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ExplainSpeaking: Reading Global Hunger Index and Indian govt’s response

The government has rejected the Global Hunger Index report, claiming it is an effort to 'taint' India and questioning its methodology. What does the report say, and how did it reach its conclusions? And how far is the government justified in its criticism?

In common parlance, “hunger” implies discomfort due to a lack of food. However, the GHI is a more complex measure. (Express File Photo by Partha Paul)

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Dear Readers,

Last week, Concern Worldwide and Welthungerhilfe released the latest edition of the Global Hunger Index report. It ranked India 107th out of 121 countries that could be ranked and 136 countries that were assessed; for 15 countries, individual scores could not be calculated and ranks could not be determined owing to lack of data.

The Indian government responded by summarily dismissing the report, going so far as to claim that it was done to “taint India’s image”. This is not the first time the Indian government has responded like this when faced with India’s poor ranking in the GHI.

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Before evaluating the government’s view, here’s what you should know about the GHI.

When was GHI started, and who brings it out?

The GHI is an annual publication and was started in 2006 by Welthungerhilfe and the International Food Policy Research Institute (IFPRI).

Welthungerhilfe is one of the largest private aid agencies in Germany. It claims to be politically and religiously independent. It was founded in 1962 and works to achieve the United Nations Sustainable Development goal of “Zero Hunger by 2030”. According to Welthungerhilfe, it has provided funding of Euro 4.46 billion (1 euro is equal to Rs 80) for more than 10,895 overseas projects in 70 countries.

IFPRI was established in 1975 and provides research-based policy solutions to sustainably reduce poverty and end hunger and malnutrition in developing countries. It is a research centre of CGIAR (formerly known as the Consultative Group for International Agricultural Research), a worldwide partnership engaged in agricultural research for development. The CGIAR, in turn, is funded by many entities and countries including India (see CHART 1 below)

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Chart 1: Principal funders of the CGIAR

In 2007, Concern Worldwide, an international humanitarian organisation that has been fighting hunger and poverty across the world since 1968, joined as the third co-publisher.

In 2018, IFPRI stopped being a publisher. As such, since then the GHI has been brought out by just Welthungerhilfe and Concern Worldwide.

What is the Global Hunger Index?

In common parlance, hunger refers to discomfort due to a lack of food. However, the GHI is not such a simplistic measure. Instead, it uses four separate measures to “capture the multidimensional nature of hunger”.

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To be sure, it has used multiple measures since its inception in 2006. The last update to the methods happened in 2015.

These are the four measures it uses:

1) Undernourishment: the share of the population whose caloric intake is insufficient. This is closest to the everyday notion of hunger. This makes up 1/3 of the GHI score.

2) Child stunting: the share of children under the age of five who have low height for their age, reflecting chronic undernutrition; this makes up 1/6 of the GHI score.

3) Child wasting: the share of children under the age of five who have low weight for their height, reflecting acute undernutrition; this makes up 1/6 of the GHI score.

4) Child mortality: the share of children who die before their fifth birthday, reflecting in part the fatal mix of inadequate nutrition and unhealthy environments. This makes up 1/3 of the GHI score.

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The overall score is placed on a 100-point scale and a lower score is better (CHART 2). A score between 20 and 34.9 is pegged in the “serious” category and this is where India finds itself with a total score of 29.1.

Chart 2: Composition of Global Hunger Index scores

Why does GHI look at all these variables for hunger?

According to the FAQs on the official website, “the problem of hunger is complex. The GHI includes four indicators to reflect the multidimensional nature of hunger. Together, they reflect deficiencies in calories as well as in micronutrients.”

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The report explains why using this combination of indicators to measure hunger offers several advantages.

“The indicators included in the GHI formula reflect caloric deficiencies as well as poor nutrition,” it states. The undernourishment indicator, for instance, captures the food access situation of the population as a whole, while the indicators specific to children reflect the nutrition status within a particularly vulnerable subset of the population for whom a lack of dietary energy, protein, and/or micronutrients (essential vitamins and minerals) leads to a high risk of illness, poor physical and cognitive development, and death.

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Further, by combining multiple indicators, the index “minimizes the effects of random measurement errors”.

Moreover, these four indicators are all part of the indicator set used to measure progress toward the United Nations Sustainable Development Goals (SDGs).

What has GHI 2022 found?

Typically, GHI ranks and scores are not comparable from one year to another. That’s because data is often revised and methodology changes over time. However, each year, the report provides data for three reference years, making the data comparable, to provide a trend for different countries.

The results for India and some other comparable countries are summarised in TABLES 1 through 4 below.

Tables 1-4: How India performed across the four markers of Global Hunger Index

India has made significant improvements in under-5 mortality and even child stunting has improved a bit. However, the proportion of undernourished population has gone up over the past few years.

But most worrisome is the trend on child wasting where India has slid back to a level worse than what it was three decades ago; worse still, at over 19%, India’s child wasting is the worst among all countries in the world.

What is child wasting?

According to the World Health Organisation, wasting is a reduction or loss of body weight in relation to height. It is a major health problem and, owing to its associated risks for morbidity, requires urgent attention from policymakers. Some of the main causes of wasting include:

  • poor access to appropriate, timely and affordable healthcare
  • inadequate caring and feeding practices
  • poor food security
  • lack of a sanitary environment

“Poor diet leads to increased risk of infection, and infection has a profound effect on nutritional status. A previously healthy child can quickly become wasted when faced with a severe infection, potentially leading to a loss of appetite. As wasting worsens, children become more susceptible to infections. This is known as the ‘vicious cycle’ between infection and wasting,” states WHO.

Why has the Indian government criticised GHI 2022?

This is the second year running when the Indian government has criticised the GHI report. Based on the press release, dated October 15, there are three essential parts of the government’s reaction.

First, it claims that a “consistent effort” is yet again visible “to taint India’s image as a Nation that does not fulfill (sic) the food security and nutritional requirements of its population”

Secondly, it has questioned the methodology of GHI, claiming that “misinformation seems to be the hallmark” of the annually released report. There are three sub-parts to the government’s contention:

1) That GHI uses “an erroneous measure of hunger”. In other words, it defines hunger in terms of other variables beyond the lack of food.

2) That 3 out of the 4 variables used are related to children, and as such, cannot be representative of the entire population.

3) Lastly, the government claims that the fourth indicator, the proportion of undernourished population is “based on an opinion poll conducted on a very small sample size of 3000”.

Thirdly, the government details how it has been providing additional free-of-cost foodgrains to 80 crore Indians since March 2020, over and above the entitlements under the National Food Security Act. It also mentions the supplementary nutrition provided to 1.78 crore women and 7.7crore children via the Angandwadi scheme as well as the monetary help (Rs 5000) provided to 1.5 crore women at the time of the birth of their first child.

How justified is the government in its criticism?

Let’s take the government’s points in reverse order.

The government has indeed ramped up free provisioning of basic foodgrains (rice or wheat) during Covid, but researchers argue that India’s GHI score could have been worse had it not been for this assistance. That’s because the Covid pandemic hit the poor pretty hard in an economy that was already losing its growth momentum in the three years leading up to the Covid impact.

Dipa Sinha, assistant professor at Ambedkar University and a long-time researcher on food security, says that all other evidence, such as the most recent survey on MG-NREGA done by Azim Premji University, points to extreme stress. Moreover, when it comes to nutrition and food security, Sinha says that quantity only goes so far. “A small kid doesn’t need huge quantities of food; rather a well-proportioned meal that caters to the child’s nutritional needs,” says Sinha.

What about the government’s claim that the “proportion of undernourished population” is based on “Food Insecurity Experience Scale (FIES) Survey Module conducted through Gallop (sic) World Poll, which is an ‘opinion poll’ based on ‘8 questions’ with a sample size of ‘3000 respondents’”?

Sinha says this is an incorrect assertion that the government made last year as well. She points to the FAQs available on the GHI website. Simply put, it clarifies that GHI uses the prevalence of undernourishment, which is “based primarily on data officially reported by the member countries, including India”. (see the box below)

What about the use of 3 indicators that are related to children?

Sinha points out that this is an unjustified grouse. “There are studies going back decades that show that child malnutrition and mortality data are extremely sensitive indicators of how the whole population is doing on nutrition,” she states. Further, when it comes to malnutrition, it makes a lot of sense to track children “because malnutrition that sets in childhood is very difficult to reverse in adulthood”.

What about the government’s contention that these indicators do not measure “hunger”?

“The use of the word ‘hunger’ can be questioned. But even if one calls it the Global Nutrition Index or something similar, the reality and India’s positioning will not change,” said another senior health expert, who did not wish to be identified.

Both Sinha and the other expert underscore that the authenticity of the data per se cannot be challenged because it is from India’s own data sets. “That India’s levels of child stunting and wasting are one of the worst in the world, is not in question at all,” said the other health expert.

What about the government’s allegation that GHI is doing this to malign India’s image?

Indeed, India is poorly placed on the GHI scale but it is quite a leap to conclude that the whole survey, covering 136 countries, is brought out each year just to target one country (India).

Moreover, GHI has not been started in the past two years. It was started in 2006 and India has always been a laggard when it comes to nutrition.

It is another thing that the previous government was at least willing to accept the harsh reality.

A case in point is the statement made by PM Manmohan Singh in early 2012 when a similar “hunger” report — the Hunger and Malnutrition survey (or, the “Hungama” report, as it was called) by the Nandi Foundation — presented its findings that 42% of Indian children under five years old are underweight; almost double the rate of sub-Saharan Africa.

“I have said earlier on a number of occasions and I repeat that the problem of malnutrition is a matter of national shame,” Singh said at the launch of the survey.

“Despite impressive growth in our GDP (gross domestic product), the level of under-nutrition in the country is unacceptably high. We have also not succeeded in reducing this rate fast enough…The health of our economy and society lies in the health of this generation. We cannot hope for a healthy future for our country with a large number of malnourished children,” Singh further said.

Experts say acknowledging the problem is the first and necessary step towards addressing it.

Upshot

India has a severe malnourishment problem that needs to be tackled head-on. India can do better if its government rids itself of what increasingly resembles a persecution complex. That’s because the Global Hunger Index is just one in the long list of surveys and reports — all pointing in the same direction.

For instance, in this controversy about what qualifies as “hunger”, people have paid little attention to another survey — this one brought out by Unicef on October 16.

It is called “Child Food Poverty: A Nutrition Crisis in Early Childhood”. The box below provides a quick understanding of what child food poverty is and how it is being measured.

But here is the bottom line: Unicef found that in 13 countries across the world, more than 2 in 5 children live in “severe food poverty”. India is one among those 13, giving company to countries such as Chad, South Sudan, Ethiopia, Somalia, Myanmar and Afghanistan.

Look at CHART 3 below. It maps the prevalence of underweight children on the vertical axis and the share of extreme poverty on the horizontal axis. Notice where India is vis-a-vis sub-Saharan Africa. India has a much higher prevalence of underweight children even though it has much lower levels of extreme poverty.

Chart 3: Prevalence of underweight children vs share in extreme poverty

If stunting and wasting numbers are anything to go by, India might have the largest pool of malnourished kids in the world. In less than a couple of decades, these malnourished children (with associated deficiencies and vulnerabilities) will enter the workforce. The undernourished girls among these will likely become undernourished mothers.

All these reports and charts should give any Indian policymaker pause. There is only so far one can go quibbling over semantics. The data is unequivocal.

Should the Indian government stop fussing over GHI using the word “hunger” and start focusing on the essential message of the report?

Does India need to ramp up its expenditure towards improving health and nutritional outcomes?

Share your thoughts at udit.misra@expressindia.com

And finally, last week I caught up with the authors of the most recent survey on the performance of MG-NREGA (India’s national rural employment guarantee scheme) during the Covid pandemic. Watch that episode of The Express Economist here. Beyond MGNREGA, we discuss if India’s growth strategy needs a radical rethink.

Until next week,

Udit

First published on: 18-10-2022 at 04:00 IST
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