India’s hunger problem: Where we stand, what went wrong, and how can it be fixed

Where does India rank on the hunger index?

India ranked 102 out of 117 developing countries in the Global Hunger Index lagging behind neighbours Pakistan, Nepal, and Bangladesh, with the report putting India’s hunger level at 'serious'. India’s GHI score(lower the better) did improve from 32 to 30.3 between 2010 to 19 but the pace of improvement slowed. With just 9.6% of our children between 6-23 months being fed a “minimum acceptable diet,” the problem of hunger still looms large.

In today's post, we start by understanding what the global hunger index is, look at things that went wrong both on a policy and institutional level, and what options lie ahead to fix the issue.

What is the Global Hunger index?

The GHI (Global Hunger index) is created using four primary factors: undernourishment, child wasting (lower weight than recommended), child stunting (lower height than recommended) and child mortality for children below 5. While there is some debate whether all of these measures are accurate metrics to gauge hunger (mortality rates, for example, have strong drivers of health, hygiene, and immunization), the fact that any of our children grow hungry/unhealthy despite the tremendous economic growth we make each year is cause for reflection.

I didn’t want this piece to be an alarmist or doom and gloom view, but rather a place that every person can gain something from and make atleast the children in their immediate vicinity healthier (your own, of your friends’ and colleagues’, and most importantly of people lower down in the socio-economic strata [maid, driver, milkman, etc]). That being said, it is equally important to understand what is being done wrong at a policy level so we can speak to get it corrected, so I will be highlighting some of that as well.

Where are we going wrong?

For one, our government spending on healthcare is terribly low, with less than 1% of GDP spent on healthcare by the government (lower than part of sub-Saharan Africa). This and other factors have left hospitals in our most remote and vulnerable parts terribly understaffed and is an issue that definitely needs to be worked on.

The next issue is the reductions and restrictions in the Pradhan Mantri Matrubandhana Yojna. The payouts have gone down from INR6000 to INR5000 and are only paid for the first child. Women in India, especially lower down the socio-economic strata are very undernourished. Every second woman in India is anemic, and every third woman is undernourished. The nutrition the child gets at this stage has severe consequences on the health and well being of the child long term. While there be some merit in restricting the number of children you can apply the scheme for, the cost cut imposed put our most vulnerable at risk for a measly saving to the national exchequer is definitely something that should be reversed, and perhaps improved.

The third thing we need to do is delink religion from life-saving nutrition. Eggs are a brilliant source of nutrition providing the child a wide variety of nutrients, and yet they continue to be excluded from mid-day meal schemes. While well-meaning organizations working in the space have found and actively push lentils and other vegetarian alternatives (and these are important, because a good part of the country cannot eat eggs), we should certainly attempt to make eggs available to the children who can eat them.

We now move away from what can be done at a Central and State level, which we can guide via our vote and our voice, but otherwise have little control over, to issues of behaviour and nutrition education, that all of us can learn and pass along to people who would need it most.

What can we do to improve nutrition levels in Indian children?

The first 1000 days between a woman’s pregnancy and a child’s second birthday are critical, and if done right can have profound long term benefits on the physical and mental well-being of the child. For those more financially minded, each rupee invested in improving the nutrition of mothers and children in the first 100 days has a 35x return.

As a nation whose human capital is one of its most potent resources, this is, therefore, an area we should look at very seriously. So here are a few things that are done wrong, but can be done better with a few simple tweaks. Breastfeeding within one hour of birth, exclusive breastfeeding for the first 6 months of a child’s life are critical and yet less than 50% practice it. UNICEF has done studies to tie this to sensory and cognitive development, protection against infectious and chronic diseases, and reduced childhood mortality.

The second is the introduction of semi-solid food between 6-24 months of age, something that just 42% of people practice. For most households, this is a readily available form of nutrition that the child doesn’t get access to.

The third is the three-meal frequency which less than 33% of the people practice for young children. Things like these are now readily available information and should be practiced more often.

The issue of hunger has plagued our nation for a long time, and while we have made significant progress in the years since independence, we still have a long way to go. With some good policy level steps at the Central and State level, and improved behaviour and nutrition education at an individual level, we can fight the issue together. And hopefully one day, not be on the list at all.

About the Author: The post is written by Ganesh Nagarsekar. Ganesh is a graduate from IIM Calcutta and has worked with J.P. Morgan and Goldman Sachs, before founding GSN Invest.

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