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Resource centre on India's rural distress
 
 

India is still a hunger hotspot -Arvind Virmani and Charan Singh
-The Hindu Business Line


Malnutrition, lack of clean water and prevalence of poor sanitation are the main causes of high child mortality in India.

The Global Hunger Index (GHI) was released by the International Food Policy Research Institute (IFPRI) and Welt Hunger Hilfe (WHH) recently. According to the GHI, the world has made some progress in reducing hunger since the early 1990s and the millennium development goal of halving the share of hungry people in the world between 1990 and 2015 may be within reach.But it does not seem that the more ambitious goal of drastically reducing the absolute number of hungry people in the same period is achievable. In 1990-92, one billion went hungry, while in 2013 there are still 870 million people who suffer from hunger.

Table

BOTTOM OF THE TABLE

The GHI combines three equally weighted indicators into one index. These are:

under nourishment, taking into account the proportion of undernourished people as the percentage of total population;

child underweight, considering the proportion of underweight children less than five years of age; and child mortality, considering the mortality rate of children below five years of age. The multi-dimensional approach to measuring hunger reflects the nutritional situation not only of the population as a whole but also of a physiologically vulnerable group - children - who could be sick or stunted because of lack of nutrients. In any case, GHI does not directly track hunger, as generally understood, and therefore its nomenclature is a misnomer.

Contrary to claims, GHI is not a tool designed to comprehensively measure and track hunger globally and by region and country. Neither does it provide insights into the drivers of hunger, and food and nutrition insecurity. The 2013 world GHI fell from a score of 20.8 in 1990 to 13.8 in 2013; and in South Asia, the GHI score at 20.7 is the highest in 2013.

This is mainly because of social inequality and the low nutritional, educational, and social status of women that are reflected in child under-nutrition.

In terms of GHI components, India has the highest prevalence of underweight in children under five years; 40.2 percent, the only worse country is Timor-Leste at 45.3 percent.

The proportion of under nourished in India as a percentage of total population has declined from 21.3 per cent in 1999-01 to 17.5 per cent in 2010-12 (Table). The under 5 mortality rate is the worst in India. It is for the above reasons that the overall GHI for India is very serious and not because of hunger per se.

The other countries which perform worse than India in 2013 on GHI are Burundi, Chad, Comoros, Ethiopia, Haiti, Madagascar, Timor-Leste, Zambia and Yemen.

In another work, recently released by Angus Deaton (The Great Escape, 2013), in countries like India it is malnutrition, lack of clean water and prevalence of poor sanitation that is the main cause of high child mortality.

Poor sanitation

Globally, the improvements in child mortality must be ascribed to control of disease through public health measures, mainly improvement in sanitation and water supplies, routine vaccination and adoption of good practices of personal and public health based on germ theory.

At the individual level the reduction in disease particularly diarrhoeal, respiratory and other infections among children can be ascribed to improved nutrition. In fact, according to Deaton, net nutrition, more than food, after making allowance for nutrition lost to diseases like diarrhoea, fevers and infections is important.

The other cause of high mortality is unhygienic disposal of human waste, lack of protein, energy insufficiency, and lack of vital micro nutrients such as iron.

There is a need for better pest control in countries like India. Children are particularly at risk after weaning when they switch from mother's milk to a diet that may be insufficient, unvaried, and unsafe.

Hence, it is necessary to study in depth the GHI and initiate remedial measures. The quick-fixes may not be sufficient and the need is to go beyond to providing cleaner water and better sanitation. As Virmani (2007, 2012) showed, much of inter-state and inter country variation can be explained by poor sanitation and unclean water. India can dramatically close the gap in child malnutrition (wasting) if sewage and sanitation is brought on par with other countries, at least those with similar per capita income levels.

(Virmani is former Chief Economic Advisor, GOI. Singh is RBI Chair Professor of Economics, IIM Bangalore. The views are personal.)