ranges from 25 per cent in Punjab to 39 per cent in Orissa. (This being the first time that spousal violence has been configured as part of the survey, there are no comparable statistics for the second survey.)
But unprecedented data on violence against women in the context of health might permit the reworking of policy decisions. "The survey found that infant mortality, for instance, is higher among abused women, as are other juvenile problems, and those of families and women themselves," said Sunita Kishor, senior gender specialist, ORC Macro.
Detailed data on HIV could also determine how the National AIDS Control Organisation (NACO) handles the future course of the disease in the country. The organisation will use three sources of information: sentinel survey data on women; NFHS-3 data on the general population; surveillance data on high-risk groups. The HIV/AIDS part of the survey — which left out women in brothels and truckers on the move on the debatable ground that the former were a minuscule proportion of the population and the latter impossible to nail down — found that more men than women had heard of AIDS (men: 92 per cent in Punjab to 67 per cent in Chhattisgarh; women: 70 per cent in Punjab to 41 per cent in Chhattisgarh).
The survey’s HIV content is expansive but not exhaustive: it includes knowledge on disease and treatment, discussions of it during antenatal visits, previous tests, stigma and discrimination, medically safe injections, male circumcision, sexual behaviour (which the surveyors concede is probably under reported), and condom use.
Samples for HIV testing were collected using the carrot approach: vouchers for free testing at any local clinic were given to those who agreed to provide the samples, but there was no monitoring to check how many actually went to the clinics. No names or personal identifiers were placed on the filter paper that carried the blood sample, so no one was at risk of being identified. While this might permit a more fine-tuned macro approach to the issue, it prevents interested organisations from approximating a spot-focus that could enable them to take prophylaxis and rehab to specific locations.
For obvious reasons, ORC Macro preferred to keep out of the ongoing Government of India versus WHO controversy on HIV statistics in India. "All that we found in the 15 countries we’d already surveyed," said Arnold, "was that HIV/AIDS figures actually fell from what had previously been conjectured."
Nonetheless, the survey’s new or expanded content areas should be of interest to various organisations: NACO would be interested in family life education, as should be UNICEF in child labour. Among the other new areas are birth registration, contraceptive continuation and failure rates, prenatal mortality, male involvement in family planning and maternal health, malaria prevention, tuberculosis-related knowledge and stigma, nutritional status of man and never-married women, and Vitamin A supplementation during pregnancy.
If the survey can provide all this, it might — despite the small survey corpus — redirect the government to a new exploration of family health, one of the plinths of a workable developmental policy. Furthermore, since all the data sets will be publicly available, they might help interested global and national organisations — government and otherwise — to formulate a developmental strategy that doesn’t have much of India’s population falling through the cracks.— WFS
Sleep well to stay trim
A decent night’s sleep curbs the number of pounds women put on as they age, according to a finding by a team of US researchers led by an Indian-American doctor.
In a study that followed more than 68,000 US women for 16 years, the team headed by Dr Sanjay Patel of Case Western Reserve University in Cleveland found that women who slept more each night tended to put on less weight during middle age.
The findings were published in the American Journal of Epidemiology and presented earlier this year at a medical conference.
The researchers found that women who typically clocked five hours of sleep were one third more likely to have substantial weight gain than those who slept for seven hours.
A key finding by the team also said that putting an extra 10 pounds doubles a woman’s risk of diabetes.
According to Patel, there are several possible explanations for the findings. It could be that sleep deprivation causes the body to metabolise calories less efficiently. It may also be that a lower number of hours spent sleeping reflects a basic life change that can have a fairly dramatic impact, reported the Health on the net foundation.
Whatever the reasons, sleeping seven hours or more each night could help prevent women from gaining that extra pound, say authors of the study.
The researchers based their findings on data from the long-running Nurses’ Health Study, which has followed the health of thousands of female nurses for the past 30 years. —IANS
About 3300 tonnes of gold was mined in 2005, while only 100 tonnes of platinum was mined in the same period. You would naturally expect platinum to be much more expensive than gold. Well, it is just about double the cost of gold. According to the Platinum Guild International (PGI), if all the platinum in the world were poured into an Olympic-sized swimming pool (50 m by 20 m by 2 m), it would hardly come ankle-high. In contrast, all the gold in the world would fill three such pools.
In the 1920s there were consistent efforts by European jewellers to convert the Maharajas from gold to platinum jewellery collectors. But its whiteness did not appeal to the Indian princes. During World War II, the use of platinum for jewellery was disallowed, as all platinum was required for war. But so great was the demand for "white metal" jewellery, that gold was mixed with other metals to appear white in colour. Even today white metal is often confused with platinum, but only to the undiscerning eye. It doesn’t have the same purity, strength, durability, rarity or the natural white luminescence of platinum.
There are certain disadvantages for platinum vis-`E0-vis gold. Its specific gravity is 21.2 as compared to 19.3 for gold, which means that for making the same jewellery you have to buy about 10 per cent more platinum. Further, gold is more malleable. Platinum has to be melted at high temperatures, before it can be worked on. Hence, the design and manufacture costs for platinum jewellery are higher.
When you buy a piece of gold ornament, you usually buy it by weight. That is, the cost of the piece is based on the rate per gram on the date of purchase, with additions, such as making charges and wastage, added. But when you buy platinum treasures, the break up of the price component is not available. Neither is it linked to the market price of the metal on a day-to-day basis. Every piece of the platinum jewellery sold has a price tag and is sold on a piece-rate basis. The price includes the metal price and making charges. The retailer may not display platinum prices as he does for gold. However, this does not mean that as a buyer, you are not affected by the international price movements.
Like gold, platinum can be recycled. The recovery and refinement requires greater skill. Generally, the wastage is marginally higher in the manufacturing process for platinum jewellery given the nature of the metal and the tough manufacturing process. Only skilled jewellers with the right expertise and infrastructure can create exquisite platinum jewellery. The range of platinum jewellery begins from Rs 4,000 onwards.
The PGI has been successful in carving a market in India for the metal, having launched it in 2000. From a mere 12 retailers, there are now over 350 retailers across 32 cities.