Malnutrition is a persistent problem in India, though it is often confused with hunger. According to the Food and Agriculture Organization (FAO), about 18% of India’s population was undernourished in 2012.

Undernourishment is the main cause of children’s deaths, and according to the United Nations Children’s Fund (Unicef), India houses one-third of the stunted, wasted and malnourished children of the world.

Different rounds of the National Sample Survey (NSS) suggest the proportion of households in rural areas, getting enough food every day of the year increased from 94.5% in 1993-94 (NSS 50th round) to 99% in 2009-10 (NSS 66th round). The proportion of rural households not getting enough food every day for some months of the year declined from 4.2% to just 0.9%, while those not getting enough food every day for all months of the year declined from 0.9% to 0.2%. In the urban areas, where, to begin with, shortage was much less, a similar story has unfolded. Food availability has reached a large segment of the population and the gap between the rural and urban percentages has narrowed appreciably.

In the survey undertaken from July 2009 to June 2010, the National Sample Survey Office reported that percentage of households not perceiving themselves as getting adequate food throughout the year was 2.1% or less in all major states except West Bengal (4.6%) and Odisha (4%). In urban India, similar percentage was less than 1.3% except Madhya Pradesh (1.4%).

There are a few states in which food inadequacy appears to reach a peak during some months, illustratively, Arunachal Pradesh (January, February, November and December), Odisha (February), and West Bengal (February). Inadequacy of food is being addressed through the targeted public distribution system (TPDS) and a wide network of fair price shops. Therefore, the incidence of food inadequacy has declined in major states such as Odisha and West Bengal, as well as across the country from 2004-05 to 2009-10.

Some organizations measure hunger in terms of average calorie deficiency relative to a global norm. This calorie deficit is an average, which under the assumption that the calorie distribution is normal, suggests that people at the lower end of the distribution may be consuming inadequate food. India’s calorie deficit is the highest in the BRICS (Brazil, Russia, India, China and South Africa) group. But this is not surprising given India’s per capita gross domestic product is the lowest among the BRICS. The primary justification for the Indian public distribution system (PDS) was to ensure that all Indians get adequate cereals (calories). It is widely accepted that the enormous leakages in the PDS need to be plugged and the administrative costs reduced so that higher proportion of the expenditure reaches the intended beneficiaries.

A sharply focused effort needs to be made to identify the hungry and calorie-deficient households, who may be living in remote and hilly areas, or families with dysfunctional male heads (drugs, alcoholism), aged or with serious disabilities or female-headed households.

There is still another persistent but separate issue of malnutrition which is the main cause of underweight children. For instance, in Rajasthan in 2004-05, there was no food inadequacy, but substantial malnutrition as measured by underweight children was reported. This could be due to poor sanitation represented by non-existence of sewerage systems, open sewers, toilet facility and access to piped water. A reduction in malnutrition can be achieved by a focused nutritional and public health policy, better drinking water facilities, better drainage and sewerage system, education and public campaign about nutrition, hygiene and disease precaution.

Arvind Virmani and Charan Singh are, respectively, head of and former chief economic adviser to government of India, and RBI chair professor of economics at Indian Institute of Management, Bangalore. Comments are welcome at