Human Ethical Threshold of CO2 Emissions and Projected Life Lost by Excess Emissions

IN A NUTSHELL
Author's Note
 An article which estimates the carbon footprint ethical threshold and the impact of excess emissions on human Life.

It is the first of 13 steps in updating the global burden of health inequity based on the recent UN population division trend and prospects

By Juan Garay

Professor of Global Health Equity Ethics and Metrics in Spain (ENS), Mexico (UNAChiapas), and Cuba (ELAM, UCLV, and UNAH)

Co-founder of the Sustainable Health Equity movement

Valyter.es

Human Ethical Threshold of CO2 Emissions and Projected Life Lost by Excess Emissions

 

Since 1850, nearly 1,778 billion metric tons of carbon dioxide (GtCO₂), equivalent to 478 billion tons of carbon, have been emitted into the atmosphere from fossil fuel combustion and land-use changes  (1). In 2022, global carbon dioxide emissions from fossil fuels and industry totaled 37.15 billion metric tons (GtCO₂), and these emissions are projected to have risen by 1.1 percent in 2023, reaching a record high of 37.55 GtCO₂ (2).

There is a consensus among scientists that significant dangers will arise if the global mean temperature increases by more than 2 degrees Celsius (3), yet many feed-back negative effects will start with 1.5 degrees warming. The relationship between cumulative carbon emissions and global warming indicates that  2.8 Tn of human cumulative  CO2 emissions are linked to a 2-degree Celsius rise and 2 Tn with 1.5 . To avoid exceeding 2 degrees we can only emit an additional 991 Bn tons of carbon dioxide, 241 for 1.5.  At current global annual emission rate (37 Bn Tn in 2023), we will hit 2 degree warming by 2050, and 1.5 by 2030. (4)

The United Nations has recently estimated that the global population will grow from 8 billion in 2024 to 10,1804 billion by 2100 (5), resulting in the accumulation of 765 billion life years over the remainder of the century. We estimate the ethical threshold pc by dividing the remaining carbon budget between the human life years in the remainder of the century. To keep global warming under 2 degrees Celsius during this century, the maximum annual average carbon dioxide emissions per person should be 1,3 tons, and to limit it to 1.5, just 0,3 tons. 

If the 2022 world per capita CO2 emissions (4,63 mT) were maintained during the rest of the century, excessive CO2 emissions would total almost 1,615 Tn beyond ethical limits and global warming would exceed 8 degrees. Such global warming, the highest in 50m years, would result in 218 million excess deaths and a loss of approximately 6,500 million life years, averaging about 30 years lost per excess death (6).

The relation between excess emissions and the consequence of life years lost (6.5Bn) results  in some 1,46 days lost for every excess ton of carbon dioxide emitted annually. At current emission and life expectancy levels this translates to an average of around of 450 life days (1,2 years) lost by EU citizens on o (5.5 mT pc, 3,8 above the ethical threshold, times 1,46 days and 81,5 years of life expectancy) and 1300 days (3.5  years) by those in the US (13mT pc, 11,3 above the ethical threshold, times 1462 days and 79 years of life expectancy) mainly to those living in low-CO2 emission countries.

The above estimates focus solely on the impact of climate change through temperature increase. However, global warming affects human health in many other ways, such as storms and floods, the disruption of food systems, increases in zoonoses and food-, water-, and vector-borne diseases, population displacements, and mental health issues.

 

References

1)  https://doi.org/10.5194/essd-15-5301-2023

(2)https://www.statista.com/statistics/276629/global-co2-emissions/#:~:text=Global%20carbon%20dioxide%20emissions%20from,by%20more%20than%2060%20percent

(3)https://img.climateinteractive.org/2014/02/A-Trillion-Tons.pdf

(4)https://www.mcc-berlin.net/en/research/co2-budget.html 

(5)https://population.un.org/wpp/

(6)https://www.peah.it/2018/07/5498/

 

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Interview to Ms. Gloria Nirere, Menstrual Health Training Lead in Uganda

IN A NUTSHELL
Editor's note Menstruation matters in resource-limited countries where poverty substantially impacts menstruation health management. In this connection, PEAH had the pleasure to arrange a new interview to Ugandan stakeholder Ms. Gloria Nirere currently involved as Facilitator/Training lead, Research and Customer Service professional at AfriPads manufacturer (Kampala, Uganda).

First interview was made four years ago when she was serving as menstrual health management trainer at Kampala based WoMena NGO (find HERE). 

Previously, Ms. Nirere long served in poorly equipped Ugandan contexts where she performed tasks concerning clinical research, community health, humanitarian assistance, and project management at local and national level

  By Daniele Dionisio

PEAH – Policies for Equitable Access to Health

 INTERVIEW

Gloria Nirere, MBA, BDS

Facilitator/ Training lead, Research and Customer Service professional

AfriPads, Kampala, Uganda

 

Menstruation is one of the most common and uniquely female experiences. The average woman will have 400 periods in her lifetime. That means she will spend over 3,500 days of her life menstruating. Yet for millions, the monthly cost of single-use menstrual products is simply unaffordable.

Millions of girls and women rely on unhygienic materials to absorb their monthly menstrual flow. These include old cloth, pieces of mattress and even reusing a disposable pad. In addition to these make-shift materials having a harmful impact on an individual’s health, they are undignified, uncomfortable and can make completing simple daily tasks a challenge.

Source: AFRIpads

 

PEAH: Ms. Nirere, let’s begin with few remarks on menstruation challenges in Uganda and to what extent does poverty locally impact menstruation safe management.

Nirere: It is to a large extent that poverty enhances menstrual challenges. For example, if people are poor, they will not afford to take their children to school. We have the Universal Primary and Secondary Education which is free of charge but again, most families cannot afford to buy scholastic materials, pay fees for lunch and breakfast which are the basic necessities in school. Now when it comes to provision of menstrual products, it is a by the way that’s why most parents have no separate budget for menstrual products and materials such as pads, underwear, school bag and soap for their daughters.

Poverty has also greatly contributed to Gender Based Violence. For example, some women have reported being beaten when they ask for financial support to buy menstrual products while others report that their husbands marry many women because they say that women are unclean while on their periods.  Also, most girls opt for menstrual support from older men who in turn exchange it for sex leading to early marriages and unplanned pregnancies. It would take me a full day talking about Poverty, but be rest assured that its contribution greatly influences menstrual decisions and choices across the globe.

 

PEAH: Ms. Nirere, AFRIpads was established in Sub Saharan Africa in 2010 with the goal of overcoming key challenges that women and girls face whilst on their period in relation to access, affordability and sustainability of menstrual products. Since then, AFRIpads has grown from a 3-person start-up to an award winning social enterprise that remains committed to improving menstrual health for millions across Africa and beyond. Under this perspective, AFRIpads aims to ensure that women and girls, who receive an AFRIpads Menstrual Kit, are also equipped with the knowledge and skills for maintaining a happy and healthy menstrual cycle. In a nutshell, EDUCATION IS KEY. In this regard, please focus all-round on your professional engagement and methods. 

Nirere: For more than 5 years working in this field as an educator, I have found that we have a lot of misconceptions hoovering in many communities. Starting at household level, most parents think that providing menstrual products is the main solver. We need to understand that educating communities about how and why menstruation occurs will make them aware that this is a natural and normal occurrence that requires total emotional, physical and social support. For example, in my trainings I often ask partner organisations to start by holding stakeholder meetings to involve parents, local leaders and government about the scope of MHH (Menstrual Health and Hygiene). We ask questions about latrine/toilet facilities, soap and underwear provision, ease of carrying out menstrual discussions, cultural restrictions etc. A full detailed menstrual training is executed so that by the time this girl is trained, the parents are willing and ready to provide the necessary support. I HUMBLY SUGGEST! All families should look at menstrual needs at household expenses and they should have a separated budget.

I have also discovered that TRUST is a key component for successful menstrual education. Menstrual discussions have been and are still private talks between mother- daughter or any other female relative/peers. Normalizing menstruation starts with trust. Is the person providing education building trust? Are participants willing to share their experience? Do the trainers pay attention to body language? What language is the trainer using? (This can either ehnance myths or appear offensive if less attention is payed), Has the trainer carried out background research on participants? And many more. All these allow participants to feel comfortable around the trainer and positively improve post menstrual experiences.

 

PEAH: What do you think about the importance of male involvement in menstruation education initiatives in Uganda?

Nirere: Check out my blog post on male engagement HERE. You will discover how much you did not know about why males should fully engage in menstrual interventions. In short I would say, our communities even the modern ones have not digested or welcomed menstrual discussions and I think that’s why we are still finding it hard to have all menstrual products tax exempted in many nations and better menstrual services. Also, the power in political, social and cultural spheres are dominated by males making it difficult carry out healthy menstrual discussions and decisions. 

 

PEAH: Coherently with belief that menstrual health goes beyond menstrual products, AFRIpads provides partners, alongside reusable menstrual kits, with a range of resources including a MHH (Menstrual Health and Hygiene) Education Toolkit and a Monitoring and Evaluation framework, encompassing instruments like TRAINING OF TRAINERS HANDBOOK, E-LEARNING TRAINING OF TRAINERS, FLIP CHART PACKAGE, PARTICIPANT BOOKLET, INFORMATION POSTER, and EVALUATION TOOLS. Can you kindly enter into the merits of each?

 Nirere: Upon purchase of AFRIpads products, partner organisations are given free online education and access to the training materials. The training is delivered in a Train the Trainer format after which partner staff can sustainably contact menstrual health trainings. They are given certificates as competent MHH trainers and these are awarded after passing evaluation tests administered during the training.

Trainers are given the GirlTalk Handbook which is a trainers manual, they are required to read and understand the session. I keep following up on progress and answer questions.

FLIP CHART PACKAGE: these are charts hanged on the walls as the trainer is providing the education. We know that some participants easily relate to visuals rather than listening all the time, this tool makes trainings memorable as participants can relate to the information given with the displayed visuals.

PARTICIPANT BOOKLET: these are take home booklets given to participants so that they can keep refering to in case they need to remember. It contains practice questions and leads to communal knowledge sharing.

INFORMATION POSTER: this is displayed in strategic locations where anyone around can look at, interprete and learn from it. It also promotes menstrual knowledge in communities around.

EVALUATION TOOLS: participant knowledge is evaluated before and after the training. This is a key component for all trainers to get certificates. We want to have competent trainers who can deliver MHH trainings on behalf of their organisation.

DATA COLLECTION TOOLKIT: this booklet contains a 10 step guide on how to successfully collect MHH data. Data collection training is provided following this guide and this leads to making informed decisions before and after carrying out menstrual interventions.

 

PEAH: On this wavelength, something more about instruments like the Girl Talk Booklet and the Data Collection Toolkit?

 Nirere: The Girl Talk Booklet consists of Flipchart package, posters, Girl Talk handbook, participant booklet and Training evaluation while the Data collection Toolkit consists of Visual Aids, Surveys, Consent forms and Focus Group Discussing (FGD) Guides. 

 

PEAH: AFRIpads believes that pairing reusable menstrual kits with an education curriculum is essential for breaking menstrual barriers, addressing taboos and improving menstrual health and hygiene worldwide. As such, what about the global benefits of AFRIpads reusable menstrual kits?

Nirere: By pairing AFRIpads reusable pads with education and Data collection ensures it is an all round sustainable solver for menstrual barriers. The contribution of AFRIpads reusable pads globally has quite overwhelming positive results because now we have seen over 5 Africa based reusable pad manufacturers that have picked an inspiration from AFRIpads story, the product is more sustainable, cost effective and environmentally friendly, it is culturally acceptable and appropriate, it has no gells or scents added and it has quality certified. 

 

PEAH: This matches with the scope and aims of the AFRIpads Foundation, established in July 2010, to raise funds and distribute reusable sanitary pads for vulnerable, disadvantaged girls, who lack the means to buy an AFRIpads Menstrual Kit themselves. For instance, girls living in refugee camps, who may not have the means to purchase their own pads. For only 7,50 euro one girl can be provided with an AFRIpads Menstrual Kit, which can support her to manage her period for an entire year. Please, add information about.

 Nirere: AFRIpads company is a social profit making enterprise which uses its profits to sustain the comptent staff in the factory and in various offices within and outside Uganda. Thanks to the AFRIpads Foundation working tirelessly to pull funds to support many underprivileged communities and uplift the beautiful work of small NGO’s not only in Africa but across the globe. 

 

PEAH: In this connection, kindly tells us about The Use and Care sheet (available in English, Swahili, French, Portuguese, Kinyarwanda, Arabic and more languages upon request) as an hard laminated, waterproof guide to ensure users are informed on how to use AFRIpads reusable pads safely and effectively.

Nirere: The use and care instruction guide has steps to follow for proper use and care of the product. Once an organisation buys our products or gets a donation from AFRIpads Foundation, they receive the use and care laminated instruction sheet, the same sheet is designed as a leaflet inserted in all packaged AFRIpads packets (School girl kit, Standard 4 pack, Standard 6 pack and Custom Kit). Depending on the location of targeted users, the leaflet can be translated in the language that speaks well to them.

 

PEAH: Your duties imply training of trainers: let us know more as for your approach and tools.

 Nirere: As the train lead at AFRIpads, Training of trainers involves an approach of providing information on how to successfully execute effective MHH trainings. I make background checks about the organisation and participants requesting for the training, schedule in person and online meetings to identify and assess needs, organize tailored training materials, share tips of MHH trainings and make follow up to check successful execution of trainings provided by trainees.

The training has a lot of online and in person activities like group discussions, individual tasks, role plays, brainstorming and many more.

A 3 hour training is executed using the AFRIpads Girl Talk handbook which has 3 sessions. Participants get engaged and learn how to introduce the session, dos and don’ts. Their MHH knowledge is evaluated before and after the training.

 

PEAH: Once again, thank you Ms. Nirere for your exhaustive answers and very deserving commitment

 

Millions of women and girls worldwide still cannot afford menstrual products or access water and sanitation facilities to manage their menstrual health and hygiene. Periods make them miss school, work, and negatively impact their health, but it does not have to be that way.

 Source: UN Women Africa

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Health and Financing

IN A NUTSHELL
Author's note
…if steady financing were to be secured through laws, maybe the health sector in all countries could improve and thrive. Is not only having the funds, is how wisely ministries spend these. Is there proper planning? Are priorities set and a clear plan devised to achieve these?...

 By Francisco  Becerra-Posada, MD, MPH, DrPH

Health and Financing

 

One of the fields that has an impact on the lives of populations is public health. The actions of policies and programs that seek to improve the population, not in the field of the clinic in one-to-one interactions, but through collective actions together with social improvements, have a positive impact expressed in a decrease in morbidity and mortality rates.

The region of the Americas is, among the six regions of the World Health Organization, the ones that have shown the best progress in one of the actions that is perhaps the most equitable to provide children with an equitable start in life, vaccines. The WHO established the Expanded Program on Immunization and PAHO endorsed it in 1977, just 2 years after we began our studies.

It was the Pan American Health Organization, which last year celebrated its 120th anniversary, that made the fastest progress with the Expanded Program on Immunizations. The research and development of vaccines led to the availability of biologics against measles, rubella and mumps in the 1960s, and then with the production of the vaccine against chickenpox and inactivated Japanese encephalitis in the 1970s. By then, most of our generation had already been vaccinated against smallpox and almost certainly most of us suffered from “childhood” diseases, as we used to write in our medical records.

It was our children and now our grandchildren, who have benefited from the development of vaccines. What was a vaccination scheme of six biologicals, we now have a vaccination perspective for the life course, from birth to reaching older adults, and that we now benefit from these new vaccines for those over 60 years of age.

I had the opportunity and honor to be selected to serve as PAHO’s Assistant Director between 2013 and 2018. An interesting period for the region in terms of health. The elimination of rubella and measles was achieved, the proposal towards universal health coverage and access was launched (before the WHO did so), the PAHO Public Health Review was strengthened, among many other initiatives approved by the countries of the Region.

Advances in public health and health systems in countries have come a long way, and PAHO’s role is not equal in all countries. However, the COVID pandemic demonstrated the fragility of health systems around the world. PAHO is now renewing efforts with countries to strengthen primary health care and encourage health financing.

Health financing depends on many factors, political and social decisions and commitment. However, if steady financing were to be secured through laws, maybe the health sector in all countries could improve and thrive. Is not only having the funds, is how wisely ministries spend these. Is there proper planning? Are priorities set and a clear plan devised to achieve these?

Having secure funding, would protect immunization programs, there must be financial space for incorporation of novel vaccines, and to save towards an emergency vaccine fund as a preparedness measure for when the next pandemic reaches us. We have to learn from the COVID-19 experience and the resources needed for vaccines and medical care that had to be taken from other programs to face the emergency.

Sadly, few governments have a limited vision, and rather than thinking on state policies and decisions, they are motivated by priorities set by the government in charge that sadly, are limited in time. Have we learned something from the pandemic? Will ministries continue to move as usual? Hopefully, we will see a change. Are you going to contribute to it?

 

By the same Author on PEAH

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Re-Orientation to Sustain Life on Earth: a PDF by George Lueddeke

IN A NUTSHELL
Editor's note Under One Health perspective, a live PDF here PEAH just received from our acknowledged partner Dr. George Lueddeke.
 
Originally from Canada, now residing in the United Kingdom, George Lueddeke PhD MEd Dipl.AVES (Hon.) is an education advisor in Higher, Medical and One Health education and global lead of the International One Health for One Planet Education initiative (1 HOPE) in association with national, regional, and global organisations

George Lueddeke

By George LueddekePhD

Consultant in Higher, Medical, and One Health Education

Global Lead – International One Health for One Planet Education initiative (1 HOPE)

Re-Orientation to Sustain Life on Earth

A PDF by George Lueddeke

 

Just received from Dr. George Lueddeke, PEAH is  glad to bring to the attention of  its readership a live PDF poster  full of  hyperlinks aimed, under One Health perspective, at re-orienting practices and behaviours by governments, corporations and civil society for the sake of a sustainable living on Earth.

In this connection, excerpts from what already published by Lueddeke  can believably serve as an appropriate introduction:

...After billions of years of evolution, in just a few decades we have come to an inevitable turning-point. While we have made significant scientific / technological progress, we have failed to safeguard life on the planet including ours (we are but one of about 8.5 million species!). Although we have cognitive and affective capacities for achieving a harmonious world, our lives continue to be overridden by the self-interests, ambitions, and power of a few (1%?) -think  AI and technology! 

In the longer run, it appears that “a more just, sustainable and peaceful world” can only be achieved if we all realise the consequences of our short-term thinking (e.g., profits over survival, control or enslavement over freedoms) and learn to rise above the human-fabricated divisions and inequities that divide us (social, political, religious, economic, etc.). If we fail, so will future generations and humanity. Democratic societies depend on a shared belief in ‘something greater than themselves’ and holding ‘power to account’. 

https://www.peah.it/2022/05/11063/
...Whether we are able to achieve a “more just, sustainable and peaceful world” will depend on the decisions we make now as opportunities for social transformation are becoming increasingly time- limited. There is no question that new thinking is required and that both education and research are key in moving societies in new directions to ensure planet sustainability.  To these ends, here are a few re-orientations to consider by governments, corporations and civil society in general to sustain life on the planet shifting from:

human-centrism to eco-centrism;

subject fragmentation to disciplinary integration;

knowledge transfer to knowledge discovery;

intervention to prevention and a future consciousness;

individualism to ‘learning from and with others’:

those who ‘have‘ to those who ‘have not’;

thinking globally to acting locally;

profit margins to self-fulfilment and ‘doing something good’;

self-interests, ambition, power to understanding, compassion and  truth. 

https://www.peah.it/2022/05/11063/
Enclosed below is a link to an updated capacity-building publications poster (case study) originally prepared for UN SDG acceleration Summit last year

Click HERE to see the live PDF 
The  challenges  and ‘reflections’ articles (all live) might be informative for some PEAH readers (e.g., comments on?).

 

By George Lueddeke on PEAH

Betting on SDGs in a Disequal World

Holistic Systemic Change to Care for All Life on Earth

Earth Future: Time for a Global ‘Reset’!

Reflections on Transforming Higher Education for the 21st Century: PART 3 The international One Health for One Planet Education Initiative (1 HOPE) and the ‘Ecological University’

Reflections on Transforming Higher Education for the 21st Century: PART 2 Development of a Global ‘All Life’ Narrative

Reflections on Transforming Higher Education for the 21st Century: PART 1 The One Health & Wellbeing Concept

Planet Earth: Averting ‘A Point Of No Return’?

Tackling the Root Causes of Climate Change. If Not Now, WHEN?

Commentary on ‘More for The World Organisation for Animal Health (OIE) – Impakter’

Rebuilding Trust and Compassion in a Covid-19 World

The University in the early Decades of the Third Millennium: Saving the World from itself?

The World at Risk: Covid-19, Global Sustainability and 1 HOPE

Postscript – The World at Risk: Covid-19, Global Sustainability and 1 HOPE

 On this theme, see also

INTERVIEW – ‘Survival: One Health, One Planet, One Future’ – Routledge, 1st edition, 2019

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Creating Aspirations in Aspiration District Yadgir, a Pre-Industrial Pocket of India  by Veena S Rao

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Creating Aspirations in Aspiration District Yadgir, a Pre-Industrial Pocket of India

IN A NUTSHELL
Author's note
...We are implementing a unique project to address malnutrition and provide rural livelihoods in Yadgir District, Karnataka, supported by the Department of Science and Technology, Govt. of India in partnership with Karnataka State Council for Science and Technology (KSCST) and Centre for Sustainable Technology (CST), Indian Institute of Science, Bangalore. Bharatiya Agro Industries Foundation (BAIF) Development Research Foundation are our field partners. Project details and progress are available at our website https://publicnutrition.aurosociety.org/

A valuable lesson that we have learnt so far in our journey for bringing about the much required behaviour change and belief systems change in the community and family is that children are the most aspirational and influential agents to create that change...

By  Ms. Veena S Rao, IAS (Retd)

Director,  Auro Centre for Public Nutrition, Public Health and Public Policy 

Bangalore, India 

Creating Aspirations in Aspiration District Yadgir, a Pre-Industrial Pocket of India

 

 General Background

The Government of India in 2018 initiated the Aspirational Districts Programme with the aim to transform 112 most under-developed districts of the country, quickly and effectively. The broad contours of the programme are convergence of State and Central programmes, collaboration of Central, State and District administrators, and competition among the districts through monthly delta ranking, all driven by a mass movement. The ranking is based on the incremental progress made across 49 Key Performance Indicators (KPIs) under 5 broad socio-economic themes – Health & Nutrition, Education, Agriculture & Water Resources, Financial Inclusion & Skill Development and Infrastructure.[1]

One such Aspiration District is Yadgir District in the state of Karnataka which is also the most backward district of the State. The policy of the Auro Centre for Public Nutrition, Public Health and Public Policy (ACPN) a vertical of Sri Aurobindo Society (SAS) Pondicherry, is to work in the most backward regions of the country.

We are implementing a unique project, “Establishing SHG/FPO[2] enterprises to address malnutrition and provide rural livelihoods in Yadgir District, Karnataka”, supported by the Department of Science and Technology, Govt. of India in partnership with Karnataka State Council for Science and Technology (KSCST) and Centre for Sustainable Technology (CST), Indian Institute of Science, Bangalore. Bharatiya Agro Industries Foundation (BAIF) Development Research Foundation are our field partners. Project details and progress are available at our website https://publicnutrition.aurosociety.org/

This is a unique, holistic, multi-sectoral, development project covering Horticulture, Women’s Empowerment, Nutrition and Education. Our project began in 2022 with a Base Line Survey of the two poorest quintile households of the District, and was accompanied by a multi-layered communication strategy for behavior change at community level.[3]

I am placing below an extract which tells us just how poor and worrisome the human development indicators of Yadgir District are.

  • 20% of mothers of children below 3 years (all migrant labourers) said that their infants did not consume any complementary food until they were about 2 years. The mothers said that whenever the infants were given something from the family food, mostly roti, dal, idli (a soft steamed cake made from rice and lentils) or ganji (soft boiled rice), they were not able to digest it and became ill. All the mothers were migrant workers and did not access any benefits from ICDS (Integrated Child Development Services).
  • Among children aged 6-35 years, about 64.5% are either stunted, or wasted or underweight. The proportion of children (both boys and girls) under 3 years who are not stunted, not wasted or not underweight decreases as the age increases, implying that their nutritional status/health deteriorates as they grow older.
  • Among children aged 3-5 years about 72.79% are either stunted or wasted or underweight. The proportion of children (both boys and girls) who are not stunted, not wasted and not underweight decreases as age increases, implying that the nutritional status/health of the children is deteriorating as they grow older.
  • About 17.5% of adolescent girls and 7.2% of the adolescent boys (between 11-18 years) are illiterate. None of the girls have studied up to class 10, and about 20% of boys are in class 10. Overall, about 47.39% adolescent girls and 52.9% adolescent boys are severely underweight and 27.96% girls and 30.77% boys are moderately underweight. About 57% of mothers of children under 3 years and 63.5% mothers of children between 3-5 years are illiterate. Consumption of fruits, vegetables, dairy products constitute a very small part of the daily diet.
The Table below shows some Baseline Survey Indicators compared with NFHS 5[4] Indicators for Karnataka State and Yadgir District
BLS Yadgir District NFHS 5-Yadgir District NFHS 5-Karnataka State
Percentage children under five years % (N) %(N) %(N)
Stunted* 47.9 (698) 57.6(215) 35.4 (6785)
Wasted* 32.5 (695) 17.7 (209) 19.5 (6563)
Underweight* 53.5 (703) 45.2 (219) 32.9 (6991)
Adolescent BMI (% BMI < 18.5 – total thin)$ (11-18 years) (15-19 years)
Boys 83.3 (221) 47.1 (576)
Girls 75.4 (211) 42.4 (3993)

*Statistically Significant differences at 95% CI and p < 0.05

 

I have always maintained that one of the root causes for persistent undernutrition, anemia and calorie-protein-micronutrient deficiency among large sections of India’s population, especially the poorest 30-40 percent, is a complete vacuum in the market for low cost, fortified nutritious foods, which I call the market deficit.

The daily diets of the poorest families are meagre, subsistence diets and do not provide the balanced nutrition required for healthy growth of children and adolescents during rapid growth periods, for women during pregnancy and lactation, for all age groups of both genders during or after illness, and complementary food for infants after 6 months of age. Even though the per capita income has more than quadrupled in the last decade, the vast dietary deficit in terms of protein, calorie and micronutrients remains among around 50% of our population of both sexes and all age groups.[5]

A Feasibility Study conducted through KPMG in 2018 under the World Bank funded Karnataka Multi-sectoral Nutrition Pilot Projects[6] implemented by the Karnataka Comprehensive Nutrition Mission, gives a firm finding that there is a direct correlation between high incidence of low weight, stunting and wasting among children, low body mass index and stunting among adolescents, and lack of affordable fortified energy food in the market.  The study calculates a market demand of 42 million tons of low-cost energy food per year.

Data regarding severe child malnutrition and wasting on a real time basis in the Karnataka Multi-sectoral Nutrition Pilot Projects, led by the author, confirmed that all cases of severely malnourished/wasted children were from households where both parents were engaged in construction or agricultural labour. The infants were left under the care of elder siblings or grandparents, and apart from some roti (flat bread), rice and pulses, which the infants could not eat, there was no other food in the house. And there was no affordable, nutritive children’s food available in the market.

Availability of affordable, nutritious food in the market assumed even greater importance during the COVID 19 pandemic – lockdown and post lockdown. Reports from the field categorically informed that poor rural families were on a survival diet of rice and wheat given under PDS (Public Distribution System), and sometimes some dal. In many villages, even after the pandemic, there continued to be no milk or any other food for children. A study done by Azim Premji University confirmed this[7].

On the other hand, India, one of the largest fruit and vegetable producers in the world loses a large percentage of production due to spoilage and post-harvest losses because of lack of primary processing facilities, fuel-efficient post-harvest technology and hygienic storage facilities. Horticultural loss estimates vary from 15% to 40%.[8] [9] In the absence of primary processing facilities for preservation or processing, it is to be expected that the wastage of horticulture produce will continue unless simpler methods using alternative source of energy and more decentralized operations at the grassroots for processing and preserving horticulture produce are introduced.

Our project therefore included that a Production Unit would be set up for producing fortified nutritious multi-grain food, VitaPoshan, for children, adolescents, adults and family, also using locally available horticulture produce with short shelf life, primarily tomatoes and bananas, through simple energy friendly rural technology.  Women SHGs would be trained for running the production unit with hand-holding support from us and for marketing VitaPoshan within the District. This would fill the huge technology gap that exists in Yadgir District, provide the poorest sections of the community access to affordable nutritious food, and prevent wastage of horticultural produce.

I am informed that our production unit will be the first medium scale production unit being set up in Yadgir District, though there are some small industrial units for cleaning pulses and cotton, the main agricultural crops of Yadgir District. In fact, I often describe Yadgir District as a “pre-industrial pocket of India”!

In short, the Project Objectives are: 

  • Provide livelihoods to SHGs/FPOs through Innovative Farm Based Enterprises, Value Chains and Market Linkages.
  • Address malnutrition, reduce anaemia and improve the health status of the community and provide fortified nutritious food to the rural poor – to children, adolescents, adults and family.
  • Prevent wastage of fruits and vegetables, reduce losses during glut season, arrest distress sales and reduce market risks.
  • Provide cash income to the SHGs/FPOs and contribute to their economic empowerment.
  • Build capacity of FPOs/SHGs, improve the quality of life of women through value added income generation and marketing of nutritive horticultural products preserved/dehydrated/processed through fuel efficient, green energy. 

Project Interventions, Completed and Ongoing:

  • Baseline Survey and Socio-Economic survey have been completed (2022). [10] The indicators are extremely worrisome and need urgent interventions. (Summary above)
  • SHG mobilization and Information Education Communication (IEC) Campaign for Behaviour Change is ongoing. Advocacy material is being given to the SHGs with personal counselling regarding proper child, adolescent and maternal care, and proper dietary practices within family budgets.
  • Product Development, Nutrition Analysis and Shelf Life Tests have been completed for all the four VitaPoshan products.
  • A green, environment friendly, Production Unit is being set up by KSCST and CST, for producing fortified nutritious food, VitaPoshan, for children, adolescents, adults and a special nutritious family food, which is a fortified blend of pulses and tomato powder. Trial Production is expected to start by end of June 2024 and regular production is expected to start in July 2024.
  • Marketing of products produced by the SHG women, will be done through a hybrid Marketing Strategy involving marketing by SHGs, traditional retail and wholesale distribution networks, on-line sales. Marketing training of women SHGs is going on.

We eagerly await VitaPoshan to start reaching the community, and hope to see an improvement in the human development indicators of the poorest households of the community.

A valuable Lesson Learnt

A valuable lesson that we have learnt so far in our journey for bringing about the much required behaviour change and belief systems change in the community and family is that children are the most aspirational and influential agents to create that change. We saw for ourselves how they actually created aspirations in this Aspirational District.

Initially, we had started the behaviour change programme with tried and tested methods of engaging with the women SHG members and village influencers.  Awareness generation activities were organized in villages focusing on basic child, adolescent and maternal care, and proper nutritional practices within family budgets. However, we realized that we were not creating any impact. We debated amongst ourselves – perhaps this indifference was on account of lack of trust which the community seemed to show for any kind of behaviour change messaging; perhaps their cynicism within the culture of poverty was too strong to allow them to believe the messages. After all, they had lived in this subsistence state for generations and had come to accept it with a sense of fatalism.

After much discussion and brain storming with our field partners, we finally concluded that the most influential agents of change in this generational subsistence society were the children, as they held a very special place in the family. The boys are treated as assets to take care of their parents once they are old and unable to work, and the girls are considered as temporary inmates who would move away to their marital homes after some years.  We learnt that parents here generally are very indulgent towards their children.

We therefore took a decision that we would start the behaviour change programmes through students in the senior schools. Relevant themes that were urgently required to be disseminated were selected and age appropriate IEC material in the form of posters and films were developed.

The themes covered were:

  1. Importance of balanced diet and consumption of locally available fruits and vegetables
  2. Not coming to school on an empty stomach
  3. Avoiding junk food
  4. Importance of clean drinking water and sanitation
  5. Causes of anemia and how to prevent it
  6. Intergeneration lifecycle of Malnutrition

IEC programmes were conducted in 40 senior schools across the district from November, 2022 onwards. The programmes were made more interesting through films[11], quizzes and games so that children could enjoy them and take home the messages to their parents. We deliberately selected schools in the most backward and remote villages of the district, many of which did not even have motorable roads.

Impact of Our Programme

An Impact Assessment was conducted in April 2023, across 40 schools in 37 villages, that covered formal interviews with students, parents and teachers.[12] The observations were extremely encouraging.

  • There were positive behaviour changes in around 60% families
  • Many students started eating sprouts and local fruits daily
  • All children started eating a meal before coming to school
  • Children started asking their parents for a variety of fruits and vegetables
  • Students realised the risks of junk food and chose healthier options like chikki (peanut and jiggery toffee) and banana as a snack
  • Students were not wasting vegetables served as part of their school mid-day meal
  • Teachers reported that the health of students who followed the messages has improved
  • Students were more active; they participated in games and had better concentration in the classroom

We were extremely happy that our experiment of starting behavior change and creating aspirations in the family through children worked. I hope this important learning will be useful for other development agencies, NGOs, and field workers operating in the poorest regions of the world.

 

References

[1] https://www.niti.gov.in/aspirational-districts-programme

[2] SHG- Self Help Group; FPO-Farmer Producer Organization

[3] https://publicnutrition.aurosociety.org/wp-content/uploads/2023/03/Baseline-and-Social-Survey-Yadgir.pdf

[4] National Family Health Survey 5, 2019-2020

[5] NFHS 5, 2019-20; Comprehensive National Nutrition Survey 2016-18; NNMB 3rd Repeat Survey (2012; NNMB Report 27, 2017

[6]http://karnutmission.org.in/documents/New_Feasibility_Study.pdf

[7]https://cse.azimpremjiuniversity.edu.in/wp-content/uploads/2020/06/Compilation-of-findings-APU-COVID-19-Livelihoods-Survey_Final.pdf

[8]https://www.researchgate.net/publication/374116896_Post_harvest_losses_of_fruits_and_vegetables_in_India

[9] https://www.nationalheraldindia.com/national/40-vegetables-fruits-get-wasted-in-india-iari-director#google_vignette

[10] https://publicnutrition.aurosociety.org/wp-content/uploads/2023/03/Baseline-and-Social-Survey-Yadgir.pdf

[11] The films can be viewed @ https://publicnutrition .aurosociety.org/gallery/

[12] : https://publicnutrition.aurosociety.org/wp-content/uploads/2023/04/27-4-Impact-Assessment.pdf

 

By the same Author on PEAH

Karnataka Multisectoral Nutrition Pilot Project (2014-2018): Some Significant New Evidence Based Findings and Need for Further Research

Multisectoral Nutrition Interventions: Impact and Transitions in Undernutrition, Stunting and Wasting in Children – An Open Experiment in Two Remote Blocks of Karnataka

Nourishing India – What Needs to Be Done

Betting on SDGs in a Disequal World

IN A NUTSHELL
Editor's note  Far-reaching reflections here PEAH just received from our acknowledged partner Dr. George Lueddeke. 

 Originally from Canada, now residing in the United Kingdom, George Lueddeke PhD MEd Dipl.AVES (Hon.) is an education advisor in Higher, Medical and One Health education and global lead of the International One Health for One Planet Education initiative (1 HOPE) in association with national, regional, and global organisations

George Lueddeke

By George LueddekePhD

Consultant in Higher, Medical, and One Health Education

Global Lead – International One Health for One Planet Education initiative (1 HOPE)

Betting on SDGs in a Disequal World

 

Excerpts on SDGs shared with evolving regional 1 HOPE-TDR steering committee members (Africa, Americas, Asia, Europe) may be of interest to PEAH readership… trying to raise awareness of several important developments impacting on our collective futures:

G7 leaders at the Italy summit (13-15 June 2024) Image Credit: International Institute for Sustainable Development (IISD) 

(1)G7 Pledges to Accelerate SDGs, Transition from Fossil Fuels This Decade

(2) UN Sustainable Development Goals

 

…The 2024 progress assessment reveals the world is severely off-track to achieve the 2030 Agenda. As illustrated in Figure 1, out of 135 targets with trend data and additional insights from custodian agencies, only 17% are progressing as expected to be achieved by 2030. Nearly half (48%) exhibit moderate to severe deviations from the desired trajectory, with 30% showing marginal progress and 18% indicating moderate progress. Alarmingly, 18% have stagnated, and 17% have regressed below the 2015 baseline levels…
(3) UN 2024 SDG progress report
Countries are ranked by their overall score. The overall score measures the total progress towards achieving all 17 SDGs. The score can be interpreted as a percentage of SDG achievement. A score of 100 indicates that all SDGs have been achieved.
(4)  Country Rankings

(5) 1 HOPE-TDR: “Cultivating an active care for the world and those with whom we share it” (UNESCO)
It is in Part 2 of the 2024 SDG Report and gives a clear picture - including progress- of where the world stands in relation to the SDGs and makes a case for 1 HOPE-TDR (e.g., #14,#15,#16)  and the urgency for all stakeholders - Government, Civil Society (e.g., academia),  Business..- to shift from human-centrism ('it's all about us') to Earth /eco-centrism ('it's about all life on the planet) and sustaining our 'blue' planet in a shared environment.

(6) Figure 2.2 | World SDG Dashboard 2024 

 

Importantly, the countries with the highest scores are all democracies (freedoms!).  Anyone who believes that living in an autocracy or neo-fascism is better must take a close look at North Korea today – along with recalling life under Nazi Germany.  The recent  article North Koreans face lives devoid of hope, UN rights chief says is a wake-up call for us all and clearly demonstrates that freedom of  choice  in all aspects of life is far better than  enslavement!  Indeed, the happiest countries in the world are those where freedom of the press is the greatest!

 

readers are invited to comment on the content and suggestions of this post   

 

—————————-

By George Lueddeke on PEAH

Holistic Systemic Change to Care for All Life on Earth

Earth Future: Time for a Global ‘Reset’! 

Reflections on Transforming Higher Education for the 21st Century: PART 3 The international One Health for One Planet Education Initiative (1 HOPE) and the ‘Ecological University’ 

Reflections on Transforming Higher Education for the 21st Century: PART 2 Development of a Global ‘All Life’ Narrative 

Reflections on Transforming Higher Education for the 21st Century: PART 1 The One Health & Wellbeing Concept 

Planet Earth: Averting ‘A Point Of No Return’? 

Tackling the Root Causes of Climate Change. If Not Now, WHEN?

Commentary on ‘More for The World Organisation for Animal Health (OIE) – Impakter’

Rebuilding Trust and Compassion in a Covid-19 World

The University in the early Decades of the Third Millennium: Saving the World from itself?

The World at Risk: Covid-19, Global Sustainability and 1 HOPE

Postscript – The World at Risk: Covid-19, Global Sustainability and 1 HOPE

 On this theme, see also

INTERVIEW – ‘Survival: One Health, One Planet, One Future’ – Routledge, 1st edition, 2019