We estimated the burden for each of the nutritional deprivation indicators along two dimensions of Prevalence (P) and Headcount (H), and combined them to derive a Prevalence-Headcount Metric (PHM).
Prevalence
The metric P was calculated as children with nutritional deprivation (q) divided by the eligible sample of children (n) in the district (j) and expressed in percentage as:
Pj = (qj / nj) × 100
The P metric quantifies the risk of a child experiencing nutritional deprivation in a district. For example, in the Kupwara district of Jammu and Kashmir, 137 (q) out of 435 (n) sample of eligible children were stunted, translating into a district prevalence of 31.5%; in other words, one out of every three children is at risk of being stunted. Thus, the P metric helps identify districts where the future risk of a specific nutritional deprivation should be reduced.
However, the P metric does not contain any information on the absolute number of children who are at risk because it does not take into account the total population of children in a district. For example, consider the districts of Hyderabad (16.7%) and South Garo Hills (16.6%); both have the same P metric but differ with regards to the under-five population of 398,513 and 23,953, respectively, translating to different levels of absolute burden.
Headcount
The metric H is given as the product of P and the total eligible population N for each district.
Hj = Pj × Nj
Returning to the above example, the number (H) of stunted children is substantially large in Hyderabad (66,553) than South Garo Hills (3,970) despite both districts having the same prevalence because the total population burden by nutrition deprivation in Hyderabad is substantially larger.
Prevalence-Headcount Metric
We developed a combined Prevalence-Headcount metric (PHM) that takes into account the features of both the risk (P) as well as the headcount (H) to provide a comprehensive picture of the burden of nutritional deprivation in a district. We computed the PHM using the following steps. We exemplify these steps using the district of Kupwara, Jammu and Kashmir for the nutritional deprivation indicator of stunting.
P = Prevalence; H = Headcount;
PHM = Prevalence-headcount metric;
j = District;
q = Number of children with nutritional deprivation within the eligible sample;
n = Eligible sample; N = Eligible population;
norm = Normalized; max = district with the Maximum value;
min = district with the Minimum value;
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STEP 1: Calculating Prevalence
Formula: Pj = (qj / nj) x 100
Examples: qj = 137
nj = 435
Pj = (137 / 435) x 100 = 32%
STEP 2: Calculating Headcount
Formula: Hj = Pj x Nj
Examples: Pj = 32%
Nj = 166791
Hj = (32 / 100) x 166791 = 53373
STEP 3: Normalizing the Prevalence
Formula: Pjnorm = (Pj - P(min)) / (P(max) - P(min))
Examples: Pj = 32%
P(max) = 65%
P(min) = 13%
Pjnorm = (32 - 13) / (65 - 13) = 0.365
STEP 4: Normalizing the Headcount
Formula: Hjnorm = (Hj - H(min)) / (H(max) - H(min))
Examples: Hj = 53373
H(max) = 460209
H(min) = 346
Hjnorm = (53373 - 346) / (460209 - 346) = 0.115
STEP 5: Calculating the PHM
Formula: PHMj = (Pjnorm + Hjnorm)/2
Examples: Pjnorm = 0.365
Hjnorm = 0.115
PHMj = (0.365 + 0.115) / 2 = 0.24
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