Not Just Global Hunger Index, NFHS-5 Also Raises Concern On India’s Nutrition Status

New Delhi: 1-year-old Laxmi in Madhya Pradesh’s Shivpuri at barely 2.5kgs weighed much less than an average 8kgs (as per WHO). On October 9, her father reached a community health center in their town from where she was shifted to two different hospitals until the malnourished girl died in Gwalior on October 11. According to Dr Pawan Jain, Chief Medical Health Officer (CMHO) of Shivpuri, the girl had ‘acute malnutrition’ and was referred to a medical college in Gwalior. A committee has been constituted to probe the matter.

Little Laxmi is not alone. This devastating reality is reflected in the National Family Health Survey (NFHS-5), India’s ranking on the Global Hunger Index (GHI), 2021 and other surveys.

Also Read: 33 Lakh Children In India Malnourished, Over 50% Cases Severe: Report

Over 33 Lakh Children In India Are Malnourished: Centre

In response to an RTI query by news agency PTI, the Ministry of Women and Child Development said, ‘Over 33 lakh children in India are malnourished and more than half of them fall in the severely malnourished category with Maharashtra, Bihar and Gujarat topping the list.’

The total 33.23 lakh (33,23,322) is a compilation of data from 34 states and union territories. The numbers were registered on the Poshan tracker app developed last year as a governance tool for real-time monitoring of nutritional outcomes.

Additionally, ‘SDG India Index & Dashboard 2020-21 Partnerships In The Decade Of Action’ prepared by NITI Aayog states that 33.4 per cent children aged under five are underweight whereas 34.7 per cent are stunted.

India’s own NFHS reflects the gravity of malnutrition in the country. The NFHS-5 (2019-21) report released on November 24 has shown that the percentage of obese children and adults, rose in India in the last five years. Moreover, as per the survey, several of India’s nutritional indicators have shown minor improvement, since NFHS-4 was conducted in 2015-16. The report shows:

– Nearly three per cent decline in child stunting – from 38.4 (NFHS-4) to 35.5 (NFHS-5).

– While child wasting has seen a 1.7 per cent decline, the percentage of children under five who are severely wasted has increased by 0.2 per cent.

– The percentage of underweight children has also reported a 3.7 per cent drop.

– Children under the age of 5, who are overweight have increased from 2.1 per cent (NFHS-4) to 3.4 per cent that is a 1.3 per cent rise.

Also Read: What Does The Latest National Family Health Survey Reveal About The Nutritional Status Of India?

It’s important to note that under NFHS-5, 17 states and 5 union territories were surveyed before the COVID-19 pandemic. According to experts, the pandemic is likely to exacerbate hunger and malnutrition in the country. Talking about the same, Dr Antaryami Dash, Head – Nutrition, Save the Children, said,

The global estimate shows that without action, between 2020 and 2022, an additional 3.6 million children will become stunted, and an additional 13.6 million children will become wasted. This will result in an additional 2,83,000 deaths of children under-five. However, it is important to note that any developments in 2021 are not yet reflected in the latest prevalence of undernourishment data, which covers 2018-2020 in the recent Global Hunger Index (GHI) report. The full effects of the COVID-19 pandemic will only be reflected in the GHI data in the coming years.

The GHI is a tool designed to comprehensively measure and track hunger at global, regional, and national levels. Data for the indicators come from data collection efforts by various UN and other multilateral agencies including Food and Agriculture Organization (FAO), United Nations Interagency Group for Child Mortality Estimation (UN IGME), joint database of UNICEF, WHO, and the World Bank, as well as from WHO’s continuously updated Global Database on Child Growth and Malnutrition, the most recent reports of the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS), and statistical tables from UNICEF.

The level of hunger in India has been called serious with an overall score of 27.5. India now ranks at 101 out of 116 countries assessed, down from 94 out of 107 in 2020. This is worse than neighbouring countries like Pakistan, Bangladesh and Nepal. India is better than only 15 countries including Afghanistan, Yemen and Somalia.

Also Read: Government Of India Extends 5 Kilogram Of Free Foodgrains Scheme Till March 2022

As per the findings of the GHI, since 2000, India has made substantial progress, but there are still areas of concern, particularly regarding child nutrition. Here are some key findings:

– The proportion of undernourished in the population has come down from 18.4 per cent in 2000 to 15.3 per cent in 2021. However, there is a 0.3 per cent increase when compared to 2012.

– Similarly, the under-five child mortality rate is relatively low at 3.4 per cent compared to 9.2 per cent in 2000.

– Though child stunting (low-height-for-age) has seen a significant decrease – from 54.2 per cent in 2000 to 34.7 per cent in 2020 – it is still considered very high, as per the GHI report.

– At 17.3 per cent, India has the highest child wasting (low-weight-for-height) rate of all countries covered in the GHI. The prevalence has increased from 15.1 per cent in 2012.

Also Read: What Causes Obesity In Children And How To Prevent It?

The Controversy Around GHI 2021 Report

The central government has strongly rejected India’s fall in rank and said,

It is shocking to find that the Global Hunger Report 2021 has lowered the rank of India on the basis of FAO estimate on the proportion of the undernourished population, which is found to be devoid of ground reality and facts and suffers from serious methodological issues. The publishing agencies of the Global Hunger Report, Concern Worldwide and Welt Hunger Hilfe, have not done their due diligence before releasing the report.

Though GHI reports show trends from the year 2000, it clearly states that GHI scores and rankings are comparable only within each year’s report, not between different years’ reports, owing to revisions of the source data and methodology. Hence, the government’s allegation that India’s ranking has slipped is factually incorrect.

To track a country’s GHI performance over time, each report includes GHI scores and indicator data for three reference years. In the 2021 report, India’s GHI scores can be directly compared with its GHI scores for 2000, 2006, and 2012, it noted.

Also Read: Opinion: When Will We Talk About Food Security?

Hunger In India VS Neighbouring Countries

NDTV spoke to Dipa Sinha, Right to Food Campaign activist to get clarity on the findings of the latest GHI report and understand the status of hunger and malnutrition in India. To begin with, Ms Sinha said that with regard to GHI findings, the concern is that every year India is among the bottom 10 per cent which makes it more evident that hunger and malnutrition are prevalent. Both the percentage of undernourished and wasted children has increased in India compared to 2012. She added,

Even if you sideline GHI’s findings, the government’s own data suggests a poor state of nutrition in India; in fact, there seems to be a reverse in gains made. For example, a 10 per cent decline in child stunting was reported from 2005-06 (NFHS-3) to 2015-16 (NFHS-4).

The latest GHI report states that the level of hunger in India is worse than that of Pakistan and Bangladesh. To this, Ms Sinha said that malnutrition doesn’t only mean food; there are multiple other factors which contribute to the well-being, for instance, sanitation, dietary diversity, and women’s health. She said,

Bangladesh has been investing heavily in women empowerment for the past 10-15 years. Similarly, the speed at which the rate of open defecation in Bangladesh came down is much higher than India’s. Yes, India has various food safety net programmes, but the budget allocated to these schemes has reduced over the years. Our growth has been poorer.

Also Read: COVID-19 Has Made Children More Vulnerable To Malnutrition, Here’s How

Experts Take On How Can India Address Hunger

When asked how India can improve its ranking and address the issue of hunger, Dr Dash said hunger is a complex subject and so are the solutions it demands. He explained,

We need to look at it from a “one-health” and “whole-of-society” approach which can only be delivered through a “whole-of-government” system. We need to guarantee food availability and production and supply are sustained and classified as essential services. It will be important for governments, donors, and NGOs to work closely to ensure social protection measures, such as cash and food transfers, health care, and employment schemes reach the most vulnerable.

Talking about the steps required to address hunger in India in the light of the COVID-19 pandemic, Basanta Kumar Kar, Recipient of the Global Nutrition Leadership Award, emphasised upon leaving no one behind. He said,

The novel coronavirus pandemic has upset the food and nutrition systems multifold by disruptions, limiting people’s income sources and restricting food and nutrition supplies and services. The women and children and socially marginalised are hardest hit due to multiple exclusions. In order to bring down key malnutrition indicators to a single digit by 2040, India needs to double or quadruple the current rate of reduction levels by giving it the required push. It is necessary to focus on the excluded population and geographies for a scalable impact. Secondly, infant feeding is abysmally low so invest in maternal and infant child feeding, prioritise actions and invest in the first and second window of opportunity.

Also Read: Opinion: The Sustainable Development Goal Of Zero Hunger VS Where India Stands

Mr Kar also called for new legislation on food and nutrition which can take care of sustainable food and nutrition; food safety; preserving bio-safety and biodiversity. Additionally, Mr Kar touched upon food wastage and said,

Reducing food waste will have bearing on reducing incidence on greenhouse gas emissions, sustainable climate-sensitive nutrition, slow the destruction of nature through land conversion and pollution, enhance the availability of food and thus reduce hunger and malnutrition.

Commenting on addressing malnutrition in India, Sachin Jain, Right to Food Activist called it a matter of public policy and said,

We should include edible oil and pulses in the food programmes. We should include eggs and other protein diets in the Integrated Child Development Services (ICDS) and mid-day meal (MDM) programme. Also, the biggest demand of the time is to start supporting the millet producers.

Also Read: Opinion: India’s Malnutrition Burden Still High, Is Poshan 2.0 The Answer?

NDTV – Dettol have been working towards a clean and healthy India since 2014 via Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity,  that is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.