The report notes that India has the highest child-wasting rate in the world, at 18.7 per cent, reflecting acute undernutrition. It places India way below a neighbour like Bangladesh, which has a score of 19, a rank of 81 and is categorised on the GHI Severity of Hunger Scale as “moderate” – a class jump over the Indian numbers.
The findings of the Global Hunger Index (GHI) 2023 in respect of India should not be allowed to be side-tracked by the remarks of the Women and Child Development Minister Smriti Irani that have been heavily and rightly criticised by the Opposition as arrogant and making a mockery of an important issue like hunger. The Index has placed India at the bottom of the heap of nations, at rank 111 out of the 125 countries with sufficient data available to calculate 2023 GHI scores. The GHI Report 2023 gives India a composite score of 28.7, indicating a level of hunger that the report has called “serious” (scores between 20 and 34.9). Scores 35 and above are categorised as alarming and above 50 as extremely alarming.
The term “hunger” refers to the index based on the four component indicators used to calculate the scores – undernourishment, child stunting, child wasting, and child mortality. Taken together, according to the GHI, the component indicators reflect deficiencies in calories as well as in micronutrients. The GHI sources data from internationally accepted sources, and has named the following in its appendix on sources: WHO, UNICEF, UN, FAO, and the USAID’s Demographic & Health Surveys.
The report notes that India has the highest child-wasting rate in the world at 18.7 per cent, reflecting acute undernutrition. It places India way below a neighbour like Bangladesh, which has a score of 19, a rank of 81 and is categorised on the GHI Severity of Hunger Scale as “moderate” – a class jump over the Indian numbers. But the minister was drawn to another comparison: Pakistan, she noted, was reported ahead of India (rank 102, score 26.6) in the GHI 2023 report as if that by itself proves that the report is not to be believed.
Living in denial
This is not the first year the government has officially come out to disregard the report and challenge its findings and question its sources. A similar dismissal came on last year's GHI data as well. In a statement issued earlier this month, the Ministry of Women and Child Development said child wasting as tracked by its Poshan Tracker app “has been consistently below 7.2 per cent, month-on-month, as compared to the value of 18.7 per cent used for child wasting in the GHI 2023”. Yet, there are many reports that point out that the app isn’t necessarily delivering as planned with reports of phones that would not work or have yet to arrive, issues related to training and a host of hurdles that are only to be expected when a mega change project is implemented. More significantly, data collected via the app isn’t freely available in the public domain.
Moreover, India's extensive NFHS-5 reported that 36 per cent of children under age five years are stunted (too short for their age), only marginally changed from 38% seen in NFHS-4, signifying chronic undernutrition. Similarly, 19 per cent of children under age five years are wasted (too thin for their height), only slightly down from 21 per cent seen in NHFS-4 – a sign of acute undernutrition. And 32 per cent of children are underweight, down from 36 per cent during NHFS-4.
'Gross underutilisation of funds'
A low-tech solution to track and record work and collect nutrition-related data on a real-time basis and link payments to the Anganwadi workers isn’t particularly revolutionary; its implementation and successful adoption by millions across the country is where the real worth of the work lies. This is hard and challenging work that requires nurturing, support, humility and the willingness to accept failure where it is seen. Gung-ho statements of the kind that tend to appear from official accounts are precisely the way such a project cannot succeed or surmount the hurdles of being accepted enough to be embraced internally for data collection and externally as a credible source for data.
Consider that the Parliamentary Standing Committee on Education, Women, Children, Youth and Sports in its report in Mar. 2021 noted “gross underutilisation of funds under important schemes like Poshan Abhiyaan, Pradhan Mantri Matru Vandana Yojana, Beti Bachao Beti Padhao … the benefits often do not reach the intended beneficiaries, and therefore, the ministry should utilise the funds allocated under various Heads to the fullest extent and strive to achieve results at the grass-root level.” It noted that the honorarium paid to Anganwadi works (about INR 3,500 per month plus incentives of Rs.500 per month) should be enhanced. It asked for “concerted efforts to provide well-constructed, well-ventilated buildings with piped potable water supply for drinking and cooking purposes and tap water in toilets to all anganwadi centres and devise a mechanism to constantly monitor and conduct inspection of anganwadi centres to curtail administrative and financial mismanagement at the grass root level …”
These and other issues it reported form a host of constructive suggestions that are an indicator of the challenge before the nation and the ministry in particular. This is best solved by working with teams to look for problems, to focus on the difficult, to allow the frustration to vent and to use the free airing of complaints and the free flow of data to get to the right picture and then do the work to change the ground reality.
Need to accept real data
Such an approach goes hand-in-hand with opening a dialogue with the global development agencies and report writers, GHI included, to show how and why every effort is being made to improve the ‘poshan tracker’ data, and not use it as a weapon to say India is right and the world is wrong. Hunger is not a subject for scoring points; it cannot go away miraculously with the launch of an app or even the pouring of money. Change is a slow process after all. The GHI numbers should be a trigger for faster change. They ought to stir the moral conscience of all citizens and lead us to ask questions on our idea of development, and how and why our children go to sleep without enough food while we celebrate high GDP growth.
Consider that one of the greatest achievements in health has been the eradication of smallpox. Dr. Edward Jenner discovered the vaccine in the late 18th century (1796 AD) but smallpox was eradicated globally only as late as 1980. Why this long gap? Technology or medical prowess was only one end of the solution; its implementation in a complex environment, in the midst of the Cold War and amid resistance to the very idea of vaccination required a leader like Dr. Donald A. Henderson, noted epidemiologist and educator who headed a ten-year long international drive against smallpox. It required hard work, diplomacy, working with difficult partners and a willingness to change based on real data from the ground. It required listening, patience and diplomacy to walk a path that eventually eradicated a dangerous disease and created history.
That was the success of modern medicine but no less the success of an attitude and an approach that reached out across difficult frontiers to learn and understand -- lessons that remain relevant for the India of today.
(The writer is a journalist and faculty member at SPJIMR, Mumbai. Views are personal. By special arrangement with The Billion Press)