India’s hunger conundrum
The sharp reduction in number of underweight children lies behind India’s gains in the Global Hunger Index
Last month, the International Food Policy Research Institute (IFPRI) launched the 2014 Global Hunger Index (GHI). This year, the news for India was better than in most years, primarily because India finally has new data on child nutrition. The government of India kindly shared the provisional estimates of child underweight from a survey conducted jointly by the ministry of women and child development and the United Nations Children’s Fund (Unicef) India early enough this year so that IFPRI could include these results in the GHI computations for 2014.
As reported in several news reports, the GHI results this year were a welcome change from the previous years, when the reporting focused on the gloom and doom around hunger and nutrition in India. This in itself must have been a pleasure for the Indian public to read about. Notably, many of the better news reports also highlighted the challenges that lie ahead and wrote thoughtfully about several issues. Interestingly, there has been much speculation and debate about IFPRI’s perspectives on what had led to these changes.
Now, the primary driver of India’s poor performance on GHI in the recent past has been the prevalence of underweight children, and the new data indicate that the percentage of underweight children has gone down quite substantially from 2005 (43.2%) to 2013 (30.7%, provisional estimate). The 30.7% number was, incidentally, almost identical to the modelled estimate that IFPRI’s fantastic GHI number-crunching team had derived, which supported our decision to use the figure provided to us by the government. This change in the percentage of underweight children is what ultimately drove the overall GHI score down, improved India’s GHI rank, and changed the GHI category from alarming to serious.
So, what drove the decline? Is it improvement in water and sanitation? Is it women’s education? Is it economic growth and poverty reduction? Is it due to the Integrated Child Development Scheme (ICDS) or the National Rural Health Mission (NRHM) or the public distribution system (PDS)? Or is it due to the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA)?
The brief box on India in the GHI report raises hypotheses but the answers will not be known until more analyses can be done (once the new data are fully available to the public) to understand where the changes in India are coming from. Let’s remember that most Indian programmes are not well-evaluated. There is not a single evaluation of either PDS or MGNREGA that provides conclusive evidence that they have moved the needle directly on child nutrition. But do they have the potential to have improved the underlying conditions for nutrition (food security, jobs, etc.)? Even this is not unequivocally answered.
There are several questions, therefore, that need answers based on a thorough analysis before any real interpretations can reliably be made. These include:
•Which states are progressing faster than others? Which states show stagnating declines?
•What factors have led to changes when examined at a national level?
•How do those factors differ when looked at from a state-level lens?
•What can we learn about leadership, about the role of nutrition-specific actions, and about the nutrition-sensitive areas of action?
Do we truly know what factors caused these improvements? No. Frankly, the bottom line is that we might never know but we do know—all the research on child nutrition tells us this—that achieving declines in stunted or underweight children does take several things, working together, to move the needle. Our recent work on contributors to improvements in child stunting in Maharashtra supports our global analyses on multiple factors and the key role of leadership.
Reducing malnutrition is about economic development and social equity going hand-in-hand. It is about economic growth. It is about women and society. And it is about health, nutrition and social protection too. It is, therefore, also very much about leadership that cares about nutrition as an issue, and social equity as a fundamental need in society. It is only this leadership that can move and mobilize a set of levers related to economic growth, to improving social conditions and opportunities for women, to livelihoods and living conditions for all people, and to delivering quality health, nutrition and sanitation. And these levers do ultimately translate into better outcomes in the most vulnerable and voiceless members of society—young children.
We hope the new government will deliver on their newly announced commitments to nutrition in the budget speech and via the moves towards revitalizing a Nutrition Mission to truly mobilize leaders in the political domain, in the bureaucracy and across industry, philanthropy and civil society, to address the multiple causes of undernutrition in India. For our part, IFPRI, and our many partners in India, are committed to working on building and sharing knowledge on what works to improve nutrition—in India and across the globe.
Purnima Menon and Lawrence Haddad are senior research fellows at the International Food Policy Research Institute (IFPRI).
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