What explains India’s poor rank under the Global Hunger Index, and what are the solutions?

What explains India’s poor rank under the Global Hunger Index, and what are the solutions?

Context

• The Global Hunger Index is a peer-reviewed annual report, jointly published by Concern Worldwide and Welthungerhilfe, designed to comprehensively measure and track hunger at the global, regional, and country levels.

Parameters used to calculate the GHI:

• Undernourishment: It is the share of the population with insufficient caloric intake, and uses Food and Agriculture Organization data
• Child Wasting: the share of children under the age of five who are wasted (that is, who have low weight for their height, reflecting acute undernutrition)
• Child Stunting: children under the age of five who have low height for their age, reflecting chronic undernutrition
• Child Mortality: the mortality rate of children under the age of five.

How is the data collected?

• These parameters use information from the World Health Organization (WHO), the World Bank and the United Nations, although all these international organisations draw from national data, which, in India’s case, includes the National Family Health Surveys (NFHS).
• There is always a time lag in such data, so the 2020 scores are based on data from 2015-19.
• Based on the values of the four indicators, the GHI determines hunger on a 100-point scale where 0 is the best possible score (no hunger) and 100 is the worst.
• Each country’s GHI score is classified by severity, from low to extremely alarming.

Global Health Index Scale

• The GHI showed that nearly 690 million people in the world are undernourished; 144 million children suffer from stunting, a sign of chronic undernutrition; 47 million children suffer from wasting, also a sign of acute undernutrition.

India’s ranking

• India has been ranked 94 on the 2020 Global Hunger Index (GHI), lower than neighbours like Bangladesh and Pakistan.
• In 2020, India falls in the ‘serious’ category on the Index, with a total score of 27.2.
• This is a definite improvement from the situation two decades ago, when it scored 38.9 and fell into the ‘alarming’ category.

Comparison

• India’s scores are abysmal when compared to its peers in the BRICS countries.
• China and Brazil both scored under five, and are considered to have very low levels of hunger.
• South Africa is ranked 60 with a score of 13.5, indicating moderate levels of hunger.

• In the serious category, India stands with some of the poorest African nations, as well as its own South Asian neighbors, all of whom have better scores except Afghanistan.
• India is tied at the 94th rank out of 107 countries, sharing the rank with Sudan.

How does India fare on the different parameters in comparison to other countries?

• In terms of overall undernourishment, 14% of India’s population does not get enough calories, an improvement from almost 20% in 2005-07.
• The child mortality rate is 3.7%, a significant drop from 9.2% in 2000. Many countries fare worse than India on these two parameters.
• India’s poor score comes almost entirely from the child stunting and wasting
• Almost 35% of Indian children are stunted, and although this is much better than the 54.2% rate of 2000, it is still among the world’s worst.
• Also, 17.3% of Indian children under five are wasted, which is the highest prevalence of child wasting in the world.
• There is no change from two decades ago, when it was 17.1%. In fact, the situation improved to 15% in the 2010-14 data period, but worsened again by 2015-19.
• However, experts say this decline may also be partially due to vagaries in data collection.

What is the main cause for such high levels of child stunting and wasting in India?

• There is an interesting difference observed between child wasting in South Asia and the poorer nations of Africa, according to researchers.
• African babies are usually healthy at birth, but as they grow up into their toddler years, undernourishment starts to kick in.
• South Asian babies, on the other hand, show very high levels of wasting very early in their lives, within the first six months.
• This reflects the poor state of maternal health
• Mothers are too young, too short, too thin and too undernourished themselves, before they get pregnant, during pregnancy, and then after giving birth, during breast-feeding.
• It is more than a health issue, there are social factors like early marriage.
• Almost 42% of adolescent girls aged 15 to 19 have a low Body Mass Index (BMI), while 54% have anaemia.
• Almost 27% of girls are married before they reach the legal age of 18 years, and 8% of adolescents have begun childbearing in their teens.
• Nearly 50% of the women have no access to any sort of contraception
• These poor indicators of maternal health have dire consequences for the child’s health as well.
• Poor sanitation, leading to diarrhoea, is another major cause of child wasting and stunting.
• At the time of the last NFHS, almost 40% of households were still practising open defecation.
• Only 36% of households disposed of children’s stools in a safe manner. One in ten children under the age of five suffers from diarrhoea.

Comparison between Indian States:

• The Comprehensive National Nutrition Survey shows wide variability across States.
• Almost one in three children in Jharkhand show acute undernutrition, with a 29% rate of wasting.
• Although this is the worst State by far, other large States such as Tamil Nadu, West Bengal, Madhya Pradesh, Chhattisgarh and Karnataka also have one in five children who are wasted.
• Interestingly, other States that usually fare poorly on development indices, such as Bihar, Rajasthan and Odisha, actually do better than the national average, with 13-14% rates of wasting.
• Uttarakhand and Punjab, along with several north-eastern States, have levels of child wasting below 10%.
• In terms of stunting, Bihar performs the worst, with 42% of children too short for their age.
• Other populous States like Madhya Pradesh and Uttar Pradesh also have stunting rates just below 40%, and so does Gujarat.
• At the other end of the scale, Jammu and Kashmir has only 15% stunted children, while Tamil Nadu and Kerala are around the 20% mark.

Way forward:

• Food insecurity, poor sanitation, inadequate housing, limited access to healthcare — all result in maternal distress that leads to the kind of slow, chronic wasting seen in Indian children.
• Although India has overall food security with record levels of foodgrain production in recent years, access to healthy food is still difficult for poor households.
• There is no single solution. Every kind of household deprivation that makes life difficult for women needs to be dealt with. The focus needs to be on healthy mother