The minister of a model Indian state like Gujarat has admitted in the Assembly that of the 5.70 lakh malnourished children in the state, nearly 4.38 lakh children are underweight, while 1.31 lakh fell in the ‘severely underweight’ category. The highly-urbanised district of Ahmedabad accounted for the highest number of malnourished children. Hence, India’s ranking in the GHI report needs more attention than objection.
India has been ranked 111 among 125 countries in the Global Hunger Index (GHI) report released by two European agencies on October 12, 2023. India slipped four positions as compared to last year. The countries ranking lower than India are very small economies as compared to India. India is among one of the fastest growing ones.
‘Concern Worldwide’ and ‘Welt Hungerhilfe’, two NGOs from Ireland and Germany, respectively, have come out with the report. According to the publishers, it is a peer-reviewed report which has been prepared annually from 2006. The report says that high scores may be a symptom of several underlying problems relating to the nutritional status of the country. Four factors were considered for calculating the GHI scores: undernourishment, child stunting, child under-5 mortality and child wasting, i.e. children who have low weight for their height. All these indicators are components of the universally agreed UN Sustainable Development Goals (SDGs).
A high GHI score can be evidence of a lack of food, a poor-quality diet, inadequate child care-giving practices, an unhealthy environment, or a combination of these factors. According to the report, India has the highest child ‘wasting’ (low weight for height) rate across the world, at 18.7%, reflecting acute undernutrition. In fact, ‘wasting’ is considered to be the worst form and indicator of all forms of child under-nutrition.
As far as childhood stunting (low height for age) goes, India, again, comes in the category of ‘very high’ risk countries. More than 35% children have been marked stunted in India, although several other African countries and some east-Asian countries perform worse than India on this parameter.
With about 16.6% of the overall population undernourished, India’s levels of undernourishment have been marked as of ‘medium’ risk. And, in under-5 mortality, India has been categorised as a country with ‘low risk’, with about 3.1% of children dying before the age of five.
The prevalence of anaemia among women aged 15-24 has been reported as a major problem for the country. More than 50% of women and adolescents are anaemic in the country – one of the highest across the world.
The Indian government has rejected this report like it has done on previous occasions. Issuing a statement on October 12, the government has termed the methodology of the report preparation faulty, and has raised concerns about the selection of the four parameters used.
The government said that three out of the four indicators used for calculation of the index are related to the health of children and cannot be representative of the entire population. The fourth and most important indicator ‘Proportion of Undernourished (PoU) population’ is based on an opinion poll and the sample size was too small.
GHI report makers have denied the allegations of the Indian government. They said the Prevalence of Undernourishment (PoU) rate – which the Indian government objected to while discrediting their report – is just one-third part of the total GHI score. It considers the average per capita availability of food as obtained through carefully constructed food balance sheets. PoU was partly arrived at using data sources officially given by the Indian government only.
The second component of PoU is the calorie requirements of the population. It considers the distribution of calorie intake in the population as estimated through official consumption surveys conducted by governments.
The Indian government also cast doubts over using stunting and wasting as two indicators for the GHI report preparation. The government says ‘hunger’ may cause stunting and wasting, but they could also be a result of factors like sanitation, genetics, utilisation of food intake etc. Therefore, it raised questions over using ‘hunger’ as something it termed as ‘causative/outcome’ for stunting and wasting, for the GHI scores. There is hardly any evidence that the fourth indicator, namely, child mortality is an outcome of hunger.
Malnourished children, particularly those with severe acute malnutrition, have a higher risk of death from common childhood illnesses such as diarrhoea, pneumonia and malaria. Nutrition-related factors contribute to about 45% of deaths in children under 5 years of age.
The government also contested the childhood wasting figures of India. It said the government’s ‘poshan’ tracker said 7.3% of the children were ‘wasted’ as against GHI figures of 18.7%. An inter-agency UN exercise had estimated the prevalence of wasting at 18.7% – the source of GHI’s wasting rate for India. The government’s own National Family Health Survey (NFHS)-5 data for 2019-21 had said the corresponding figure was 19.3%.
The GHI report is not an outlier to point out India’s poor performance in nutrition. The SOFI reports have done so consistently over the past. The SOFI-2023 report pointed out that 74.1% of the Indian population is unable to afford a healthy diet. Only countries like Nepal, Pakistan, Sierra Leone, Nigeria, Niger, Burkina-Faso, Ghana, Liberia, Guinea and Guinea Bissau had a higher share of their respective populations than India which were not able to afford a healthy diet.
The SOFI-2023 report also said 233.9 million (24 crore) people in India are ‘undernourished’. Undernourishment, according to the SOFI report, is defined as the condition of an individual whose habitual food consumption is insufficient to provide, on average, the amount of dietary energy required to maintain a normal, active and healthy life.
The Global Hunger Index methodology has long been established and tested. United Nations, Food and Agriculture Organisation etc highly value the quality of data and analysis. The minister of a model Indian state like Gujarat has admitted in the Assembly that of the 5.70 lakh malnourished children in the state, nearly 4.38 lakh children are underweight, while 1.31 lakh fell in the ‘severely underweight’ category. The highly-urbanised district of Ahmedabad accounted for the highest number of malnourished children. Hence, India’s ranking in the GHI report needs more attention than objection.
