Editorial Analysis – 04-05-2023

India’s Hunger Paradox

Syllabus: GS2/ Health, Government Policies & Interventions, Issues Arising out of their Design & Implementation

In Context

• A national effort to establish routine dietary and nutritional assessments for the entire population is the need of the hour. 

Data on food consumption pattern 

• Required calorie percentage:
  • According to the World Health Organisation, at six months of age, 33 percent of the daily calorie intake is expected to come from food. 
    • This proportion increases to 61 percent at 12 months of age. 
  • The recommended calorie percentages mentioned here are the minimum amount that should come from food. 
• “Zero-food”:
  • According to the fifth National Family Health Survey (NFHS-5) data conducted in 2019-21, among mothers with a child between ages 6-23 months, 18 percent reported that their child did not eat any food whatsoever — referred to as “zero-food” — in the 24 hours preceding the survey. 
    • The zero-food prevalence was 30 percent for infants aged 6-11 months, 
    • Remains worryingly high at 13 percent among the 12-17 months old, and 
    • Persists even among 18-23 months-old children at 8 percent.
• “Zero-protein”:
  • Underlying the sobering overall statistic of an estimated 60 lakh zero-food children of 6-23 months of age in India not getting to eat every day lies substantial deprivations in specific food groups. More than 80 percent had not consumed any protein-rich foods for an entire day (“zero-protein”).
• “Zero-milk”:
  • Close to 40 percent did not eat any grains (roti, rice, etc) for an entire day, and six out of 10 children do not consume milk or dairy of any form every day (“zero-milk”). 
  • India has seen notable success in various production metrics for food items, recently becoming the world’s leading country in milk production. 
    • Yet the above statistics on zero-food underscore that achieving sufficiency in the production of food does not necessarily mean attaining food security among the population.

Issues & challenges

• Severe food insecurity:
  • Going without food for an entire day at this critical period of a child’s development raises serious concerns related to severe food insecurity. 
• Faulty assessment:
  • The assessment of the extent of nutritional deprivation among young children in India has, thus far, relied on measures of anthropometric failure such as the percentage of children short for their age (stunting) or weighing less given their height (wasting), compared to a reference population. 
    • These anthropometric measures are, at best, proxies suggesting plausible overall deficiencies in the child’s environment, without any guidance on the specific nature of the deficiencies.

• Non-communicable diseases:
  • The rising burden of cardiovascular and other non-communicable diseases in India, particularly among the rapidly growing “middle class”, is strongly linked to diet and nutrition.

Suggestions

• Access to nutritious food:
  • It is time to elevate food intake among young children to be of primary importance, as opposed to being referred to as “complementary” in policies and guidelines related to maternal, infant and young child nutrition. 
  • Access to adequate and affordable nutritious food is equally necessary for mothers for healthy breastfeeding.
• Need of improved assessments:
  • To better understand food security for all populations in India, assessments using household-level food insecurity modules developed by the Food and Agriculture Organisation can be adapted to measure the extent of food insecurity among Indian households.
• Evidence-based policy:
  • Measuring the availability, accessibility and affordability of nutritious food, especially for disadvantaged and vulnerable populations such as young children, constitutes the foundation for any evidence-based policy to end hunger and improve nutritional security among Indians.

Suggestions for improving existing policies 

• India has its work cut out for achieving the Sustainable Development Goal (SDG) 2 of “zero hunger”, which aims to end hunger and ensure year-round access to safe, nutritious, and sufficient food by 2030. 
• Mission Poshan 2.0:
  • Mission Poshan 2.0, the overarching flagship programme dedicated to maternal and child nutrition, has evolved in the right direction by targeting SDG 2 “zero hunger” and focusing on food-based initiatives, including its flagship supplementary nutrition programme service as mandated by the 2013 National Food Security Act. 
    • However, to effectively monitor and assess the performance of Poshan 2.0, there is an immediate need to develop appropriate food-based metrics.
    • To this end, the zero-food metric provides a good start. 
  • The success of the Swachh Bharat Mission (SBM), which increased access to improved toilets among Indian households from 48 percent to 70 percent between 2016 and 2021, offers valuable insights for Poshan 2.0, in its strategic use of directly trackable metrics, as well as a strong political commitment at the highest levels.
• Pradhan Mantri Garib Kalyan Anna Yojana:
  • To achieve the SDG of zero hunger, and building on the Pradhan Mantri Garib Kalyan Anna Yojana, India should consider a strategic initiative led by the Prime Minister’s Office aimed at eliminating food insecurity in India and ensuring affordable access to sufficient quantity and quality of nutritionally diverse food, with a special and immediate focus on India’s youngest children.

Way ahead

• Fixing the pre-existing schemes is the obvious answer to addressing India’s multi-dimensional nutrition challenge.
  • Getting the already existing schemes right requires greater involvement of local government and local community groups in the design and delivery of tailored nutrition interventions.
• The need of the hour is to make addressing child malnutrition the top priority of the government machinery, and all year around.