Child Mortality

Child Mortality 1

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Child Mortality 2

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Child Mortality 3

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While the info-graphics above need no explanation, for those who lack the time to enlarge the image and peruse them, am mentioning below some key take-aways :

  • 6.6 Mn children under the age of 5 died in 2012
  • The global under-5 mortality rate equals 48 deaths per 1000 births

o   In case you thought the scourge of pneumonia had been banished, think again ; it accounts for 17% of these deaths, and is the largest contributor, along with prematurity. Pneumonia is still the leading cause of deaths in 83 countries

o   Malaria is still a major killer in Sub-Saharan Africa, causing about 14 percent of under-five deaths in the region.

o   Deaths due to diarrhoea have been nearly halved in the past decade but it still accounts for a tenth of all under-five deaths. Deaths due to Diarrhoea are high in countries such as India, Afghanistan, Ethiopia, Somalia, Angola, Niger etc.

  • India, Pakistan, Bangladesh, China, Indonesia, Nigeria and China, 7 of the most populous countries, collectively accounted for half of the total number of under-five deaths globally

o   While China is mentioned among these, it’s under-5 mortality rate (at 14 deaths per 1000 births) is actually much less than that of the other nations , it features on this list die it’s large population base

o   Of these nations, the statistic is the worst for Nigeria, with an under-5 mortality rate of 124 deaths per 1000 births

In case to wish to see statistics on under-5 mortality rates or causes for a particular country, you can click on this link for causes and this link for rates.

  • Ravindra Ramavath

 

June 5, 2014 at 8:32 am Leave a comment

Quality of Available Education

As promised in our last post, here are some interesting statistics from Pratham’s ASER survey about the quality of education available currently.   Education infographic - ASER 2013

 

 

In addition, for viewing this data by state, click on this link to view the enrolment data, and on this link to view the data on arithmetic ability. If interested, you can also view the changes in these parameters over time.

  • Ravindra Ramavath

May 15, 2014 at 9:28 am Leave a comment

Micro-entrepreneurs and Math

Our last post focussed on literacy levels and the availability of schools in a few focus states. This post is anecdotal in nature and contains some observations about the various ways in which the lack of a quality education hinders micro-entrepreneurs from developing necessary business skills and attaining their full potential ; the next post will share some quantitative data on the quality of education available to children currently.

While interacting with adult learners at the Cream training programmes offered by Tree Society to rural micro-entrepreneurs, I’ve noticed that they struggle with basic math and/or with the application of basic math. Yet, the adults undergoing CREAM training are not illiterate; all of them have attended school for at least a few years, most are 10th or 12th pass, and some are graduates from a local college.

 

There are those who know the calculations – can manage division, decimals, percentages etc. – but struggle to apply these in real-life situations.

[  A simple example : The owner of a small business may know what percentage is and even how to convert a percentage to a value; i.e. he knows that 10% of 200 = 20

But he may struggle when faced with a question in words. ‘A business sold goods worth Rs. 4000 this month. It expects a 10% increase in sale value next month. What will be the value of total sales next month ?’ ]

I have also noticed another phenomenon – even when they learn how to apply a formula and use it, any change in the structure of the problem or in the way they need to apply a formula leaves them slightly confused as algebraic manipulation is a skill not taught to them. For example, even if they understand a formula for profitability and its application, they are unable to rearrange and apply the formula to a problem where desired profitability and costs are known, but selling price and revenue are to be calculated.

Then there are some adults who seem to have learnt hardly any Math beyond counting and addition in childhood. They struggle with sums that involve simple division and cannot interpret decimals or fractions correctly. They are fazed by basic calculations such as margin or profit %, growth rate etc. As a result, the micro – businesses they run are inefficient and fail in adopting well-established processes such as setting the right selling price for their product, or estimating the right amount of raw material based on a sales forecast, or making a reasonably accurate sales estimate in the first place. The experience of teaching this set of micro-entrepreneurs made me start wondering about the state of primary education in our country and the implications on the supposed demographic dividend (or liability) for our future.

In fact, as data from Pratham’s ASER survey shows, it’s no surprise that so many of the adult learners struggled with division; even today, only 25% of children in class V can solve a division problem, and this proportion rises to only 46% of students in class VIII (wait for our next post for more information and some interesting infographics on this).

  • Zenobia Driver

May 13, 2014 at 4:47 pm 2 comments

India’s Demographic Dividend and Education

In this post last year, we’d looked at the composition of the increase in India’s population from 2001 to 2026 and seen that nearly 50% of all births between 2001 and 2026 will be in 7 states – Uttar Pradesh, Rajasthan, Bihar, Jharkhand, Uttaranchal, Madhya Pradesh and Chhattisgarh. One of the points we’d wondered about in that post was whether good quality education is and would be available to these children. The infographics that follow share some basic information about the supply of education; we’ll share information on the quality of available education in a subsequent post. Till then, to whet your appetite on the topic of quality, here’s a link to a article from the Mint on the available infrastructure and quality of education in Bihar.

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  • Ravindra Ramavath

April 3, 2014 at 5:50 am Leave a comment

Colors of India – Part 2

Continuing our series on how brands are bringing out different shades of India, part 2 of the series explores how ads are honing in on the nuanced evolution of India and Indian-ness. Here are a few examples: 

The wedding ad from jewelry brand Tanishq tackles several Indian stereotypes and shows how attitudes and perceptions are changing in the Indian society. It addresses issues like remarriage and single parenthood, which are considered taboo in India. In addition to this, it very subtly also addresses the change in the role that women are playing these days – the bride walking herself to the mandap with the head not covered, in a society where the bride is surrounded by girlfriends, sisters and aunts to escort and typically dons a ghoonghat (veil). By showing a dusky bride, it challenges the stereotype that only fair is beautiful.

The Bharat Matrimony ad shows how respecting and supporting your partner is a big contributor to a happy marriage, and how husbands are more accepting of this. The ad shows a husband supporting his wife’s decision to work and giving her the freedom and encouragement to do what pleases her and standing up for his wife’s decision to work despite it displeasing his parents. It indicates the changing dynamics within family, the base institution of a society.

The new Daawat Basmati Rice Pyaar Ki Special Bhashaa (The Special Language of Love) ad talks about the Indian way of expressing love – not through hugs, kisses and I love yous – but through the food we serve and share. While most scenes depicted in the ad show women cooking and serving, towards the end it also shows how men are playing a more active role in the kitchen and the household.

On a lighter note, Hero’s Thoda Aur (A Little More) ad discovers this beautiful nuance in behavior amongst Indians – the very common habit to ask for a little bit extra. Whether its haggling at a kirana store, or asking a vegetable vendor for lemon and chillies for free while buying other vegetables or asking for extra spoonful of toppings when buying ice cream or asking someone to drop them off a little further – these are scenes that happen in everyday lives of Indians, and this new campaign portrays this behavior very well.

 

Brands are embracing the changing Indian-ness, and like never before; connecting their products to new-age attitudes, perceptions and behaviors but with an Indian flair.

Have you noticed any such ads? Please do share with us.

 

• Roshni Jhaveri

March 28, 2014 at 4:14 am Leave a comment

Colors of India – Part 1

 

Wishing all our readers a very Happy Holi.

Holi inspired us to think of the different colors of India and how leading brands are interpreting and highlighting them. Brands are depicting evolving India through its different interpretations. While the messaging is different, the underlying theme is highlighting the different aspects that make India India.

Part 1 of this series explores how companies are employing the social change approach for brand building. While it has been a popular brand-building method abroad for over a decade, the trend has only picked up recently in India.

Garnier Men launched a social initiative “PowerLight a Village” in conjunction with Project Chirag. The initiative is aimed at lighting thousands of households across India that are yet to see any electricity through solar power.

 

Similarly, last year it was Stayfree, which addressed several problems faced by women through its Stayfree Women for Change campaign in association with Unicef. It addressed issues like anemia, dropping out of school and lack of general hygiene and health facilities.

Click here and here for more ads from the series.

 

Over the years, Jaago Re by Tata Tea has become a credible platform for catalyzing social change through its social awakening ads. In the first phase of the campaign, efforts were directed to involve the youth in the voting process. In its second phase, it embarked on its anti-corruption drive, beginning with its Aaj se khilana bandh, pilana shuru’ campaign. Its most recent ad is about creating awareness amongst women from the upper strata of society about the power of voting through the Power of 49 campaign.

 

What we love about these ads is the link between the brand name, the benefit it offers and the social initiative it is associated with. Love the ideas and the execution.

 

  • The Escape Velocity Team

 

P.S. Stay tuned next week for part 2 on this series on how brands are bringing out different shades of India.

March 20, 2014 at 5:36 pm Leave a comment

Molecular Diagnostics – An Introduction

Molecular Diagnostics (also known as nucleic acid based diagnostics) studies the composition of an individual’s genetic material – i.e. our DNA – in order to arrive at conclusions that have medical implications. The reason this science that is still in its infancy is hailed by many as the next frontier of medicine is that it is far more precise than previous methods, faster by several orders of magnitude – often giving results in hours vs. the weeks required by conventional tests, and can give results with far lower sample quantities. Additionally, it can sometimes give information that is simply not available from any other test.

Some kinds of molecular diagnostic tests help understand the likelihood of a patient responding positively to a particular medication, others help identify mutations that predict the probability of a healthy individual developing certain ailments in the future, yet others help conclusively identify the ailment at the root of troublesome symptoms so that the cause could be treated properly.

Basics of the science underlying the technique :

(note – those uninterested in a basic biology lesson can skip this section)

The cornerstone of molecular diagnostics is the identification of pathogenic mutations in an individual’s genetic material, i.e. their DNA.

Our DNA is made up of a sequence of pieces called genes. Each gene is made up of a series of bases (Adenosine,Thymine,Cytosine,Guanine, commonly written as A,T,C and G) in a certain order. These bases and the precise locations on the gene at which they are present are a molecular code that carries information required for making all the functional molecules – RNA and proteins – required by us. These proteins, once synthesised, are responsible for our characteristics – whether it’s the colour of our eyes and skin, our blood group, our tendency to gain weight quickly, or male-pattern baldness etc. Thus the bases and the sequence of their location on the genes are responsible for our heritable traits.

Small changes in the sequence of bases on a gene – such as substitution of one base for another, or omission or repetition of a small segment, can change the gene’s function and manifest as a difference, say in physical appearance etc. You can think of these bases on the gene as letters on this page that occur in a certain order to form words and sentences. Occasionally, a typographical error – a missing alphabet, a duplication, or a wrong substitution may occur, some do not matter much and we can still read the words and unnerstand them, but others may gargle (garble) the meaning of a word or sentence.

Similarly, most variations are harmless, but some can make the gene faulty; for instance, a particular protein may not be produced properly, or produced in the wrong amounts or not produced at all; such variations that make the gene’s operations faulty are called mutations. These mutations are the signposts that molecular diagnostics searches for and draws conclusions from. Thus the science is based on being able to recognise and map the structure of each gene, and identify mutations in them, as well as the knowledge of those mutations that affect our metabolic processes / physiology. This is not as easy a task as it sounds as human genes have from a few hundred up to two million bases on them (yes, really !) and you have to know and locate the specific mutation that is responsible for the effect under consideration.

(For further information on structure of the DNA, you can read the following :

What is a Genome

What is DNA 

What is a gene

How genes work 

Mutations and health

What is a gene mutation and how does it occur 

Inheriting genetic conditions )

 

Some Scenarios in which a molecular diagnostic test could be used :

Therapy support and therapy monitoring :

Determining probable response rates to certain therapies and their appropriateness for use in specific patients. In doing so, molecular diagnostics enables more personalised / individualised therapies, either with the goal of minimising harmful side-effects and / or judging how well individuals will respond to a planned course of treatment and whether they should go in for it.

This DNA-based approach to treatment, known as pharmacogenomics, is already in use in combating certain cancers.  Chemotherapy is prohibitively expensive and often has extremely painful side-effects, and not all patients respond equally well to a medication or cocktail of medications; getting the combination right often involves an initial trial-and-error phase, a frustrating and physically tortuous time for the patient. In the case of certain types of cancer, molecular diagnostics can help predict a patient’s response to a medication, thus avoiding much trauma – both emotional and physical, and saving time and money.

Take breast cancer, for instance. One of the medications used to avoid a recurrence after radiation therapy or chemotherapy is the drug Herceptin from Genentech. Now about 20-30% of breast cancer patients exhibit an over-expression of the Her2/neu gene and only these patients benefit from treatment with Herceptin.  A molecular diagnostic test to check for presence of the mutation of Her2/neu gene helps identify those that would benefit from the treatment; thus it costs about Rs. 15,000-20,000 to figure out whether a treatment running into lakhs of rupees will actually benefit someone. This is the personalised approach to medicine rather than the one-size-fits-all-with-the-same-ailment approach.

 

Early Detection Testing :

Detecting the presence of pathogens through detection of their RNA or DNA.

Using a molecular diagnostic test, diseases caused by a virus – think HIV and AIDS, HPV and cervical cancer, Hepatitis B, Hepatitis C etc. – could be quickly and reliably diagnosed well before the initial symptoms appear, thus giving physicians a longer treatment window and the patient a chance of earlier treatment and earlier return to good health. In these instances, the tests checks whether the RNA of the virus (ahem, which is significantly different from our DNA) can be detected in the patient’s tissue / sputum / blood sample sent for testing.

These tests can be used to detect other pathogens such as bacteria too. Consider the traditional diagnostic tests for TB which is caused by bacteria (Mycobacterium Tuberculosis). The current battery of tests include the Mantoux tuberculin skin test, a tissue culture, a sputum test, a chest X-Ray and a blood test; in spite of conducting all of these, there is a chance of getting a false positive or false negative result when the results are available a few weeks later. On the contrary, one molecular diagnostic test can confirm not just the presence of TB but also identify the genetic mutations in the bacterium and identify the strain of the bacterium responsible for the symptoms and which drugs it is resistant to, all this within a few hours.

Valuable info indeed in this era of multi-drug resistant TB (MDR-TB), when making a fast and accurate diagnosis of the type of TB infection a patient may have is the most important step to curing a patient.

 

Predisposition testing :

Analysing the probability of an individual developing certain genetically inherited diseases.

Such tests, done for risk analysis of cystic fibrosis, breast cancer and other hereditary diseases, can help understand whether an individual has a higher probability of developing an ailment than the general population. These are not definitive tests, in that they cannot predict whether an individual will get the ailment in future, they can only tell us that an individual has a higher or lower probability than the general population does of getting the ailment. Hence, there is still a lot of debate about whether such information is beneficial for an individual or not, whether it makes them worry unnecessarily about factors which they have no control over.

For instance, consider the BRCA1 and BRCA2 genes that belong to a class of genes known as tumour suppressor. A woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.

In a family with a history of breast or ovarian cancer, it may be informative to analyse a tissue sample of a patient (sufferer of breast cancer) and identify which harmful mutations are present; then other family members can be tested to find out if they also have the same mutation and their probability of developing breast cancer later can be computed. However, while a negative result can rule out breast cancer and bring a sense of relief, a positive test result only provides information about a person’s probability of developing cancer in future. It cannot tell whether an individual will definitely develop cancer; not all women who inherit a harmful BRCA1 or BRCA2 mutation will develop breast or ovarian cancer.

Note : Common medical problems such as heart disease, diabetes, and obesity do not have a single genetic cause—they are likely associated with the effects of multiple genes in combination with lifestyle and environmental factors, in such cases, genetics has a smaller, more complex role to play. More on this and other matters in another post.

  •  Zenobia Driver

(with a lot of assistance from assorted secondary sources)

March 10, 2014 at 12:54 pm Leave a comment

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