This year’s Global Hunger Index (GHI) did not go down well with the government. This was expected given that it ranks India 101 out of 116 countries for which reliable and comparable data exist. To add insult to injury, the GHI puts India far below some of its neighbouring countries.
Barring last year’s rank of 94 out of 107 countries, India’s rank has been between 100 and 103 since 2017. This year’s slide in the rank assumes significance especially in the context of COVID19.
Is India’s performance on hunger as dismal as denoted by the index ?
This question assumes immediacy, especially since the government has questioned the methodology and claimed that the ranking does not represent the ground reality. This calls for careful scrutiny of the methodology, especially of the GHI’s components.
The GHI has four components.
The first — insufficient calorie intake — is applicable for all age groups, whereas the remaining three — wasting (low weight for height), stunting (low height for age) and mortality — are confined to children under five years.
The data on deficiency in calorie intake, accorded 33% weight, is sourced from the Food and Agriculture Organization’s Suite of Food Security Indicators (2021). Had the GHI been estimated using the latest data on calorie intake, usually provided by the National Sample Survey Office, things might have looked even worse given that the leaked report of 2019 indicated that consumption expenditure in India declined between 2011-12 and 2017=18 by 4%.
In rural India, it was worse at about 10% per annum. The data on child wasting and stunting (2016-2020), each accounting for 16.6% of weight, are from the World Health Organization, UNICEF and World Bank, complemented with the latest data from the Demographic and Health Surveys.
Under five mortality data are for 2019 from the UN Inter Agency Group for Child Mortality Estimation. Contrary to what is being claimed by the government, the assessment of the situation of hunger is not based on the results of a ‘four question’ opinion poll, conducted telephonically by Gallup.
However, this does not mean that the GHI is free from inadequacies. A problematic component Conceptually, the GHI is largely children oriented with a higher emphasis on undernutrition than on hunger and its hidden forms, including micronutrient deficiencies.
The first component — calorie insufficiency — is problematic for many reasons. The lower calorie intake, which does not necessarily mean deficiency, may also stem from reduced physical activity, better social infrastructure (road, transport and healthcare) and access to energy saving appliances at home, among others.
Recent analysis establishes that ‘physical disease environment’ at the State level also significantly influences the calorie intake. For a vast and diverse country like India, using a uniform calorie norm to arrive at deficiency prevalence means failing to recognize the huge regional imbalances in factors that may lead to differentiated calorie requirements at the State level.
From this vantage point, a large proportion of the population in Kerala and Tamil Nadu may get counted as calorie deficient despite them being better in nutritional outcome indicators. So, prevalence of calorie deficiency in these States may be overestimated.
Conversely, there are States that have a higher average level of calorie intake, such as Bihar and Uttar Pradesh, but their needs may even be higher than the earmarked level of required calories for India as a whole because these States have high prevalence of communicable diseases and low level of mechanization in the economy.
Thus, it is likely that the existing methodology might underestimate the prevalence of calorie deficiency in these States. All this raises questions on the appropriateness of the calorie component of the index. India’s own official estimates of prevalence of calorie deficiency are not free from this anomaly.
Tackling wasting and stunting The GHI highlights India’s dismal record in a domain that it can hardly defend, which is child undernutrition. India’s wasting prevalence (17.3%) is one among the highest in the world.
Its performance in stunting, when compared to wasting, is not that dismal, though. Child stunting in India declined from 54.2% in 1998–2002 to 34.7% in 20162020, whereas child wasting remains around 17% throughout the two decades of the 21st century.
Stunting is a chronic, longterm measure of undernutrition, while wasting is an acute, shortterm measure. Child wasting can manifest as a result of an immediate lack of nutritional intake and sudden exposure to an infectious atmosphere.
Quite possibly, several episodes of wasting without much time to recoup can translate into stunting. However, a higher order of priority was accorded to stunting, both in research and policy, for the right reasons as it is a stable indicator and does not oscillate with minor changes in circumstances, while wasting does.
Sporadic emergent circumstances in different regions may increase wasting prevalence. Effectively countering episodes of wasting resulting from such sporadic adversities is key to making sustained and quick progress in child nutrition.
Thus, variations in wasting prevalence across the region should guide the relative emphasis of policy attention. If India can tackle wasting by effectively monitoring regions that are more vulnerable to socioeconomic and environmental crises, it can possibly improve wasting and stunting simultaneously.
There seems to be no shortcut way of improving stunting without addressing wasting. Additionally, studies say that COVID19 is likely to exacerbate child undernutrition in general and child wasting in particular.
Such insights should have driven social policy to counter the adverse impacts of COVID19 on food and nutrition insecurity. Unfortunately, India lost this opportunity as Integrated Child Development Scheme services were either nonfunctional or severely disrupted — partly because the staff and services were utilised to attend to the COVID19 emergency.
An exception
India’s relatively better performance in the other component of GHI — child mortality — merits a mention. Studies suggest that child undernutrition and mortality are usually closely related, as child undernutrition plays an important facilitating role in child mortality.
However, India appears to be an exception in this regard. India’s child mortality rate has been lower compared to SubSaharan African countries despite it having higher levels of stunting.
This implies that though India was not able to ensure better nutritional security for all children under five years, it was able to save many lives due to the availability of and access to better health facilities.
The low ranking does not mean that India fares uniformly poor in every aspect. Should we then dismiss the GHI as it shows India in a bad light and relegate it to political white noise because it does not suit us?
Or should we gracefully accept its insights informing us that our performance in some aspects might actually be dismal and requires urgent attention and course correction?
This ranking should prompt us to look at our policy focus and interventions and ensure that they can effectively address the concerns raised by the GHI, especially against pandemic induced nutrition insecurity.
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Steve Ovett, the famous British middle-distance athlete, won the 800-metres gold medal at the Moscow Olympics of 1980. Just a few days later, he was about to win a 5,000-metres race at London’s Crystal Palace. Known for his burst of acceleration on the home stretch, he had supreme confidence in his ability to out-sprint rivals. With the final 100 metres remaining,
[wptelegram-join-channel link=”https://t.me/s/upsctree” text=”Join @upsctree on Telegram”]Ovett waved to the crowd and raised a hand in triumph. But he had celebrated a bit too early. At the finishing line, Ireland’s John Treacy edged past Ovett. For those few moments, Ovett had lost his sense of reality and ignored the possibility of a negative event.
This analogy works well for the India story and our policy failures , including during the ongoing covid pandemic. While we have never been as well prepared or had significant successes in terms of growth stability as Ovett did in his illustrious running career, we tend to celebrate too early. Indeed, we have done so many times before.
It is as if we’re convinced that India is destined for greater heights, come what may, and so we never run through the finish line. Do we and our policymakers suffer from a collective optimism bias, which, as the Nobel Prize winner Daniel Kahneman once wrote, “may well be the most significant of the cognitive biases”? The optimism bias arises from mistaken beliefs which form expectations that are better than the reality. It makes us underestimate chances of a negative outcome and ignore warnings repeatedly.
The Indian economy had a dream run for five years from 2003-04 to 2007-08, with an average annual growth rate of around 9%. Many believed that India was on its way to clocking consistent double-digit growth and comparisons with China were rife. It was conveniently overlooked that this output expansion had come mainly came from a few sectors: automobiles, telecom and business services.
Indians were made to believe that we could sprint without high-quality education, healthcare, infrastructure or banking sectors, which form the backbone of any stable economy. The plan was to build them as we went along, but then in the euphoria of short-term success, it got lost.
India’s exports of goods grew from $20 billion in 1990-91 to over $310 billion in 2019-20. Looking at these absolute figures it would seem as if India has arrived on the world stage. However, India’s share of global trade has moved up only marginally. Even now, the country accounts for less than 2% of the world’s goods exports.
More importantly, hidden behind this performance was the role played by one sector that should have never made it to India’s list of exports—refined petroleum. The share of refined petroleum exports in India’s goods exports increased from 1.4% in 1996-97 to over 18% in 2011-12.
An import-intensive sector with low labour intensity, exports of refined petroleum zoomed because of the then policy regime of a retail price ceiling on petroleum products in the domestic market. While we have done well in the export of services, our share is still less than 4% of world exports.
India seemed to emerge from the 2008 global financial crisis relatively unscathed. But, a temporary demand push had played a role in the revival—the incomes of many households, both rural and urban, had shot up. Fiscal stimulus to the rural economy and implementation of the Sixth Pay Commission scales had led to the salaries of around 20% of organized-sector employees jumping up. We celebrated, but once again, neither did we resolve the crisis brewing elsewhere in India’s banking sector, nor did we improve our capacity for healthcare or quality education.
Employment saw little economy-wide growth in our boom years. Manufacturing jobs, if anything, shrank. But we continued to celebrate. Youth flocked to low-productivity service-sector jobs, such as those in hotels and restaurants, security and other services. The dependence on such jobs on one hand and high-skilled services on the other was bound to make Indian society more unequal.
And then, there is agriculture, an elephant in the room. If and when farm-sector reforms get implemented, celebrations would once again be premature. The vast majority of India’s farmers have small plots of land, and though these farms are at least as productive as larger ones, net absolute incomes from small plots can only be meagre.
A further rise in farm productivity and consequent increase in supply, if not matched by a demand rise, especially with access to export markets, would result in downward pressure on market prices for farm produce and a further decline in the net incomes of small farmers.
We should learn from what John Treacy did right. He didn’t give up, and pushed for the finish line like it was his only chance at winning. Treacy had years of long-distance practice. The same goes for our economy. A long grind is required to build up its base before we can win and celebrate. And Ovett did not blame anyone for his loss. We play the blame game. Everyone else, right from China and the US to ‘greedy corporates’, seems to be responsible for our failures.
We have lowered absolute poverty levels and had technology-based successes like Aadhaar and digital access to public services. But there are no short cuts to good quality and adequate healthcare and education services. We must remain optimistic but stay firmly away from the optimism bias.
In the end, it is not about how we start, but how we finish. The disastrous second wave of covid and our inability to manage it is a ghastly reminder of this fact.