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Even as India is making rapid progress on health, paradoxically the Global Hunger Index (GHI) has placed India among the bottom 15 ranks, at No. 111 out of 125 countries. Also, the World Happiness Index ranked India No. 126 out of 136 countries, again in the bottom 15. Intriguingly, Palestine is at No. 99.
For a moment, let’s forget such rankings and instead look at India’s progress on hunger parameters. Hunger is being reduced in India at the same pace as the world. The World GHI score has reduced from 28 in 2000 to 18.3 in 2023. In comparison, India has reduced hunger from 38.4 in 2000 to 28.7 in 2023. So, both India and the world have reduced hunger by 9.7 points. Interestingly, after 2010, India has reduced hunger at a faster pace than the world.
Further, if the GHI score is measured by using data from the Poshan Tracker for under-five stunting and under-five wasting, India’s rank rises by at least 20 places, leaving behind Mali, Djibouti, Guinea, Haiti, Burkina Faso, Ethiopia, Zambia, Nigeria, Papua New Guinea, Pakistan, Angola and Congo (Democratic Republic). The question that naturally arises then is why this data was not used in the GHI’s construction.
Now coming to the deeper insights on the GHI, which has been constructed using four factors: (a) proportion of undernourished in population; (b) under-five mortality rate; (c) proportion of under-five wasting; and (d) under-five stunting. Proportion of undernourishment is the only factor representing the population, while the rest are for children under five years of age.
If undernourishment alone is considered, at least 41 countries would be behind India in the 2023 GHI score. Even when it comes to the under-five mortality rate, 56 countries are behind India. India is significantly better than what the GHI index portrays, since on undernourishment and under-five mortality rate—each with a weightage of a third—it performs much better than other countries.
Now, the GHI methodology shows India as a laggard in under-five stunting and wasting. Each of these has a weightage of a sixth. These two parameters, with a combined weightage of one third, are where India has been placed in the bottom 15. On undernourishment and under-five mortality, which have a combined weightage of two-thirds, India is ranked much higher in the middle. Thus, paradoxically, in the GHI methodology, one-third rules over two-thirds!
Further, we must look carefully at under-five stunting and wasting, especially the former, to check whether these actually represent hunger. Two standard deviations from (or less than) the mean WHO standard height-for-age may be called ‘stunted,’ but is this due to nutrition alone or does genetics also play a major role? That is a matter of empirical debate. In fact, 60-80% height variability is due to the gene factor alone. Hence, while the 2-standard deviation test may seem statistically correct, in practice we are comparing height-for-age across continents and ethnicities. In this approach, it is statistically assumed that children who are two standard deviations below the WHO average could grow taller (go above two standard deviations, i.e.) with nutrition alone, without a role for genetics in determining height.
Comparing height-for-age this way is analogous to comparing apples with oranges. Instead, there should be within group comparisons. That way, we can more meaningfully target the problem of stunting.
In under-five wasting (low weight for height), India has been placed at the very bottom of all countries in the GHI sample. High wasting in India is indeed something to work on. However, the Poshan Tracker, which is a dynamic growth monitoring tracker of the Poshan Abhiyan, shows the wasting rate to be only 6% for the 72 million under-five children under assessment. If the same rate is considered for determining the GHI score, there would be 38 countries that would fall behind India.
In summary, in three out of the four parameters used in measuring the GHI score—undernourishment, under-five mortality and under-five wasting—India’s performance is not at the bottom of the world’s ranking table, but in the middle. When it comes to under-five stunting, nutrition alone cannot help, and within group comparisons should be done for genetics, a factor that is more important than nutrition.
Taking all four in consideration, India would certainly find itself in the middle of the rankings than at the bottom in terms of hunger. Therefore, we should positively work towards improving child nutrition through the Poshan programme without being bothered by such indices, which create confusion and belittle the decade-long efforts of the Indian government.
These are the authors’ personal views.
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Updated: 06 Nov 2023, 07:19 PM IST
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