Global Hunger Index 2023: India ranks 111 out of 125 countries

Context: India’s ranking in the Global Hunger Index (GHI) has slipped from 107th place out of 121 countries in 2022 to 111th place out of 125 countries in 2023, according to the report jointly published by Concern Worldwide and Welthungerhilfe. This indicates a worsening situation with regards to hunger and underlines the ongoing challenges in addressing food security and malnutrition in the country.

More about Report: 

• The GHI score is calculated on a 100-point scale reflecting the severity of hunger, where zero is the best score (no hunger) and 100 is the worst. 
• India’s ranking is based on a GHI score of 28.7 on a 100 point scale. This categorises India’s severity of hunger as “serious”. 
• The country came after neighbouring countries Pakistan (102nd), Bangladesh (81st), Nepal (69th) and Sri Lanka (60th). However, India fared better than South Asia and Africa South of the Sahara, which recorded a score of 27 each.
• While the rate of undernourishment in India stood at 16.6 percent and under-five mortality at 3.1 percent, the prevalence of anaemia in women aged between 15 and 24 years stood at 58.1 percent.
• As per the index, India also has the highest child wasting rate in the world at 18.7 percent, reflecting acute undernutrition. 

Global Hunger Index:

Each country’s GHI score is calculated based on four indicators. 

What is Hunger?

• Hunger is a condition in which a person cannot eat sufficient food to meet basic nutritional needs for a sustained period. Hunger can manifest itself in different ways – undernourishment, malnutrition and wasting.

Concerns/Effects

• Human Well-being: Ensuring that people have access to sufficient and nutritious food is fundamental to their health and well-being. Hunger can lead to malnutrition, which in turn can cause a range of physical and mental health problems, particularly among children.
  • While mortality has declined by half and fertility by two-fifths, malnutrition has only come down by about one-fifth in the last 40 years. The inescapable conclusion is that further progress in human development in India will be difficult to achieve.
• Economic Development: A well-nourished population is more productive. When people are not hungry and malnourished, they can work effectively, contribute to the workforce, and participate in economic activities, leading to overall economic growth.
  • Malnutrition costs India at least $10 billion annually in terms of lost productivity, illness, and death and is seriously retarding improvements in human development and further reduction of childhood mortality (World Bank).
  • This inter-generational cycle of undernutrition transmitted from mothers to children greatly impacts India’s present and future.
• Educational Attainment: Malnourishment can also significantly lower cognitive development and learning achievement during the preschool and school years, and subsequently result in lower productivity.
  • Nutritional anaemia is implicated in low physical and mental performance.
  • Malnutrition not only blights the lives of individuals and families but also reduces the returns on investment in education and acts as a major barrier to social and economic progress.
  • Widespread child undernutrition greatly impedes India’s socio-economic development and potential to reduce poverty.
• Reducing Inequality: Hunger often affects marginalized and vulnerable communities disproportionately. Addressing hunger is a step toward reducing socio-economic disparities and promoting social equity.
• Food Security: It is important for a country’s stability and security. Addressing hunger helps ensure social stability and reduces the potential for social unrest and conflict.
• Global Commitments: India, like many nations, has made international commitments to eradicate hunger and improve nutrition under initiatives like Goal 2 of the 2030 Sustainable Development Agenda seeks to end hunger and all forms of malnutrition, and double agricultural productivity between 2015-2020.
  • According to UNICEF, one in three malnourished children in the world is Indian. It is estimated that reducing malnutrition could add some 3% to India’s GDP.

Reasons behind India’s persistent problem of hunger:

Inappropriate child feeding practices:

The WHO and UNICEF recommend that breastfeeding should be initiated within the first hour of birth and infants should be exclusively breastfed for the first six months. 

NFHS-5 says that only 42% of infants are breastfed within one hour of birth and only 64% of infants are exclusively breastfed for first 6 months. 

Low Female literacy:

Nutrition levels are majorly affected by the education level of women. It increases awareness about nutrient-rich diet, personal hygiene, good feeding practices etc. Educating women also help in containing the family size in poor, malnourished families. But female literacy in India is only 65% and the rate is much lower for the states like Bihar and Rajasthan that recorded high levels of malnutrition in children. 

Poor Sanitation: 

Repeated infection with diarrhoeal diseases due to poor sanitation contributes to chronic malnutrition by inhibiting intestinal absorption of nutrients and is strongly correlated with stunting. The proportion of people with access to improved sanitation facilities in India is only 49% as per NHFS-4.

Micro nutrient deficiency: 

According to studies, more than 80 per cent of the Indian population suffers from micronutrient deficiencies, contributing to compromised immunity. This is mainly due to lack of dietary diversification, changed dietary habits, food processing resulting in plant micronutrient loss, crop homogenisation. 

Food inflation: 

With rising food inflation families become less able to buy and eat nutritious food. According to a report of ADB, 1 per cent increase in food inflation leads to an increase of 0.3 per cent in both infant and child mortalities, and 0.5 per cent in undernourishment. 

Limitations of existing schemes:

• The ICDS program, while successful in many ways, has not made a significant dent in child malnutrition. This is mostly due to the priority that the program has placed on food supplementation, targeting mostly children after the age of three when malnutrition has already set in.
• Stringent conditions to avail the benefits of Pradhan Mantri Matru Vandana Yojana  has led to the exclusion of teenage mothers and poor women who birth more than one child, thereby abetting the intergenerational cycle of undernutrition. Exclusion errors, non-inclusion of  nutritious items such as pulses and edible oil in the PDS basket failed to improve the nutritional status of poor households.

• Poverty: Poverty restricts food choices and has been the causative factor of hunger-related deaths.
• Climate change impact: Erratic rainfall and increasing frequency of extreme events have impacted agricultural activities everywhere creating unfavourable conditions for food production.
  • Natural disasters: Natural disasters such as floods, tropical storms and long periods of drought are on the increase with catastrophic consequences for the hungry poor in developing countries.

• Gender inequality: In many parts women’s nutritional requirements are often unmet as they consume whatever is left after everyone else has eaten.
• A person’s ‘nutritional quotient’ is also dependent on demographic factors like gender, caste, age, etc. For instance, the nutritional needs of girl children and the elderly are not adequately addressed in our society.
• Corruption: Corruption in PDS is widely recognised. PDS a food distribution scheme is mired with inefficiencies and corrupt practices denying food to many.

Measures taken by the Government: 

• POSHAN Abhiyaan is an overarching umbrella scheme to improve the nutritional outcomes for children, pregnant women and lactating mothers by holistically addressing the multiple determinants of malnutrition. It involves convergence of multiple programs and schemes: ICDS, PMMVY, NHM (with its sub components such as JSY, MCP card, Anaemia Mukt Bharat, RBSK, IDCF, HBNC, HBYC, Take Home Rations), Swachh Bharat Mission, National Drinking water Mission, NRLM etc.
• Pradhan Mantri Poshan Shakti Nirman (PM POSHAN) for providing one hot cooked meal in Government and Government – aided Schools.
• Food fortification: 
  • Fortification of wheat is being implemented in 12 states on pilot basis.
  • Fortification of edible oil, too, was made compulsory across the country by FSSAI in 2018.
  • Fortification of milk was started in 2017 under which the National Dairy Development Board of India (NDDB) is pushing companies to add vitamin D.
  • States have been scaling up the use of double-fortified salt in an effort to combat iron and iodine deficiencies.
• Price stabilisation fund to regulate the price volatility of important agri horticultural commodities like onion, potatoes and pulses.

Measures to be Taken

• Systemic overhaul of the public administration and service delivery systems, as well as engagement from the community.
• Need to invest in the infrastructure of ICDS and the Anganwadi centres as well as improve their coverage.
• Need to better target nutritional programs and substantially increase their quality and impact. 
• Inclusion of all vulnerable groups (children, adolescent girls, mothers, expectant women) under the safety cover of ICDS.
• Fortification of essential food items with legal provisions (e.g., twin fortification of salt with both iodine and iron).
• Popularize low-cost nutritious food.
• Control of micro-nutrient deficiencies with a special focus on vulnerable groups. Some district-level interventions have aimed to address this issue. For instance, Angul district in Odisha, which has a large geographically isolated tribal population, has periodic grievance redressal camps set up in areas far from the Anganwadi centres to provide ICDS services.
• Need to address gaps and inefficiencies in the present setup through public awareness, community engagement and empowerment, while such an intervention would assist the community in realising their rights and entitlements, and then act as a deterrent to inefficiencies and gaps, it would also help in developing community-based solutions to malnutrition, unburdening the stressed public healthcare and ICDS infrastructure.
• Strengthen inter-departmental convergence and resource allocation based on real-time data. In this regard, the approach undertaken by Bangladesh has been successful and replicable in India.

Conclusion

For solving the malnutrition challenges in India requires the nutrition policy and program to have lasting and old challenges, as well as keep pace with new and emerging challenges.

Mission Poshan 2.0 (Saksham Anganwadi and Poshan 2.0) has been announced in the Budget 2021-2022 as an integrated nutrition support program is the right step in this direction.