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What It Means To Be Hungry In India

Amid the poor ranking, Indian experts are of the view that bad implementation processes, lack of effective monitoring and siloed approaches is the reason behind the debacle which often result in poor nutrition indices.

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Shocking, and the methodology used for the report was "unscientific", said the Union Ministry Of Women And Child Development (WCD), in a sharp response to the Global Hunger Index (GHI) 2021. The statement came after India slipped to the 101st position from 94th in 2021, out of 116 countries, and is behind its neighbours like Pakistan, Bangladesh, and Nepal.

The WCD Ministry in a statement 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 Hungerhilfe have not done their due diligence before releasing the report.”

Expert Blames Policies:

Amid the poor ranking, Indian experts are of the view that bad implementation processes, lack of effective monitoring and siloed approaches is the reason behind the debacle which often result in poor nutrition indices.

Amitabh Behar, CEO of Oxfam India, “This trend of undernutrition in India is unfortunately not new, is actually based on the government’s own National Family Health Survey (NHFS) data. The data shows that between 2015 and 2019, a large number of Indian states actually ended up reversing the gains made on child nutrition parameters. This loss of nutrition should be of concern because it has intergenerational effects, to put it simply - the latest data shows that in several parts of India, children born between 2015 and 2019 are more malnourished than the previous generation.”

Poonam Muttreja, Executive Director Population Foundation of India said, “Several reasons could have aggravated the nutrition and health crisis in children over the last five years. The downward trend on the Global Hunger Index 2021 could be on account of stunting being concentrated among children from households facing multiple forms of deprivation, including poor dietary diversity, low levels of maternal education and household poverty as revealed by the Global Hunger Index 2020. Economic slowdown and stagnation in wages among the poor could have reduced people’s ability to consume nutritious diets resulting in food insecurity.”

The constant denial: 

Oxfam India also pointed out key issues such as malnourishment of children, the drop in child nutrition by 18.5 per cent and only 0.57 per cent has been allocated in the union budget. It also mentioned that 4 per cent of its gross domestic product and 8 per cent of its productivity are due to child malnutrition alone. The government said only 3.9 per cent of Anganwadi children are malnourished in India and the value shown in the GHI is inflated, as per Oxfam India.

"There are massive negative consequences to not arresting high levels of malnutrition. In India, both our adult population and our children are at risk. For instance, the BMI of a quarter of our (teenage and middle-aged) women is below the standard global norm, more than half of our women suffer from anaemia. A quarter of our (teenage and middle-aged) men also show signs of iron and calcium deficiencies as per the latest round of NHFS data," said Varna Raman, Lead, Research and Knowledge Building at Oxfam India. 

The Union budget this year discussed India’s POSHAN (Prime Minister's Overarching Scheme for Holistic Nourishment scheme) with “increased” allocations to POSHAN 2.0, however, the POSHAN Abhiyaan that was launched in 2017 to improve nutrition among children, pregnant women and lactating mothers has languished due to poor funding resulting from clever clubbing with other schemes within the health-budget and even worse implementation. Only 0.57 per cent of the current budget has been allocated toward funding the actual POSHAN scheme and the amount for child nutrition dropped by a whopping 18.5 per cent compared to 2020-21.  

Muttreja also talked about how insufficient human resources are also a huge concern for states as several sanctioned posts continue to remain vacant for Child Development Project Officers (CDPOs) and Lady Supervisors (LSs). Close to 30 per cent of sanctioned posts for CDPOs and LSs and 10 per cent of sanctioned positions for Anganwadi workers and Anganwadi helpers remain vacant. 

“This has been the case since the pre-pandemic period and continued during the COVID-19 pandemic. Inadequate investments in the integrated Child Development Scheme (ICDS), the release of funds in smaller tranches and lesser utilisation of funds by states have resulted in only 46 per cent of the allocated budgets being released and 41 per cent budgets being utilised by states for Poshan Abhiyaan. Further in 21 states and UTs, the uptake of services from Anganwadis have been poor as the number of children receiving the supplementary Nutrition Programme were less than half the estimated number of beneficiaries between March 2017 and June 2019,” said Muttreja.

India behind Pakistan, Bangladesh, and Nepal: 

India's position in 2020 was not good, however, this time it slipped to 101 from 94th and is behind its neighbours Pakistan, Bangladesh and Nepal.

Malnutrition and undernutrition continue to be significant issues for the country. The Comprehensive National Nutrition Survey 2016-18 revealed that there are still around 20 million children under five years of age who are suffering from wasting, over 40 million children are chronically malnourished, and more than half of Indian women aged 15-49 years are anaemic.  

“All of us as Indians and not just the Government should be extremely concerned about India’s rank going down even further to 101 out of 116 countries from 94 and being placed under the ‘serious category’ in the Global Hunger Index 2021. The index is calculated on the basis of four indicators — undernourishment, child wasting, child stunting, and under-five mortality. It is indeed a red flag and we should view it as a warning on how much more we need to do,” Muttreja said.

Required Steps Need to be taken: 

Muttreja also said that the NFHS 5 Phase I findings from 22 states and 7 Union Territories reveal that stunting (low height-for-age) has increased among children under five years of age in 11 states and 3 UTs between 2015-16 and 2019-20 on account of poor nutrition. Similarly, wasting (low weight-for-height) has increased in 9 states and 3 UTs between NFHS 4 and 5. The proportion of underweight children has increased in 14 states in comparison to NFHS-4. These findings are worrisome. While Poshan Abhiyaan, launched by the Prime Minister in 2018, was a step in the right direction, we need to accelerate the progress and also do mid-course corrections where needed.   

“There is an urgent need to address the widespread prevalence of malnutrition across the country, with a special focus on poor-performing pockets and regions. Institutionalizing and strengthening data management systems is critical for addressing data gaps, improving monitoring, facilitate better decision-making and optimal utilisation of available budgets. There is also a need for active involvement of all relevant ministries and departments, civil society organisations, community-based organisations in planning, coordination and implementation of nutrition-specific interventions," Muttreja said.

"We need a holistic and convergent approach to improve health and nutrition outcomes for women and girls. It is important to recognize that reproductive, maternal and child health and nutrition cannot be addressed in isolation as these are closely linked to the health status of girls and women in various stages of their life cycle. Prevailing social norms, such as early marriage, teenage pregnancies, unsafe abortions lead to compromised nutritional and health status amongst young girls and subsequently their children. It is an established fact that healthy mothers are most likely to have healthy babies and healthy babies are most likely to achieve their potential in their lifetime,” Muttreja further added.

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World Hunger Index 2021