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2020 MAR   10

Global Hunger Index and Malnutrition in India

2022 OCT 18

Mains   > Social justice   >   Health   >   Poverty allieviation

IN NEWS:

  • In the Global Hunger Index, 2022, India ranked 107 out of 121 countries. With a score of 29.1, the level of hunger in India has been labelled "serious".

GLOBAL HUNGER INDEX (GHI):

  • Global Hunger Index (GHI) is a tool designed to comprehensively measure and track hunger at global, regional, and national levels.
  • The report is prepared jointly by Irish aid agency Concern Worldwide and German organisation Welthungerhilfe.
  • The GHI score is calculated based on four indicators:
    1. Undernourishment: the share of the population that is undernourished (that is, whose caloric intake is insufficient.
    2. Child Wasting: the share of children under the age of five who have low weight for their height, reflecting acute undernutrition.
    3. Child Stunting: the share of children under the age of five who have low height for their age, reflecting chronic undernutrition; and
    4. Child Mortality: the mortality rate of children under the age of five.

INDIA & GHI:

  • India was ranked 101st in the 2021 report and 94th in the 2020 report.
  • At 107 in 2022, India is ranked much behind its South Asia neighbours. Other SAARC countries have fared better. Only war-torn Afghansitan is far behind India in the index.
  • India’s GHI score has been declining: from 38.8 points in 2000—considered ‘alarming’—to 29.1 in 2022 and hence falls under the “serious” category.

  • As per the report:
    • India’s child-wasting rate, which reflects acute malnutrition, is the highest in the world at 19.3 per cent.
    • India noted improvement in two parameters of child stunting from 38.7 per cent in 2012-16 to 35.5 per cent in 2017-21 and child mortality from 4.6 per cent in 2014 to 3.3 per cent in 2020.
  • India came out strongly against the Index over the questions of methodology and data sources. The Ministry of Women and Child Development (MWCD) stated 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 estimate of the undernourished population accounts for a very small sample size.
  • The ministry of Women and Child Development further said that the report completely disregards government’s massive effort to ensure food security during the pandemic.
  • Contrary to the index, NFHS-5 data highlights that India has shown improvement in child nutrition indicators. It has shown improvement in stunting and wasting and a significant reduction in under 5 mortalities.

MALNUTRITION:

  • Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.
  • The term malnutrition addresses 3 broad groups of conditions:
    • Under nutrition: which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age).
    • Micronutrient-related malnutrition: which includes micronutrient deficiencies (a lack of important vitamins and minerals)
    • Overweight: Obesity and diet-related non-communicable diseases (such as heart disease, stroke, diabetes and some cancers).

INDIA’S MALNUTRITION SCENARIO:

  • The Food and Agriculture Organization (FAO) estimates that 194.4 million people in India (about 14.5% of the total population) are undernourished.

Among Children:

  • According to Lancet, about 68% of the deaths of children under the age of five in India can be attributed to child and maternal malnutrition.
  • The Hunger index 2021 report has termed the level of hunger in India “alarming”. At 17.3 percent, India has the highest child wasting rate of all countries covered in the GHI. Child stunting stands as 34.7 percent in 2016–2018.
  • The prevalence of obesity among 5 to 19-year-old Indian children, ranged between 3.6% and 11.7%. It is predicted that by 2025 there will be 17 million obese children in India.
  • According to UNICEF, India is likely to witness an increase in malnutrition by at least 10% due to the pandemic.

Among Adults:

  • According to UNICEF report, over 80 per cent adolescents in India suffer from Hidden hunger.
  • According to NFHS 5, as many as 66.4 percent women suffered from anaemia in 2019

https://www.dailyrounds.org/blog/wp-content/uploads/2020/09/IMG_20200908_160244-1024x614.jpg

CAUSES OF MALNUTRITION:

Malnutrition occurs as a complex interplay among various factors such as:

I. SOCIAL:

  • Poverty:
    • It affects the availability of adequate amounts of nutritious food for the most vulnerable populations.
  • Prevalence of infectious disease:
    • Infections like malaria and measles or recurrent attacks of diarrhoea may precipitate acute malnutrition and aggravate the existing nutritional deficit.
    • Metabolic demands for protein are higher during infections and the child may take in less food either due to reduced appetite or due to food restrictions by the mother. Thus leading to malnutrition
  • Poor sanitation:
    • Lack of pure drinking water and poor sanitation leads to spread of diseases which lead to acute malnutrition.
  • Gender inequality:
    • In most of the households, women and girls receive less food than the economically active male members.
    • Early marriages, less gap in pregnancies, malnourished pregnant girl, prevalence of anaemia adversely affects the nutritional status of the mother >> A malnourished mother will give birth to an underweight baby.
  • Social exclusion:
    • Nutrition vulnerabilities are compounded by differentials in socio economic status and vary by vulnerable community groups such as SC, ST, minorities and others
  • Intergenerational cycle of under-nutrition:

 

II. INDIVIDUAL:

  • Consumption habits:
    • Lack of awareness of nutritional qualities of food, irrational beliefs about food, inappropriate child rearing and feeding habits all lead to under nutrition in the family.
  • Changing food patterns:
    • Food consumption patterns have changed substantially in India over the past few decades. Cereals like rice and wheat have become dominant, which has resulted in the disappearance of many nutritious local foods like millets and pulses.

III. OTHERS:

  • Covid shock:
    • The momentum set by the nutrition movements were disturbed once Covid lockdowns led to the shutting of schools, Anganwadi centres, Nutritional Rehabilitation Centres. Further, frontline workers had to be engaged in Covid-related work that took precedence over their daily duties like managing nutrition-strengthening activities.
  • Exclusion from welfare schemes:
    • Due to various factors like inclusion-exclusion errors, lack of documents and not linking Aadhar card with bank accounts, several beneficiaries remain outside the social welfare schemes.
    • Eg: During the lockdowns, government allotted an additional 5 kg of wheat or rice per person per month under the Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY). But only the 79.51 crore people with ration cards are eligible for this, leaving many to fend for themselves.
  • Poor implementation of schemes:
    • While there are several schemes to enhance nutritional status, its implementation has been lagging.
    • Eg: In 2018-19, only 44 per cent of the funds released under the Annual Programme Implementation Plan (APIP) for ICDS were reported to have been utilised.
  • Migration:
    • Seasonal migrations have long been a livelihood strategy for the poorest households in India. Migration in certain cases result in temporary and poor living condition, lack of access to PDS etc. >> which in turn lead to malnutrition
  • Disasters:
    • Floods, Droughts and other disasters disrupt food supply chain and hence result in lower intake.
    • Eg: The one year of Covid-19 pandemic has pushed 230 million Indians into poverty with a 15% increase in poverty rate in rural India and 20% surge in poverty rate in urban India, says a report by the Azim Premji University.

GOVERNMENT EFFORTS:

  • Legislative measures:
    • The National Food Security Act (NFSA), 2013:
      • Aims to ensure food and nutrition security for the most vulnerable through making access to food a legal right.
    • Maternity Benefit (Amendment) Act 2017:
      • The amended act has increased the maternity benefits from 12 weeks to 26 weeks
      • This is in line with the recommendation of the World Health Organisation which mentions that children should be exclusively breastfed by the mother for the first 24 weeks. Thus, it will aid in improving survival rates of children and healthy development of both mother and child.
  • Policies and schemes:

      • India has set a target to end all forms of malnutrition by 2030. To this end, in the Union Budget 2021-22, Mission Poshan 2.0 was announced to improve nutritional outcomes in 112 aspirational districts. Poshan 2.0 merges supplementary nutrition programmes and the POSHAN Abhiyaan.
    • Integrated Child Development Scheme:
    • Mid-Day Meal Scheme:
      • It is a school meal programme designed to better the nutritional standing of school-age children nationwide.
      • The programme supplies free lunches on working days for children in primary and upper primary classes.
    • One nation, One Ration card scheme:
    • National Nutrition Strategy (NNS):
      • It was launched by NITI Aayog in 2017 with the goal of attaining “Kuposhan Mukt Bharat" or malnutrition-free India, by 2022.
      • It seeks to ensure that every child, adolescent girl, and woman attains optimal nutritional status - especially those from the most vulnerable communities.
    • Pradhan Mantri Matru Vandana Yojana (PMMVY):
      • It is a maternity benefit programme which includes conditional cash transfers to pregnant women in their bank account directly to meet enhanced nutritional needs and partially compensate for wage loss.
      • Recently the Women and Child Development Ministry has subsumed the scheme under Mission Shakti.
    • National Health Mission:
      • The mission envisages achievement of universal access to equitable, affordable and quality health care services. It has components for the prevention and reduction of anaemia in women.
    • PM Ayushman Bharat Health Infrastructure Mission:
    • National Policy for Children, 2013
      • It aims to protect and encourage the rights of the children to survival, health, nutrition, education, development, protection and participation
    • Swachh Bharat including Sanitation and the National Rural Drinking Water Programme
  • State level-initiatives:
    • Rajasthan Government launched Indira Gandhi Matritva Poshan Yojana to provide a cash transfer of ?6,000 to the mother for the birth of the second child.
    • Jharkhand has recently decided to provide eggs at least six days a week to children aged 3-6 years at Anganwadi centres.
    • Tamilnadu has launched a Breakfast scheme in government school for children of class I to V. (Click here to read more

WAY FORWARD:

  • Decentralised approach
    • Strengthen the ownership of Panchayati Raj institutions and urban local bodies over nutrition initiatives. This is to enable decentralised planning and local innovation along with accountability for nutrition outcomes
  • Focussing on primary health care:
    • Improving the primary health centres and other health care services in the rural areas will definitely improve the nutrition profile of women and children.
  • Social campaign for attitudinal change:
    • Government should coordinate with civil society groups to launch mass campaigns on delaying marriage of girls, ensuring gender parity within families, need and benefit of proper sanitation facilities and balanced diet.
  • Increase financial allocation:
    • Investment in nutrition has a cost-benefit ratio of 1:16. Hence public spending to improve nutritional security has higher efficiency. To attain the same the government has to allocate more financial resources to address malnutrition.
  • Technological interventions:
    • Food fortification must be encouraged to address the nutritional imbalances in diets. For the same, fortified food can be included in the PDS scheme.
  • Governance reforms:
    • Focus on the most vulnerable communities in districts with the highest levels of child malnutrition and develop service delivery models based on evidence of impact.
  • Community led approach:
    • Use community volunteers and local people in planning, beneficiary selection, program implementation and monitoring.
  • International co-operations:
    • Set up task forces involving UN agencies, NGOs and bilateral agencies to share technology and best practices.

CONCLUSION:

With sustained prioritization, increased resource allocation, adopting comprehensive, coordinated and holistic approach with good governance and help of civil society, India has the potential to end malnutrition in all its forms and turn the ambition of Kuposhan Mukt Bharat by 2030.

PRACTICE QUESTION:

Q. ‘Worsening of malnutrition has been one of the hidden costs of the pandemic’. In this regard, discuss the various measures taken by the government to address malnutrition in India?