The fierce competition between the two to beat each other in the field of cricket is legendary. Every win is a cause of celebration! A subdued version of it is seen even in hockey matches. But recently India beat Pakistan in a much closely fought match with significant relevance to the most part of the population but none seems to rejoice! India at 31.4, ranked several notches above Pakistan (32.6) in 2017 Global Hunger Index but this did not entice positive reporting in media or anywhere. Why? Partisan media?
Not really! A quick glance at the below comparative answers it all. From an absolute number perspective, India contributes 25% to global hungry people count of 800 million.
Among BRICS and some of its own neighbors, India is a poor last but one! People jumping to conclusion that it is because of population pressure, may find it disheartening to know that China has more people than India and if you are looking at per capita population, then Bangladesh at 1252 is way higher than India at 445 and Sri Lanka is close by at 338.
The narrative becomes more cynical is we look at the ‘Improvement Story’ between 2000 and 2017 Hunger Index. Except Sri Lanka and Pakistan, rest have done much better than India (Brazil & China at more than 50%).
The story is nearly similar when a similar comparison is done on Human Development Index (HDI) released by UNDP (2015). As per UNDP “The Human Development Index (HDI) is a summary measure of average achievement in key dimensions of human development: a long and healthy life, being knowledgeable and have a decent standard of living” (see below, taken from UN site).
A country with poor results in its management of hunger will surely impact ‘a long & healthy life’ and ‘decent standard of living’!
Coming back to Global Hunger Index, it is driven by 4 components; Proportion of undernourished in the population, Prevalence of wasting in children under five years, Prevalence of stunting in children under five years and Under-five mortality rate.
India’s poor performance is reflected in all the 4 parameters though we can take some solace that we are better positioned in the first one than most of the others. The figure in the parenthesis reflects the year duration which was used for latest data by GHI 2017.
Till now the it is the story of the country as reflected in the Hunger Index that is released by the ‘International Food Policy Research Institute’ and the Human Development Index released by UNDP.
But a more disturbing picture becomes visible if we dig deeper within India. Here we will go by our government records and we will use the NHS (National Health Survey) data of 2015-16
The below graph provides a snapshot on some of the key parameters on health and nutrition which are closely linked with hunger index. It also shows how developmental difference continues to impact the life of rural livelihood.
%age of infants who receives an adequate diet (age between 6-23 months) is an abysmally low at 9.6% with Rural at 8.8% and Urban doing slightly better at 11.6%. That reflects directly on health parameters where:
- ~ 40% of children under 5 are stunted (height for age)
- > 35% underweight (under 5) and
- ~ 60% anemic (6-59 months child)
One interesting point is Rural out-performing Urban in ‘Children under 6 months exclusively breastfeed’ which is perhaps a combination of more infant formula available or feasible for urban population and also lifestyle issues where newbie mothers are not so willing/ available to breast feed for long!
The worst part is that the improvement across years is quite pale (FY16 to FY06- previous NHS survey). Except children who are anemic and breastfeeding, in rest of the parameters we have actually remained nearly static or even worsened off! (one disclaimer, NHS survey reports states ‘The figures of NFHS-4 and that of earlier rounds may not be strictly comparable due to differences in sample size and NFHS-4 will be a benchmark for future surveys.’)
The gender, age and demographic disparity is one of greater concern. Children as usual is worse off and so is the case for Rural and Female.
Actually, this disparity runs deeper. Even within urban, slums speak a different story altogether. In India, 17% of urban dwellers (~65 million people) live in slums. Studies have found that exclusive breastfeeding is low and childhood under-nutrition higher in slums compared to rest of the urban areas and so are diseases like diarrhea which increases child mortality rates.
We will now dig deeper into region/ state level disparity which establishes the fact that as a country we have not done well in ensuring the nutritional & health development in most part of the country. Next few country maps illustrate the same. While in first map, higher is better, for rest, lower is better!
For obvious reasons, a near reverse of the above is seen in most of the country mapping below as lower adequate diet impacts most of these parameters.
The other challenge is the lack of homogenous improvement across the states from FY06 to FY16. The below map showcases this heterogeneity. Since split of Andhra Pradesh happened after FY06, the comparable for AP & Telangana is not available.
The question is what we are doing as a country?
- India launched the food security program costing $21 billion introduced by the earlier government and continued by current dispensation will cover 50% urban and 75% rural, providing wheat at 2 rupees a Kg and rice at 3 rupees a Kg.
- Schemes like ICDS (Integrated Child Development Services), Midday meal
The above schemes primarily tried to address following issues:
- Rice & Wheat are both rich source of calories and lack of sufficient calorie intake is the most common definition of hunger. Calorie intake is essential for body to function
- Vaccination programs to immunize children against most prevalent diseases
- Advisory & Monetary support to pregnant and mothers of new born. This includes the monthly 1000 INR that a newly mother is entitled to for first 6 months after childbirth under the Pradhan Mantri Matritva Sahyog Yojana (earlier named as Indira Gandhi Matritva Sahyog Yojana (IGMSY). This is also tied to mother exclusively breastfeeding the child for the first 6 months. This is expected to provide food security/ availability of nutritious foods for pregnant & lactating mothers. This is important for birth of healthy babies and ensure the mother & baby remains healthy after birth
Surely, these schemes have not performed at expected level and lacunae remains as otherwise the country would not have been staring at the dismal state of hunger/ malnutrition evident from the data earlier presented. A review of several expert’s opinions, research articles points to following concerns:
- Lack of economic development especially in rural areas resulting in inability to access sufficient quality food despite availability. In an interview, FAO India representative (Food & Agricultural Organization, a UN Body) states ‘Food production is more than adequate, …people does not have enough income’
- Prevalence of hidden hunger. Taking sufficient calories is only part of the solution, intake of protein & micronutrients is also very important to address hunger. For example, the traditional dal-rice menu is actually a good example of a balanced diet as it provides calories with protein.
- Ineffective implementation of schemes remains a major challenge and that’s why one can observe significant variation in different health/ nutritional metrics between states. Effective implementation should also mean making the target population aware of their rights so that they claim their entitlements. The other challenge is that current system leaks resulting in lack of proper utilization of funds allocated to these schemes resulting in less than expected improvement in malnutrition
- Lack of ownership for these programs also is cited one of the big reason tardy implementation
- Inequality in distribution remains another challenge, as the country has not succeeded in the distribution while agricultural productivity increase has been impressive (60s to 90s). This primarily pertains to the public distribution system (PDS) which is known for being ineffective, leaky and rampant to corruption.
The government is aware of these facts courtesy the combined effect of different studies/ surveys; voices of different human rights organization; inputs from organizations like FAO/ UNDP. For example, quick glance of the ebook 2016 (Jan-Dec 2016) by Department of Public distribution reveals below:
- PDS system reforms to make it more effective. Also; Aadhar is expected to play a big role in elimination of duplicate beneficiaries
- Policy Change to address acute malnutrition in the population. Strategy of fortification of food has been adopted. Initially this will be for wheat flour and oil. For rice, technology & cost is being evaluated. Fortification in general refers to addition of nutrients like vitamins & minerals and if this is the case, then it will help in alleviate the burden of ‘hidden hunger’
The efficacy of the reforms and policy changes will need to be seen and will probably be observable only after a certain time lag as some problem needs correction over generations, example in case is child stunting which seems to be correlated to mothers who are stunted. All of this also has social impact as today ‘girl child’ seems to be disadvantaged in respect to ‘boy child’ in most of the metrics involving children. A more focused/ targeted approach with inbuilt mechanism to ensure effective delivery is the need of the hour as the disparity across states, regions within states, communities within same region and gender across child is highly evident.
For a brief understanding of the issue, one can also watch following commentaries which I have found very informative.
All graphs, charts, calculations are works of Randomwalks.in. In case one needs access to the data, you can reach us at our mail id given in Contact.
- Government of India Ministry of Consumer Affairs, Food and Public Distribution – Department of Food and Public Distribution ebook 2016
- Global food policy report (IFPRI) 2017
- Global Hunger Index (IFPRI) 2017
- http://hdr.undp.org/en (UN HDI Homepage), HDI 2015 report
- National Family Health Survey- 4 2015-16, India and the States Fact sheets
- UN site (http://in.one.un.org/un-priority-areas-in-india/nutrition-and-food-security/). Videos were originally found at this site
- Featured image is taken from http://indianexpress.com/article/india/india-news-india/maha-guv-initiates-coordinative-response-to-check-malnutrition-3031431/. We don’t have any rights on this image and in case there is a challenge in using the same, we will take the image off