India Votes for Loksabha: Phase-III 2009

Tomorrow (30 April 2009) is the third phase of elections. It is being conducted in 107 constituencies spread across 11 states. They are Bihar (11), Gujarat (26), Jammu & Kashmir (1), Karnataka (11), Madhya Pradesh (16), Maharashtra (10), Sikkim (1), Uttar Pradesh (15), West Bengal (14), Dadra & Naagar Haveli (1), and Daman & Diu (1) (see Map).

This phase is special as being in Mumbai, I would also be voting tomorrow. The elections for the ten seats in Maharashtra are those in Mumbai (6) and Thane (4). The Chief Electoral Officer Mumbai has put up helplines for people to find out their booths. The helpline numbers are 2279 3925 and 3219 7767. One can also SMS and get information, the mobile numbers are: 9320 899623, 9320 928504, 9320 948340, 9322 193799, and 9324 376961.

My constituency is Mumbai North West and when I called up I was successful in getting the details of my polling booth (Gurukul Vidyalaya, Ground Floor, Room No.1, General AK Vaidya Marg, Malad (E)). This is close to my place of residence at IGIDR.

I will elaborate a little more about my constituency. There are 21 candidates in the fray. They are: Athar Siddiqui (Bahujan Samaj Party, BSP), Ad.Kamat Gurudas Vasant (Indian National Congress, INC), Gajanan Kirtikar (Shiv Sena, SHS, in alliance with the Bharatiya Janata Party, BJP), Aggarwal Rishi Dharampal (Jago Party (JGP), a new party with base in Rajasthan that is against corruption), Abu Asim Azmi (Samajwadi Party, SP), Jadhav Bhikaji Gangaram (Kranti Kari Jai Hind Sena), Thakare Shalini Jitendra (Maharashtra Navnirman Sena (MNS), a party formed after splintering from Shiv Sena), Tawade Dilip Narayan (All India Forward Bloc), Pawar Subhash Pandurang (Prabuddha Republican Party), Vaijanath Sangram Gaikwad (Bharipa Bahujan Mahasangha) and eleven independents - Anita Ramkrushan Rupawate, Kamble Satish Kisan, Dayanand Nivruti Kamble, Dhotre Maruti Yamnappa, Ninad Manjardekar, Pramod Sitaram Kasurde, Bhatia Ripudaman Singh (a marine engineer), Mohammed Rafiq Abdul Razak Shaikh, Mahadev Limbaji Galphade, Dr. Vijay Bhave (a child specialist), and Santosh Pandurang Chaike.

As a layman one began by thinking that Ad Gurdas Kamat (INC) and Gajanan Kirtikar (SHS) are strong contenders. The former's traditional vote bank may be dented by Athar Siddiqui (BSP)and Abu Azmi (SP) whereas Shalini Thakare (MNS) may dent that of Kirtikar. In fact, an on line poll in Mumbai Mirror for Mumbai Nort West gives more than half the votes to Athar Siddiqui and 15 per cent to Shalini Thakare. For the other five Mumbai constituencies the Mumbai Mirror results are as follows. Dr. Mona Shah (Professional Party of India) and the Banker Meera Sanyal (Indepent) doing well in Mumbai South. Sanjay Nirupam (INC), Shirish Parkar (MNS) and Ram Naik (BJP) are fighting it out in Mumbai North. Priya Dutt Roncon (INC) is ahead of Shilpa Sarpotdar (MNS) who seems to be denting BJP's Ram Jathmalani in Mubai North Central. Shailen Ghosh (Independent) and Shweta Parlekar (MNS) seem to be doing better than Eknath Gaikwad (INC) and Suresh Gambhir (SHS). In Mumbai North East, Shishir Shinde (MNS) seems to be better poised than that of Kirit Somaiya of BJP and Sanjay Dina Patil of Nationalist Congress Party (NCP).

The Times of India's Lead India series indicates that Mumbai North West looks for Mr Clean while highlighting the candidatures of Kamat, Kirtikar, Azmi and Thakare. On line voting of issues by Mumbai Votes identified corruption, terrorism, public transport, disaster management and environmental protection. Based on the Manifesto and promises of the contenders, Rishi Aggarwal of JGP seems to be the real Mr Clean.

In Mumbai North West, five candidates have provided their profile in websites and four of them have a group in facebook in their support. They are Rishi Aggarwal (FB group), Abu Azmi (FB group), Shalini Thakare (FB group), Ripudaman Bhatia (FB group), and Dr Vijay Bhave.

A broad reading at this stage is that MNS is going to give a run to BJP-Shiv Sena combine in the city. If only they would not have cultivated an anti-North Indian image they would have been a force to reckon with. There is a mood for change and there are going to be some major surprises. The dampener is that with a holiday being declared tomorrow, followed by labour day May 1st and the weekend many people might have taken a break and gone out of the city. Nevertheless, my word is that INC-NCP and BJP-SHS better watch out!

Hunger and Undernutrition

The July 2008, id21 insights, issue # 73 is about Improving the nutritional status of women and children. The editorial begins by reminding us that a high global food prices would make large proportions vulnerable in Sub-Saharan Africa and South Asia. Even in the absence of rising food prices there was an increase in child undernutrition indicating that income growth is not the answer for all ills.

Despite the understanding that reducing child undernutrition (particularly that of the adolescent girl) is paramount in addressing a number of Millennium Development Goals (MDGs), one wonders Why is undernutrition not a higher priority for donors? Andy Sumner, Johanna Lindstrom and Lawrence Haddad point out that one-third of the children in Sub-Saharan Africa and South Asia are undernourished. What is more, the proportions are increasing in the former. In prioritizing undernutrition they suggest the following. The community of research institutes in nutrition, think-tanks and international Non-Governmental Organizations should put up a strong case. There isa a need to link undernutrition to a failure of governance. The proportion of children underweight could be a more potent measure than poverty.

Nicholas Alipui suggests that Strong public-private sector partnerships can help to reduce undernutrition. There is a clear need for well-focused and strategic partnership between the private and public players. There is scope with regard to Ready-To-Use Therapeutic Foods (RUTFs) for six plus months children suffering Severe Acute Malnutrition (SAM). However, care should be taken to note that this should be not be considered as a substitute for breast feeding, as is being marketed by some private players. Two other related papers in this are that of Community-Based Management of Severe Acute Malnutrition, A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children's Fund (UNICEF), 2007, and Infant and Young Child Feeding and Care by the UNICEF.

The success of salt iodisation has helped reduce iodine deficiency disorder like cretinism, mental retardation and premature birth in 70 per cent of the population as against 20 per cent in the early 1990s. Other related documents in this are Micronutrients - Iodine, Iron and Vitamin A and a 2004 Copenhagen Consensus Challenge Paper Hunger and Malnutrition by Jere R. Behrman, Harold Alderman and John Hoddinott.

In The price of hunger: The relationship between poverty and food intake David Mepham indicates that undernutrition is a symptom and cause of poverty. Halving people with less than one dollar a day would go a long way but it should also be complemented with halving the number of people suffering from inadequate food consumption. Income poverty and inadequate consumption are related and particularly so in large parts of Sub-Saharan Africa and South Asia where average per capita per day returns turn out to be less than the cost of a healthy diet. Poor diet can impair growth and development affecting achievements in schooling and productivity in adulthood and thereby extending deprivation to the next generation. Thus, undernutrition and poverty need to be tackled together and also complemented with nutrition education.

"Malnutrition concerns not enough food, too much food, the wrong types of food, and the body's response to a wide range of infections that result in malabsorption of nutrients, or the inability to use nutrients properly to maintain health. Clinically, malnutrition is characterised by inadequate or excess intake of protein, energy, and micronutrients such as vitamins, and the frequent infections and disorders that result" (World Health Organization).

In Africa, 30 per cent of children are malnourished because of low birth weight and growth faltering in the post-natal period. John Mason and David Sanders indicate that The persistence of child malnutrition in Africa worsens during droughts, conflicts, economics crisis and HIV epidemic. Accelerating globalization is affecting poor farmers. Removal of tariffs income support to farmers in developing countries would increase export opportunities for poorer farmers. Improvements in child nutrition would augur well for reducing child mortality, morbidity and enhancing intellectual development. These are further elaborated in the Impact of Drought and HIV on Child Nutrition in Eastern and Southern Africa and Community Health and Nutrition Programs in Disease Control Priorities in Developing Countries 2nd Edition, edited by Dean T. Jamieson et al, 2006.

The poor Nutrition for mothers and children by Isatou Jallow is in contravention with Article 25.2 of the Universal Declaration of Human Right by which motherhood and childhood are entitled to special care and assistances. Non-exclusive breastfeeding in the first six months is an important risk factor for child mortality and disease burden. Maternal short stature and iron-deficiency anaemia that account for one-fifth of maternal mortality can be attributed to poor nutrition. The World Food Programme can address these concerns while also conveying to communities that (i) child care is not the sole responsibility of women, (ii) improving mother and child nutrition will have positive impacts on the whole society and (iii) there is a need to link mother-child nutrition programme with school feeding and other such programmes to advocate the relevance of nutrition thought an individual's lifecycle. A suggested reading is Halving Hunger: It Can Be Done.


Barbara Macdonald raises the question Why have donors committed so few direct investments to eliminate child undernutrition? Despite some encouraging new initiatives, the constraints identified are (i) the lack of effective coordination amongst the key international and state organisations responsible for reducing undernutrition, (ii) gaps in evidence about the impacts of nutrition interventions, including rigorous evaluation of current programmes, and (iii) the daunting challenge of insufficient trained people to design, implement and evaluate programmes. It also brings into focus two recent publications. (1) 'Maternal and Child Undernutrition Series', The Lancet 371, edited by R. Horton, January 2008, (link for registered users). (2) Vitamin and Mineral Deficiencies Technical Situation Analysis: a Report for the Ten Year Strategy for the Reduction of Vitamin and Mineral Deficiencies', Food and Nutrition Bulletin, 28(1) supplement 2, edited by T. Sanghvi, M. van Ameringen, J. Baker and J. Fiedler, 2007, (link for registered users).

The most important question is What can be done to accelerate progress against undernutrition? Ricardo Uauy drawing from his coauthored paper Effective International Action Against Undernutrition: Why has it Proven so Difficult and What can be Done to Accelerate Progress? in The Lancet suggests four areas. (1) Stewardship and guidance: International organisations must work together to create evidence-based simple, consistent and prioritised guidance. (2) Aid and investment: Increase aid for direct nutrition intervention and better target the neediest group. A case of comparison is that though Disability Adjusted Life Years from undernourishment would be similar to that from Human Immunodeficiency Virus (HIV), aid to latter is almost 20 times greater. (3) Direct service provision: During disasters and conflicts impact of nutritional intervention programmes need to be documented and evaluated for their efficacy (including cost-effectiveness). These will create operational standards as also better coordination mechanisms to improve emergency response. (4) Strengthening resources: To address the shortage of skilled personnel funding need to re-orient training and research to more programme-relevant topics to help increase nutrition interventions.

The issue also provides some useful links of:

Global Alliance for Improved Nutrition – GAIN

Micronutrient Initiative

Save the Children

School Feeding global website

Towards 4 + 5 - Research Programme Consortium on Maternal, Newborn and Child Health

UNICEF - United Nations Children's Fund

United Nations System Standing Committee on Nutrition

World Food Programme

Indian Votes for Loksabha: Phase II 2009

The second phase of elections is for 141 parliamentary seats (see Map). Voting for Inner Manipur took place yesterday. For the remaining 140, it is taking place today (23 April 2009). The distribution across the 12 states are: Andhra Pradesh (20), Assam (11), Bihar (13), Goa (2), Jammu & Kashmir (2), Karnataka (17), Madhya Pradesh (13), Maharashtra (25), Manipur (1), Orissa (11), Tripura (2), Uttar Pradesh (17) and Jharkhand (8). Voting for the remaining assembly seats in Andhra Pradesh (140) and Orissa (77) are also taking place today. As in the case of the first phase, violence has errupted in some parts (particularly, Bihar and Jharkhand).

In the last four to five days I visited Hyderabad in Andhra Pradesha and Nagpur in Vidarbha. In both the places, summer temperature has reached beyond 40 degree, which is three to four degrees above the norm. This could, on the one hand, adversely affect voter turnout, and, on the other, dampen the electioneering spirit. The third phase campaigning needs some thandai.

India Votes for Loksabha: Phase-I 2009

Today, 16 April 2009, is the schedule for the Phase-1 of General Elections 2009 in India to its Parliament (Loksabha). Voting will take place in 124 constituencies spreading across 17 states/union territories. They are one in Andaman & Nicobar Islands, 22 (of the 42) in Andhra Pradesh, two in Arunachal Pradesh, three (of the 14) in Assam, 13 (of the 40) in Bihar, 11 in Chhattisgarh, one (of the six) in Jammu & Kashmir, 20 in Kerala, one in Lakshadweep, 13 (of the 48) in Maharashtra, one (of the two) in Manipur, two in Meghalaya, one in Mizoram, one in Nagaland, six (of the 14) in Jharkhand, 10 (of the 21) in Orissa (see Map). In Andhra Pradesh (154 out of 294) and Orissa (70 of the 147) voters have to also cast for their respective Assembly constituencies. Voting time is from 7am to 5pm.

Some of the prominent places of elections are Vidarbha in Maharashtra (the cotton zone receiving limelight in recent years for increasing farmers' suicides), Chhattisgarh where the Government claims to have created a people's movement (Salwa Judum) to take on Naxalites. The Telengana region in Andhra Pradesh with almost all parties endorsing the formation of a new state. The state also has a new party Praja Rajyam (People's rule) with their matinee idol Chiranjeevi at its helm. Kandhamal in Orissa where one witnessed communal disturbances last year, a reason cited by the current ruling party of Biju Janata Dal (BJD) with Naveen Patnaik as Chief Minister to break ties with their alliance partner Bharatiya Janta Party (BJP) just before the current elections. A common thing of the regions in these four states as also Jharkhand is that they are largely from the contiguous geographical region called Dandakaranya of the Central Indian Plateau. They are also either rainfed or dryland regions with high incidences of poverty.

For the 124 loksabha seats 1715 (including 122 women) candidates are in the fray whose fate would be decided by more than 143 million eligible voters. Electronic voting machines would be used. However results have to wait till all the five phases of elections are over. The remaining phases will be on 23 April, 30 April, 7 May, and 13 May. Counting will take place on 16 May 2009.

We are Indians

Today I chanced upon the blog We Are Indians. It is a good one. More importantly it provides links to the manifestos of the two major parties, Congress (or here) and BJP (or here, see highlights) in the run-up to the 2009 general elections. The author has also given a comparison between the two. The most important message from the blog is to go out and vote. From the blog, one could implicitly know that the IBN portal covering the general elections 2009 is a good one.

Detecting Cervical Cancer

In the paper HPV Screening for Cervical Cancer in Rural India, The New England Journal of Medicine 360 (14): 1885-1394, April 2, 2009 Rengaswamy Sankaranarayanan et al. discuss about a cheaper screening alternative for cervical cancer in resource-poor settings. This has positive implications for health care of women in developing countries.

This uses cluster-randomization. From 52 cluster villages 131,746 women in the 30-59 age-group participated. Four group were assigned 13 cluster villages each randomly. Further, the groups were randomly assigned to undergo different screening mechanisms.

One group (34,126 women) was tested through Deoxyribonucleic acid (DNA) for human papillomavirus (HPV) ; note that Harald zur Hause was one of the recipients of the 2008 Noble prize in Medicine for his discovery of HPV - he received half of the cash award and the other half was shared by Françoise Barré-Sinoussi and Luc Montagnier for their discovery of the human immunodeficiency virus. A second group (32,058 women) was subjected to cytologic testing through a pap smear test where collected tissues are analysed at the cellular structure for early detection of cancer, as is being done for women in developed countries. The third group (34,074 women) was subjected to a visual inspection of the cervix with acetic acid (VIA), another low-cost option. Finally, the fourth (control) group (31,488 women) received standard care.

The design, particularly exclusion of care to the control group, was approved by the ethics committee of the institutes involved - International Agency for Research on Cancer (IARC), Nargis Dutt Memorial Cancer Hospital and Tata Memorial Centre. This process of ethical review should be an integral part of randomization experiments by social scientists/economists.

This is a follow-up study based on the period January 2000-December 2007. The results indicate that for the HPV testing group when compared with the control group one observes significant reduction in incidences of advanced cervical cancer as also deaths. This shows promise for women in low-resource settings or developing countries like India.

Another fact about the publication is that there are 18 authors and some of them are graduates (with a Bacelor;s degree) from different backgrounds (Arts, Commerce and Science). This is an ethical lesson that users of large scale survey data in economics/social sciences need to follow.