Global Hunger Index (GHI) is not about counting people dying out of starvation or a country enjoying food surpluses or facing food shortages. India successfully banished famines and stopped importing degrading PL 480 wheat aid for feeding its teeming millions many years ago. Barring only a few unfortunate countries in sub-Saharan Africa, no one dies of starvation any longer. India is a net exporter of wheat and rice. For the last three decades, the country is truly Aatmnirbhar in food/calories.
GHI is about chronic and acute undernutrition which leads to the under-development of human body and brain. This undernutrition is captured as 'chronic hunger' in GHI and is most evident in India’s stunted and wasting children and, to a significant extent, in their mothers.
That is where the GHI 2022 calls out India’s sub-optimal performance. It holds a good mirror before us. Instead of dismissing or demonising the report using irrelevant facts and arguments, we should collect our heads together and frame policies and programmes to put an to end to this thus far intractable problem and ignominy.
GHI Captures Chronic Malnutrition in Children in India
GHI, using Food and Agriculture Organisation (FAO) and country-published data, has assigned scores to an overall of 121 countries and on each of the four building block benchmarks— child mortality (proportion of children dying before the age 5), child stunting (low height for the age which measures low birth weight and poor nutrition in first 1000 days), child- wasting (low weight for the height which indicates acute undernutrition until children complete 5 years) and undernourishment (which measures general undernutrition).
Stunting and wasting of children together has 1/3rd weight with child mortality and general undernourishment accounting for the rest 1/3rd of each. The Weighted score of these four benchmarks is the overall GHI score of a country.
To capture absolute and relative state of under-nourishment, the scores are classified in five segments. Extremely alarming (GHI score ≥50) makes the worst reading. Alarming (between 35-50) and Serious (between 20-35) also underline a quite unflattering situation. Moderate (between 10-20) indicates good progress and low (≤10) a satisfactory position.
India with a score of 29.1 is bang in the middle of ‘Serious’ category with further disturbing news coming in the form of India’s hopelessly poor 107th ranking of 107 (out of 121 countries) indicating continuous slipping from 94 rank in 2020 and 101 in 2021. India’s performance is the worst in South Asia with only Afghanistan behind India.
Mortality Rate Reduced but Child Health Under Threat
GHI does not make a grim reading for India in all the four constituent parameters.
India has done very well in the child mortality parameter. India’s child mortality rate, GHI informs, is in the best performance class of ‘Low’ with a score of 3.3. GHI records India’s consistently improving score with child mortality rate coming down from 9.2 in 2000, to 6.8 in 2007, to 4.8 in 2014 and 3.3 in 2022. India has surely succeeded in making sure that its children don’t die young.
India is, however, still not producing and rearing healthy children. India’s child stunting rate is in the ‘Alarming’ category with a highly disappointing score of 35.5; although this has also come down from ‘Extremely Alarming’ score of 54.2 in 2000. It is quite discomforting that there are only a few countries in Sub-Saharan Africa which have child stunting score worse than India.
It is the child wasting, where we come out the worst. Child wasting, on top of the child stunting indicates the worst nutrition status of the children and their mothers. It is our shame India is the worst performer in the world in child wasting with a score of 19.3.
To put salt into our festering wounds, it is the only category where our performance is deteriorating as well. Our 2022 GHI child wasting score of 19.3 is much worse than the score of 17.1 in 2014. Child stunting and wasting is our Achilles Heel. We are deeply stuck in this quagmire.
Internal Survey Confirms Nutrition Deficit
The government has attacked India’s undernourishment score of 16.3, which though not flattering, is in ‘Moderate’ category, indicating progress.
However, India’s own Surveys and data fully confirm GHI scores.
The Fifth National Family Health Survey 2019-21 (NFHS-5 2019-2021) reported that 35.5% children under 5 were stunted and 19.3% wasted in India. The GHI score of 35.5 for child stunting and 19.3 for child wasting is exactly the same score as the NFHS-5.
Why are we then we fighting with the messenger who uses our own data to hold mirror before us?
Food Security Programmes Feature Glaring Loopholes
India spends massive budgetary resources, in lakhs of crores, in running programmes for tackling the issue of food security in general and undernutrition in children.
The Integrated Child Development Services (ICDS), now reincarnated as 'Poshan-2' addresses undernutrition in children by providing supplementary nutrition to the children and the expecting & lactating mothers.
National Food Security Act (NFSA) addresses general undernutrition by making it obligatory for the governments to provide five kilogram of wheat/rice/coarse cereals to every identified, deprived person. There are over 80 crores of Indians who get cereal nutrition under NFSA.
The current government doubled the NFSA food allowance in 2020 by launching an additional scheme—Pradhan Mantri Garib Kalyan Yojana (PMGKY). PMGKY is a wasteful freebie as NFSA scales provide adequate calory intake. Unfortunately, PMGKY keeps getting extended and is presently renewed till end December 2022.
How Can India Bounce Back in Its Food Policy?
The Poshan-2 and its earlier version ICDS, running for last forty years, has been implemented in a dysfunctional manner and has not really succeeded in denting child stunting and wasting.
PMGKY, instead of addressing the problem of child stunting and wasting, stunts and wastes fiscal health of the Government. It should be immediately stopped.
It would make for a better impact if the Government were to use these freed-up resources to focus on India’s stunted and wasting children. For this, it would have to design a programme to provide more complete nutrition (proteins and essential minerals besides cereals) to all the families identified with women in reproductive age and with existing stunted and wasting children. Additionally, the Government must specifically focus on health and environmental surroundings and conditions of these families.
This programme must be a fully decentralised outcome-based programme, leaving the choice of nutrition to the family and the community in place of badly full and para government staff administered ICDS/Poshan Programme. Government should deliver resources linked to outcomes.
This would deliver much better results. If we could deliver results in the Ease of Doing Business Index (also bitterly complained against by India before we changed our approach in 2015), we can surely earn ‘Moderate’ and ‘Low’ GHI scores as well. While that would give us good psychological comfort, the real gain would be building an India with healthy and better performing Children of India.
(Chief Policy Advisor, SUBHANJALI; Former Finance and Economic Affairs Secretary and Author of The $10 Trillion Dream)
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