Hidden hunger, according to the International Food Policy Research Institute’s latest Hunger Report, weakens the immune system, stunts physical and intellectual growth and can lead to death. Hidden hunger leads to economic chaos as well, plunging countries into cycles of poor nutrition, low productivity, poverty and low economic growth.
Further hunger and malnutrition if not tackled in time and adequately, deprives a country of healthy and educated citizens and skilled labour, something that stares India in the face today.
According to a joint survey by the UNICEF and the Union Ministry of Women and Child Development done in 2013-14, which forms the basis for the new Global Hunger Index Report for 2014, India’s proportion of underweight children declined from 45.1 percent in 2005-06 to 301.1 percent in 2013-14. In this index, the status of India has improved one notch, from what the Global Hunger Index calls ‘alarming’ to ‘serious.’
The new data seems to indicate that India has attained better health standards over the period, reversing the earlier notion that even countries such as Bangladesh and Nepal had achieved better results in tackling malnutrition and hunger than India, in spite of faster economic growth in the latter. This healthier outcome was brought about, according to the International Food Policy Research Institute (IFPRI), by the expansion and higher prioritisation of programmes such as the Integrated Child Development Services (ICDS) and better monitoring by the Supreme Court-appointed committees.
Other identified reasons include the improvement in access to health services under the National Rural Health Mission (NRHM), provision of more work under the National Rural Employment Guarantee Act (NREGA) and improved delivery of cheap food grains under the Public Distribution System (PDS).
As explained by Dr Purnima Menon, Senior Research Fellow at IFPRI, “In the last ten to fifteen years, what happened in India was similar to what we have seen in Brazil and China; fast growing economies with reasonably concurrent investment in social sector programmes.” Dr Menon credits these programmes for improvements in the health situation, especially hunger and malnutrition among children.
Therefore, it is necessary to understand that despite the many limitations of social programmes such as the ICDS, NRHM and NREGA, they have played a critical role in the recalibration of India’s position in the hunger index from alarming to serious.
India Together file illustration of children eating 'panjiri' at an anganwadi centre in Sirohi district of Rajasthan. Pic: Ankita Agarwal
Such an observation urges one to deliberate on the positive relations between growth and development in the social sector, even though the comparison with China and Brazil may not be entirely fair given that the investment in the social sector in these countries has been much higher, and the distribution of wealth and income has also been better.
Half a truth?
Although India’s achievements are laudable, hunger and malnutrition have been persistent and the country still has the largest number of hungry people and malnourished children in absolute numbers. The decline in poverty and hunger has to be measured in proportion to the increase in wealth, which reveals that the creation of wealth due to fast economic growth has neither triggered commensurate decrease in income inequalities nor led to increased dignity for the poor.
In their book An Uncertain Glory: India and Its Contradictions, Professors Amartya Sen and Jean Dreze point out that the lack of success in broad-basing development and mitigating hunger is due to lack of sufficient investment in the social sector, as in China and Brazil. Sen and Dreze note that India spends 1.2 per cent of its GDP on public health care, while China spends 2.7 per cent. The understanding that growth can take place only at the cost of development programmes to help the poor and deprived leads to neglect of the social sector.
Sen and Dreze believe, based on the set of data that they use for analysis in the book, that GDP-induced growth in itself not only fails to address socio-economic disparities, but also hinders outcomes in the field of health and nutrition. Such an understanding is also testified to by the annual reiteration of the United Nations Human Development Index and reports.
The assertions by Sen and Dreze and indeed by many other scholars, indicating the inadequate progress in health, hunger and malnutrition indices in India, throw up questions over the recent findings of the IFPRI and their latest Global Hunger Index Report. It also creates scepticism about the accuracy and completeness of statistics collected by the UNICEF and the Government of India.
It is a fact that these statistics are based on provisional data and are restricted in scope. This has been stated in the IFPRI Report itself. The IFPRI, in fact, berates the Indian government and its agencies for their inability to collect data regularly enough to provide complete and updated information.
The real challenges
However, the real reasons behind so many people in our country having to suffer persistent hunger even as the storehouses overflow with food grains is something that scholarly theorising has not been able to pin-point. Take the recent case of Baron District in south Rajasthan, which has been witness to continuing starvation and malnutrition deaths. The population here comprises one among the most deprived; people live in miserable conditions and hunger deaths among children are not uncommon, despite an active media and political mobilisation. .
Ironically, Baran has good sources of irrigation and several livelihood and government programmes on paper to provide extra food and employment. And yet, hunger deaths continue to occur regularly, year after year. This is a great paradox or contradiction which needs to be resolved if one has to understand the problem and find a solution that can be replicated in the country as a whole.
It can be said with certainty that more regular and qualitatively better data collection is needed to evaluate the outcomes of development programmes in improving health and eliminating hunger and malnutrition. Better-defined concepts and goals of development have to be formulated to set significant priorities, based on the real needs of the poor and the deprived. For example, Bangladesh and Nepal conduct health surveys every three years, but India has carried out a health survey only after ten years, which is a worrying practice.
The other problem is that the data collected are not comprehensive and do not reflect the true situation. The Multidimensional Poverty Index (MPI) developed by the Oxford Poverty and Human Development Initiative, which is being used in some countries such as Bhutan, needs to be adopted in India too.
Instead of placing a narrow focus on calorie intake, consumption, income and even social and caste surveys, it may be more useful to consider more innovative ways of measuring poverty and tackling its many dimensions based on that. This is what measures such as the MPI do, reflecting the collective distribution of acute deprivations people experience at the same time.
The MPI evaluates deprivations in health, education and standard of living in the same time frame, using indicators such as malnutrition, child mortality, educated family members, incidence of school dropouts, access to of electricity, drinking water, proper sanitation, cooking fuel, adequate flooring etc. The inability to prioritise and factor in these critical dimensions is a worrying trend that needs to be pondered upon carefully.
