Context

• The article critically analyses Global Hunger Index (GHI) in the backdrop of its recent edition that put India in “serious” category and behind all south Asian countries except the war-torn Afghanistan.
• As per the article, unlike the GHI, the National Family Health Survey (NFHS) does a good job of providing comparative state-level data including the main pointers that determine health and nutrition.

Background

• The recently released Global Hunger Index report 2022 (17th edition) ranked India 107 out of 123 countries, dropping from the rank of 101 in 2021.
• The government has rejected the report, claiming it is an effort to 'taint' India and questioning its methodology and noting the substantial efforts made by the government to improve access to foodgrains by India’s poor.

About Global Hunger Index (GHI)

• Description: The GHI is an annual publication and was started in 2006 by Welthungerhilfe (private aid agency in Germany) and the International Food Policy Research Institute (IFPRI).
  • In 2018, IFPRI stopped being a publisher. Since then the GHI has been brought out by two European NGOs, Welthungerhilfe and Concern Worldwide.
• Yardstick: The index rests on four indicators i.e. undernourishment, child stunting, child wasting and child mortality.
• Scores: The overall score is placed on a 100-point scale and a lower score is better (0 means no hunger).

Limitations of GHI

• No regional database: GHI measures and ranks countries on a hunger index at the global, regional, and national levels, but not at the sub-national level where some Indian states fare better.
• Imbalanced indicators : The GHI’s stated aim is to reduce hunger around the world. But its methodology focuses disproportionately on less than five-year-olds.
• No comprehensive picture: GHI directs governmental attention to cross-national comparisons, resulting in the rejection of underlying issues and sidetracking the public discourse.
• Lack conceptual clarity: GHI uses childhood mortality and nutrition indicators but sees hunger as a food production challenge, as described in its preamble: “Communities, civil society organisations, small producers, farmers, and indigenous groups… shape how access to nutritious food is governed.”
  • As per FAO, India is the world’s largest producer and consumer of grain and the largest producer of milk; when the per capita intake of grain, vegetables and milk has increased manifold.
  • It is, therefore, contentious and unacceptable to club India with countries facing serious food shortages, which is what GHI has done.

India’s perspective

• National Family Health Survey (NFHS): Unlike the GHI, the NFHS provides comparative state-level data, including the main pointers that determine health and nutrition.
  • Indicators: NFHS provides estimates of underweight(low weight for age), stunting (low height for age) and wasting (low weight for height).
• Significance: NFHS provide conditions that affect preschool children (those less than 6 years of age) disproportionately and compromise a child’s physical and mental development while also increasing the vulnerability to infections.
  • Also, undernourished mothers owing to social and cultural practices give birth to low-birth-weight babies that remain susceptible to infections, transporting their handicaps into childhood and adolescence.

About NFHS

• Description: It comprises detailed information on key domains of population, health and family welfare and associated domains like characteristics of the population; fertility; family planning; infant and child mortality; maternal and child health; nutrition and anaemia; morbidity and healthcare; women’s empowerment etc.
• Enhanced scope: The scope of NFHS-5 is expanded in respect of the earlier round of the survey (NFHS-4) by adding new dimensions such as:
  • Death registration, pre-school education, expanded domains of child immunization, components of micro-nutrients to children, menstrual hygiene, frequency of alcohol and tobacco use, additional components of Non-Communicable Diseases (NCDs), expanded age range for measuring hypertension and diabetes among all aged 15 years and above.

Nutritional challenges

• Breastfeeding: It is one of the first child nutrition challenges. As per NFHS 5, only 42 per cent of infants are breastfed within one hour of birth, which is the recommended norm.
  • By not being breastfed, an infant is denied the benefits of acquiring antibodies against infections, allergies and even protection against several chronic conditions.
• Young child feeding practices: Causes like not introducing semi-solid food after six months, prolonging breastfeeding well beyond the recommended six months and giving food lacking in nutritional diversity intimidate child health.
  • NFHS 5 shows that the improvement has been marginal over the last two reports and surprisingly, states like Maharashtra, Rajasthan, Assam, UP and Gujarat are at the tail end.
• Poor nutrition: The third issue is the outcome of poor nutrition. According to NFHS 5, the percentage of stunted, wasted and underweight children is 36 per cent, 19 per cent and 32 per cent respectively.
  • Disturbing trends: It is worrisome that states like Bihar, UP and Jharkhand have fallen from their own levels five years ago. Overall, there has been an eight percentage point increase in children suffering from anaemia from 59 per cent in NFHS 4 to 67 per cent in NFHS 5.
  • This has a lot to do with the mistaken belief that manufactured snacks are “good food”. This phenomenon has been found in urban slums and in villages.
• Cleanliness: The NGO named CHETNA working for women’s and children’s health and nutrition across three states (Gujarat, Madhya Pradesh, and Rajasthan) by observing home practices noted that young children are allowed to run around while eating, exposing the food to flies, dust and heat.
  • The NGO also found that children are weaned on watery liquid from cooked grain when they need nutrition-dense food to develop.

Solutions

• Nutritional plan: The WHO and UNICEF recommend that breastfeeding should be initiated within the first hour of birth and infants should be exclusively breastfed for the first six months.
  • According to NFHS 5, in India, the percentage improvement of children who were exclusively breastfed when under six months, rose from 55 per cent in NFHS 4 to 64 per cent in NFHS 5.
• Broad vision: Most beneficiaries of these food distribution programmes are kids attending anganwadis or schools, adolescents, and pregnant and lactating mothers. This must continue but newborns, infants, and toddlers need attention too.
• Awareness: India has successfully overcome problems like reduced maternal and child mortality, improved access to sanitation, clean drinking water and clean cooking fuel.
  • Families can also be motivated to start kitchen gardens and rear poultry to improve nutrition demands.

Conclusion

• No more time should be lost over the GHI rankings, which are distorted and irrelevant. Instead, states should be urged to examine the NFHS findings to steer a new course to improve the nutrition practices for the youngest and the most vulnerable sections of society.