In India, Issues relating to poverty and hunger are widespread. One of the economies with the quickest growth is India. In spite of this, India has a very high level of poverty and hunger.

In the vast majority of Indian states, between 20% and 35% of children are severely malnourished. India is ranked 101st out of 116 nations in the 2021 Global Hunger Index rankings. India has a serious level of hunger with a score of 27.5.

Poverty

Poverty can be defined as a condition wherein a person is unable to fulfill the basic necessities for the sustenance of life. These basic necessities include: Food, clothing and shelter. Poverty is a condition which drives out the essence of a decent standard of living for the people. Poverty becomes a vicious trap which gradually ends up entailing all the members of a family . Extreme poverty eventually leads to death. Poverty in India is defined keeping in mind all the dimensions of economy, semi-economy and the definitions which are devise according to international conventions.

India judges poverty levels on the basis of both consumption and income. India judges poverty levels on the basis of both consumption and income.

Consumption is measured on account of the money that is spent by a household on essential goods and income is calculated according to the income earned by a particular household. Another important concept that needs to be mentioned here is the concept of the poverty line. This poverty line acts a benchmark for the measurement of poverty in India vis-a-vis other nations. A poverty line can be defined as the estimated minimum level of income that a family needs to be able to secure the basic necessities of life. As of 2014, the poverty line is set at Rs. 32 per day in rural areas and Rs. 47 in towns and cities .

Causes of Poverty

The causes of poverty could be myriad of factors which could be broadly discussed as below:

Social

  • Over population: Over population is defined as the situation of having large number of people with too few resources and too little space. A high population density pressures the available resources in the country, as the resources can only support a certain number of people.
  • Distribution of resources: In many developing countries, the problems of poverty are massive and pervasive, developing countries generally must rely on trade with developed countries for manufactured goods, but they cannot afford much.
  • Lack of education: Illiteracy and lack of education are common in poor countries. Poor people also often forego schooling in order to concentrate on making a minimal living.
  • Environmental degradation: Environmental problems have led to shortages of food, clean water, materials for shelter and other essential resources.
  • Demographic shifts: Some researchers also cite demographic shifts as contributing to increases in overall poverty . In particular, demographic shifts have led to increases in poverty among children.

Economic

  • High rate of unemployment: Unemployment causes decline in buying capacity of population which contributes to poverty.
  • Unfair trade: High subsidies and protective tariffs for agriculture in the developed world decrease competition and efficiency and prevent exports by more competitive agricultural and undermining the very type of industry in which developing countries do.
  • Corruption: Both in government and business, places heavy cost on society. Corruption is both a major cause and a result of poverty around the world. Corruption affects the poorest the most, whether in rich or poor nations.
  • Poor Governance: Corruption and political instability resulted in weakening of business confidence, deteriorating economic growth, declining public expenditure on basic entitlements, low efficiency in delivery of public services as discussed in the earlier section on human development and a serious undermining of state institutions and the rule of law.

Political

  • Prejudice and inequality: Social inequality that stems from cultural ideas about the relative worth of different genders, races, ethnic groups, and social classes. Instead of channeling resources to help those at need, the governments of these countries choose to treat different races and creeds with prejudice and will treat others with less favouritism. Hence, this leads to poverty.
  • Centralization of Power: In centralized systems of governance one major party, politician, or region is responsible for decision-making throughout the country causing development problems.

External and Other Causes

  • Civil War: Nations experiencing civil war will experience stunted economic growth rate. It however, fails to capture the broader effects of damages to the infrastructure and social services, such as health care and access to clean water. The loss of infrastructure and breakdown of society will inevitably lead to the nation having to spend a hefty sum to rebuild and prepare itself for the economy. Furthermore, civil war diverts scarce resources from fighting poverty to maintaining a military.
  • Historical: There is a lack of uniform, basic infrastructure, such as roads and means of communication and hence, development can hardly occur in poor countries. Some scholars have asserted that colonial history was an important factor and reason to the current situation.
  • Natural Disasters: Natural disasters such as hurricanes and earthquakes have caused millions of dollars worth of infrastructure and the loss of lives. Natural disasters also affect annual agricultural output, e.g . Droughts cause the land to become barren and unsuitable for cultivation.
  • Uneven distribution of resources/lack of adequate resources in the world economy; Many countries are facing poverty due to the lack of resources in the country. These countries also lack raw materials and knowledge skills. The lack of materials also leads to lesser jobs for the population, in which will increase the rate of poverty, as this goes on and on, the rate of poverty will increase drastically.

Multidimensional Poverty Index (MPI) and India

Global Multidimensional Poverty Index (MPI) 2022 was released by the United Nations Development Programme (UNDP) and the Oxford Poverty and Human Development Initiative (OPHI).

  • The index is a key international resource that measures acute multidimensional poverty across more than 100 developing countries.
  • It was first launched in 2010 by the OPHI and the Human Development Report Office of the UNDP.
  • The MPI monitors deprivations in 10 indicators spanning health, education and standard of living and includes both incidence as well as intensity of poverty.
MPI Indicators and Dimensions
  • Global Data:
    • 1.2 billion people are multidimensionally poor.
      • Nearly half of them live in severe poverty.
      • Half of poor people (593 million) are children under age 18
      • The number of poor people is highest in Sub Saharan Africa (579 million), followed by South Asia (385 million). The two regions together are home to 83% of poor people.

Key Findings about India

  • Data:
    • India has by far the largest number of poor people worldwide at 22.8 crore, followed by Nigeria at 9.6 crore.
    • Two-thirds of these people live in a household in which at least one person is deprived of nutrition.
  • Reduction in Poverty:
    • The incidence of poverty fell from 55.1% in 2005/06 to 16.4% in 2019/21 in the country.
      • The deprivations in all 10 MPI indicators saw significant reductions as a result of which the MPI value and incidence of poverty more than halved.
    • As many as 41.5 crore people moved out of poverty in India during the 15-year period between 2005-06 and 2019-21.
      • Improvement in MPI for India has significantly contributed to the decline in poverty in South Asia.
      • South Asia now has not the lowest number of poor people than Sub-Saharan Africa.
  • Relative Reduction in Poverty:
    • The relative reduction from 2015/2016 to 2019/21 was faster: 11.9% a year compared with 8.1% from 2005/2006 to 2015/2016.
  • Performance of States:
    • Bihar, the poorest state in 2015-16, saw the fastest reduction in MPI value in absolute terms.
      • The percentage of poor in Bihar fell from 77.4 % in 2005-06 to 52.4 % in 2015-16 and further to 34.7 % in 2019-21.
    • However, in relative terms, the poorest states have not quite caught up.
      • Of the 10 poorest states in 2015/2016, only one (West Bengal) have emerged out of the list in 2019-21.
      • The rest (Bihar, Jharkhand, Meghalaya, Madhya Pradesh, Uttar Pradesh, Assam, Odisha, Chhattisgarh and Rajasthan) remain among the 10 poorest.
    • Across states and union territories in India, the fastest reduction in relative terms was in Goa, followed by Jammu and Kashmir, Andhra Pradesh, Chhattisgarh and Rajasthan.
  • Poverty among Children:
    • Poverty among children fell faster in absolute terms, although India still has the highest number of poor children in the world.
    • More than one in five children in India are poor compared with around one in seven adults.
  • Reduction of Poverty Region Wise:
    • The incidence of poverty fell from 36.6% in 2015-2016 to 21.2% in 2019-2021 in rural areas and from 9.0% to 5.5% in urban areas.
Quality of life

SDG Goal 1 Targets

  1. By 2030, eradicate extreme poverty for all people everywhere, currently measured as people living on less than $1.25 a day
  2. By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions
  3. Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable
  4. By 2030, ensure that all men and women, in particular the poor and the vulnerable, have equal rights to economic resources, as well as access to basic services, ownership and control over land and other forms of property, inheritance, natural resources, appropriate new technology and financial services, including microfinance.
  5. By 2030, build the resilience of the poor and those in vulnerable situations and reduce their exposure and vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters
    • A Ensure significant mobilization of resources from a variety of sources, including through enhanced development cooperation, in order to provide adequate and predictable means for developing countries, in particular least developed countries, to implement programmes and policies to end poverty in all its dimensions
    • Create sound policy frameworks at the national, regional and international levels, based on pro-poor and gender-sensitive development strategies, to support accelerated investment in poverty eradication actions.

Government Steps and Critical Analysis

Government Schemes to Eradicate Poverty

Government efforts to alleviate poverty in India cannot be overlooked while discussing poverty. It needs to be brought to the forefront that whatever marginal drops that has been observed in the poverty ratios have taken place due to the government initiatives aimed at uplifting people from poverty. Though, a lot still needs to be done as far as the corruption levels are concerned.

  • Public Distribution System: The PDS distributes subsidized food and non-food items to the poor. Major commodities distributed include staple food grains, such as wheat, rice, sugar and kerosene, through a network of public distribution shops established in several states across the country. But, the grains provided by the PDS are not enough to satisfy the consumption needs of a family. Under PDS scheme, each family below the poverty line is eligible for 35kg of rice or wheat every month, while a household above the poverty line is entitled to 15 kg of food grain on a monthly basis. Being the most important system, the system is not without its flaws. Leakages and diversions of grains from the PDS are high. Only 41% of the grains released by the government reach the poor . The alternative against the PDS that has been suggested is that of a cash transfer along with food support, but this will not fulfill the need of the buffer food stocks.
  • MNREGA (Mahatma Gandhi National Rural Employment Guarantee Act): This aim guarantees the right to work and ensure livelihood security in rural areas by providing at least 100 days of guaranteed wage employment in a financial year to every household whose adult members volunteer to do unskilled manual work. Employment generation under this act has been higher as compared to other schemes.
  • RSBY (Rashtriya Swasthya Bima Yojana): This is a health insurance for the poor. It provides for cashless insurance for hospitalization in public as well as private hospitals. Every below poverty line family holding a yellow ration card pays 30 rupees registration fee to get a biometric-enabled smart card containing their fingerprints and photographs.

Universal Basic Income

Universal Basic Income is a radical and compelling paradigm shift in thinking about both social justice and a productive economy. It could be to the twenty first century what civil and political rights were to the twentieth. UBI by its very definition reaches out to all the citizens of a Country or territory, irrespective of income levels. This is the idea gaining popularity in many parts of the World. It means every person should have a right to basic income to cover their needs, just by virtue of being citizens. Recently Sikkim became the first state in India to implement UBI.

Universal Basic Income (UBI) has three components: Universality, unconditionality, and agency (by providing support in the form of cash transfers to respect, not dictate, recipients’ choices).

Arguments in Favor and Against UBI
FavorAgainst
Poverty and vulnerability reduction: Poverty and vulnerability will be reduced in one fell swoop.Conspicuous spending: Households, especially male members, may spend this additional income on wasteful activities.
Choice: A UBI treats beneficiaries as agents and entrusts citizens with the responsibility of using welfare spending as they see best; this may not be the case with in-kind transfers.Moral hazard (reduction in labour supply): A minimum guaranteed income might make people lazy and opt out of the labour market.
Better targeting of poor: As all individuals are targeted, exclusion error (poor being left out) is zero though inclusion error (rich gaining access to the scheme) is 60 percent.Gender disparity induced by cash: Gender norms may regulate the sharing of UBI within a household – men are likely to exercise control over spending of the UBI. This may not always be the case with other in-kind transfers.
Insurance against shocks: This income floor will provide a safety net against health, income and other shocks.Implementation: Given the current status of financial access among the poor, a UBI may put too much stress on the banking system.
Improvement in financial inclusion: Payment – transfers will encourage greater usage of bank accounts, leading to higher profits for banking correspondents (BC) and an endogenous improvement in financial inclusion. Credit-increased income will release the constraints on access to credit for those with low income levels.Fiscal cost given political economy of exit: Once introduced, it may become difficult for the government to wind up a UBI in case of failure.
Psychological benefits: A guaranteed income will reduce the pressures of finding a basic living on a daily basis.Political economy of universality – ideas for self-exclusion: Opposition may arise from the provision of the transfer to rich individuals as it might seem to trump the idea of equity and state welfare for the poor.
Administrative efficiency: A UBI in place of a plethora of separate government schemes will reduce the administrative burden on the state.Exposure to market risks (cash vs. food): Unlike food subsidies that are not subject to fluctuating market prices, a cash transfer’s purchasing power may severely be curtailed by market fluctuations.

Pradhan Mantri Kisan Samman Nidhi Yojana (PMKISAN)

Pradhan Mantri Kisan Samman Nidhi Yojana (PMKISAN) seeks to supplement the financial needs of the farmers in procuring various inputs to ensure proper crop health and appropriate yields, commensurate with the anticipated farm income. Under the Scheme an income support of Rs. 6000/- per year is provided to all farmer families across the country in three equal installments of Rs. 2000/- each every four months.

Benefits to Farmers
  • Farmers are not able to get good prices because of adverse terms of trade, including depressed international prices.
  • Rs. 6,000 will provide farmers assured supplementary income and also helps meet their emergent expenses, especially, immediately after harvest.
MNREGA vs PMKISAN

Importance of Strengthening MGNREGA

  • Coverage:
    • PMKISAN is targeted cash transfer programme and MGNREGA is a universal programme.
    • As per 2011 Socio-Economic and Caste Census, around 40% of rural households are landless and depend on manual labour.
    • Landless can earn through the MGNREGA, but are not eligible for the coverage under PMKISAN.
    • So, PM-KISAN is not covering the landless.
  • Wages:
    • If two members of a household in Jharkhand work under Mahatma Gandhi NREGA for 30 days, they would earn Rs. 10,080 and in Haryana they would earn Rs. 16,860.
    • Jharkhand has the lowest daily Mahatma Gandhi NREGA rate and Haryana the highest. A month of MGNREGA earnings for a household is more than a year’s income support through PMKISAN anywhere in the country.
  • Eligibility:
    • It is not clear how tenant farmers, those without titles, and women farmers would be within the ambit of the scheme.
  • Corruption and Errors:
    • Universal schemes are less prone to corruption than targeted schemes.
    • In targeted programmes, it is very common to have errors of exclusion/inclusion.
    • Such errors go unrecorded.
  • Delay
    • Less than a third of the payments under Mahatma Gandhi NREGA were made on time.
    • The Centre alone has been causing a delay of more than 50-days in disbursing the wages.
    • Several Mahatma Gandhi NREGA payments have been rejected, diverted or frozen.
    • There are no clear guidelines to rectify them.
  • Success:
    • The success of PMKISAN is contingent on reliable digital land records and reliable rural banking infrastructure.

MGNREGA is an example of Participatory Democracy

  1. It is a labour programme to strengthen participatory democracy through community works.
  2. It is a legislative mechanism to strengthen the constitutional principle of the right to life.
  3. It will have strong multiplier effects.
  4. The unfortunate aspect is MGNREGA wage rates in 18 States have been kept lower than State’s minimum agricultural wage rates.
  5. MGNREGA is a boon for the landless.
  6. Work demand is 33% more than the employment provided this year.

Conclusion

The work to end extreme poverty is far from over and many challenges remain. It is becoming even more difficult to reach those remaining in extreme poverty, who often live in fragile contexts and remote areas. Access to good schools, healthcare, electricity, safe water and other critical services remains elusive for many people, often determined by socioeconomic status, gender, ethnicity and geography.

Moreover, for those who have been able to move out of poverty , progress is often temporary, economic shocks, food insecurity and climate change threaten to rob them of their hard-won gains and force them back into poverty. It will be critical to find ways to tackle these issues as we make progress.

Most of the schemes are clouded with implementation challenges. Programs are plagued by leakages on subsidies that limit its impact on the poor. These programs need to be centralized under one organization so that leakages can be prevented at multiple levels.

There are many causes of human deprivation in developing countries. One is a lack of income to obtain basic necessities including food, shelter and health and education services. Others are people’s assets including skills, land, access to infrastructure, savings, credit and networks of contacts. Because there are different categories of the poor – subsistence farmers, landless laborers, urban squatters, slum dwellers, for example; reasons for their deprivation are different. In the case of the rural poor, for example: the lack of adequate access to land, irrigation, agricultural extension services and adequate pricing for the agricultural produce are key reasons for their poverty. In the case of the urban poor living in slums and squatter settlements, regularization of their land titles for their houses and inadequate employment opportunities are key constraints on their ability to improve their living environment.


Hunger

Hunger and Malnutrition

Everyone needs food to satisfy their hunger. Hunger acts as the body ‘s indicator that it needs food. Once we have eaten enough food to satisfy our bodies’ needs hunger goes away until our stomachs become empty again. As per Oxford dictionary 1971. Hunger is defined as:

  • The uneasy or painful sensation caused by want of food; craving appetite. Also the exhausted condition caused by want of food.
  • The want or scarcity of food in a country,
  • A strong desire or craving.

Malnutrition refers to deficiencies excesses or imbalances in a person’s intake of energy and/or nutrients. It encompasses two broad groups of conditions. One is ‘undernutrition’ which includes stunting (low height for age) wasting (low weight for height) underweight (low weight for age) due to micronutrient deficiencies or insufficiencies. The other is overweight obesity and diet-related non-communicable diseases (such as heart disease stroke diabetes and cancer). Normally people affected by malnutrition under perform in various aspects of life missing out on opportunities to become productive members of society.

Types of Malnutrition

  • Protein-energy malnutrition: This type of malnutrition is due to lack of enough protein and food that provides energy (measured in calories) which all of the basic food groups provide. World hunger is based on Protein-Energy malnutrition.
  • Micronutrient Deficiency: It deals with the deficiency of vitamins and minerals. Though important this type of malnutrition is not discussed in world hunger.

People who are chronically malnourished can face significant health problems due to lack of nutrients needed for proper health and development. Someone can be malnourished for a long or short period of time and the condition may be mild or severe. People who are malnourished are more likely to get sick and in severe cases might even die.

  • Hunger: Distress related to lack of food.
  • Malnutrition: An abnormal physiological condition typically due to eating the wrong amount and/or kinds of foods. It encompasses undernutrition and overnutrition.
  • Undernutrition: Deficiencies in energy protein and/or micronutrients.
  • Micronutrient deficiency (Hidden hunger): A form of undernutrition that occurs when intake or absorption of vitamins and minerals is too low to sustain good health and development in children and normal physical and mental function in adults.
  • Undernourishment: Chronic calorie deficiency with consumption of less than 1,800 kilocalories a day the minimum most people need to live a healthy and productive life.
  • Overnutrition: Excess intake of energy or micronutrients.

Causes of Hunger and Malnutrition

The persistence of hunger in a world of plenty is the most profound moral contradiction of our age. About 68.84% of the population of India is rural major part of which greatly suffers from poverty hunger and malnutrition. Many factors contribute to the state of hunger. The reasons are complex and varied and often interconnected. Some of them are as under:

  • Nutritional Quality: Most of the hungry people are malnourished as they don’t get required diet which makes them lose weight and in severe cases their bodies begin wasting. Poor diet may lead to a lack of vitamins minerals and other essential substances leading to malnutrition. All people require certain nutrients to lead a healthy life and when they don’t consume sufficient amounts they can become sick and even die. Infants and young children are most vulnerable to the harmful effects of hidden hunger.
  • Poverty: One of the main causes of hunger and malnutrition globally is poverty-lack of purchasing power and access to resources. This holds true everywhere rich and poor countries and in urban or rural areas or in a democracy or dictatorship. Most people who are hungry are living in extreme poverty and lack resources to cover their basic needs such as food shelter and water.
  • Household food insecurity: Developing nations like India often see situations of food shortages where people especially poor struggle for survival due to insufficient food as food stored from the previous harvest runs out and families cut back on meals. This period of time may last for months depending on the size of the previous harvest. Smallholder farmers do not have adequate storage facilities to protect their supplies against pests and weather.
  • Lack of health and nutritional awareness especially among women: Women have special nutritional needs not only for themselves but also because they bear and nourish children. Lack of education among women leads to poor nutrition in the family especially Child. Female education thus is a key factor affecting the ability of mothers to provide adequate care for their child. Though women’s needs and rights are receiving greater weight in development efforts than in the past there is still a long way to be traversed to reduce incidences of malnutrition and hunger in the family.
  • Lack of availability of Safe Water: Unsafe or scarce water creates and exacerbates malnutrition. Without access to safe water crops can’t grow properly and people can’t survive or stay healthy.
  • Poor sanitation and environmental conditions.
  • Cultural Practices: Early marriages of girls teenage pregnancies resulting in low birth weight of the newborns poor breastfeeding practices ignorance about nutritional needs of infants and young children and repeated infections further aggravate the situation.
  • Poor infrastructure: Poor infrastructure causes hunger by making it difficult sometimes impossible to transport food to areas where there are shortages. There have been instances of people dying of hunger in one region while there was plenty of food in another region. Pathetic conditions of roads in addition to inadequate storage facilities make things difficult for poor in need of food.
  • Climate Change: Despite having very little contribution towards climate change the poorest developing countries are already experiencing the effects. Floods, storms, rains, droughts, heat and other extreme weather can cause communities a lot of destruction and wipe away farms. Some of these communities never recover fully again and begin to face many years of hardship.
  • Increasing Population: With an ever-increasing population across the world and no major addition to the farmland agricultural production must increase considerably to keep pace with the population growth.
  • War and Conflict: Conflict often uproots people from their homes and land so food production dwindles or stops completely. This leaves people who are already vulnerable more susceptible to malnutrition. Check if you want to keep this point.
  • Discrimination: Every country regardless of its economic growth and development has discrimination woven into its social fabric Disadvantaged groups, racial, ethnic, or religious minorities tend to be left behind. Moreover, almost in every society women and girls are more disadvantaged than their male counterparts due to prevalent culture and customs.
  • Loss of appetite: People suffering from diseases like cancers, tumours, depressive illness and other mental illnesses, liver or kidney disease, chronic infections etc. lose their appetite for food. Also people who come under the grip of drugs and alcohols may neglect food. These habits push then into poverty and malnutrition.
  • Unstable Market: People who earn less spend most of their income on food. Under stable conditions they can scarcely afford enough food to protect themselves and family members against hunger. Any fluctuation that pushes food prices up creates additional hardship. Basic grains such as wheat, rice and corn comprise large share of calories among people in developing countries who are hungry. As prices of these staple grains surge, hunger increases too. Parents tend to cut back their portions during these relatively brief periods of instability. Over a prolonged time they are forced to pull children out of school to earn income for the struggling family.
  • Seasonal Changes: For people who live in rural areas and rely on farming and livestock for food and income seasonal changes in climate along with food prices and availability affect hunger. This results in annual cycles of hunger known as the “hunger season,” that are devastating.
  • Agricultural infrastructure: Many developing countries lack key agricultural infrastructure such as enough roads warehouses and irrigation. The results are high transport costs lack of storage facilities and unreliable water supplies which ultimately reduces agricultural yields and access to food.

Hunger Related Statistics and Index

Global Hunger Index

The Global Hunger Index (GHI) is a tool designed to comprehensively measure and track hunger at global, regional, and national levels. GHI scores are calculated each year to assess progress and setbacks in combating hunger. The GHI is designed to raise awareness and understanding of the struggle against hunger, provides a way to compare levels of hunger between countries and regions, and call attention to those areas of the world where hunger levels are highest and where the need for additional efforts to eliminate hunger is greatest.

Indicators in GHI

GHI is calculated on the basis of three dimensions – (Inadequate food supply, child under nutrition and child mortality) and four indicators:

  • The first indicator is undernourishment, this is the share of the entire population, which is undernourished and reflects insufficient caloric intake , (weight 1/3)
  • The next three indicators use data for children under five:
    • Child wasting (low weight for height), reflecting acute under-nutrition, (weight 1/6)
    • Child stunting (low height for age), reflecting chronic under-nutrition, (weight 1/6)
    • Child mortality, (weight 1/3)

India has performed worse than all the countries in the South Asian region in the Global Hunger Index 2022. It has ranked 107 out of 121 countries.

Stunting and Wasting is very high in IndiaWhat does the scientific study say
India’s child wasting ratio at 20.8% is the highest of any country in this year’s Global Hunger Index. This reflects acute undernutrition.Scientists say 90% of the brain grows in the first thousand days of human life. Nerves grow and connect and build the scaffolding, which will determine how one will think and feel and learn all through adulthood.
India’s child stunting rate (low height for age), is around 38% among children younger than 5 years, reflecting chronic undernutrition.Proper nutrition and stimulation in these early years can make future decades 50% more productive.

Mother’s Education is Key

  • There is direct correlation between the nutritional status of children and their mothers’ education.
  • The Comprehensive National Nutrition Survey, which studied 1.2 lakh children between 2016-18 measured:
    • Diet diversity
    • Meal frequency
    • Minimum acceptable diet as the three core indicators of nutritional deficiency among infants and young children.
  • As per the survey, higher levels of schooling for a mother resulted in children receiving better diets. On two counts, meal diversity and minimum acceptable diet and in terms of bolstering food with micro nutrients, the children of mothers with better education did well.

Only 11.4% of children of mothers with no schooling received adequately diverse meals, while 31.8%, whose mothers finished Class XII received diverse meals. While 9.6% of children, whose mothers had finished schooling, got minimum acceptable diets, only 3.9% of children, whose mothers had zero schooling, got such a diet.

Way Forward
  • Need to improve women literacy.
  • Other important factor is awareness about the meaning of good diet. We have to assess various nutrition schemes to capture, where they are falling short.
  • Supplementary food programmes may be failing to reach the family’s most vulnerable members.
  • We have to focus on anaemic mothers, to alleviate low birth weight.
  • Sub-optimal breastfeeding practices is also a worry. Addressing malnutrition must become a top priority for both Centre and the State Governments. Weak human capital prepares us badly for the economy of the future.

Hidden Hunger: A Different Kind of Hunger

Hidden hunger, or micronutrient deficiency, is a major public health problem in developing countries. It is caused when intake of essential vitamins and minerals (e.g., vitamin A, zinc, iron, iodine) in the diet. Often, the signs of this form of malnutrition are ‘hidden’, as individuals may ‘look alright’ but suffer extremely negative impacts on health and well-being. For example, children may be stunted have poor night vision or suffer frequently from illness. Adults too may succumb more frequently to illness and fatigue easily. Factors that contribute to micronutrient deficiencies include poor diet increased micronutrient needs during certain life stages such as pregnancy and lactation and health problems such as diseases infections or parasites.

People suffering from hidden hunger have diets that are deficient in micronutrients. They habitually eat large amounts of staple food crops (such as maize, wheat, and rice) that are high in calories but lack sufficient micronutrients, and low amounts of foods that are rich in micronutrients such as fruits, vegetables, and animal and fish products. People suffering from hidden hunger are often too poor to be able to afford foods that are more nutritious, or otherwise lack access to these foods.

Hidden hunger can lead to illness, blindness, premature death, reduced productivity, and impaired mental development, particularly among women and children in developing countries.

Although a larger proportion of the burden of hidden hunger is found in the developing world, micronutrient deficiency, particularly iron and iodine deficiency is also widespread in the developed world.

The ‘hidden hunger’ due to micronutrient deficiency does not produce hunger as we know it. You might not feel it in the belly, but it strikes at the core of your health and vitality.

It is difficult to describe the magnitude of deficits for most micronutrients. For many micronutrient deficits, prevalence data are scarce. Furthermore, for many micronutrients, the relationship between intake and utilization is not well understood. Typical physical measurements of hunger, such as stunting (low height for one’s age), wasting (low weight for one’s height), and underweight may capture micronutrient deficiencies in affected populations but are inadequate proxies because the deficiencies are seldom the only factors involved. Exact measurements via blood samples and also by specific diagnoses such as night blindness, beriberi, and scurvy are more reliable ways to determine micronutrient deficiencies. Many important micronutrients lack prevalence data, because related biomarkers have not yet been identified for a nutrient deficit . As long as these gaps in data persist it will be difficult to describe the full contours of hidden hunger.

Causes of Hidden Hunger

  • Poor Diet: Poor diet is a common source of hidden hunger. Diets based mostly on staple crops, such as maize, wheat, rice and cassava which provide a large share of energy but relatively low amounts of essential vitamins and minerals frequently result in hidden hunger.
  • Poverty: Poverty is a factor that limits access to adequate nutritious foods. When food prices rise consumers tend to continue to eat staple foods while cutting their intake of non-staple foods that tend to be richer in micronutrients.
  • Impaired absorption or use of nutrients: Absorption may be impaired by infection or a parasite that can also lead to the loss of or increased need for many micronutrients. Infections and parasites can spread easily in unhealthy environments with poor water sanitation and hygiene conditions. Unsafe food handling and feeding practices can further exacerbate nutrient losses. Also Alcohol consumption can interfere with the absorption of micronutrients.
Impacts of Hidden Hunger
ElderlyIncreased Morbidity including osteoporosis and mental impairment
High Mortality Rate
BabyLow Birth Weight
Higher Mortality Rate
Impaired Mental Development
ChildReduced mental Capacity
Stunting
Frequent infections
Reduced cognitive capabilities
High Mortality Rate
AdolescentReduced mental Capacity
Stunting
Fatigue
Increased vulnerability to infections
AdultReduced Productivity
Poor Socio-economic status
Malnutrition
Increased risk of chronic diseases
Pregnant WomenIncreased Mortality
Increased Perinatal complications
Tackling Hidden Hunger

A range of interventions are needed to solve the complex problem of hidden hunger. To sustainably tackle the underlying causes will require a multisectoral approach at the national and international levels. Some of them are as under:

  • Diversifying Diets: Diversification in diet is one of the most effective ways to prevent hidden hunger sustainably. It ensures a healthy diet that contains a balanced and adequate combination of macronutrients (carbohydrates, fats and protein) essential micronutrients and other food-based substances such as dietary fiber. A variety of cereals, legumes, fruits, vegetables and animal-source foods provides adequate nutrition for most people although certain populations, such as pregnant women may need added supplements. Effective ways to promote dietary diversity involve food-based strategies, such as home gardening and educating people on better infant and young child feeding practices, food preparation and storage/preservation methods to prevent nutrient loss.
  • Fortifying Commercial Foods: Commercial food fortification which adds little amounts of micronutrients, to staple foods during processing helps consumers, in getting the recommended levels of micronutrients. Fortification, a sustainable and cost-effective public health strategy has been particularly successful for iodized salt. Other common examples of fortification include adding vitamins, iron and/or zinc to wheat flour and adding vitamin A to cooking oil and sugar. Though fortification may be particularly effective for urban consumers who buy commercially processed and fortified foods. It is less likely to reach rural consumers who often have no access to commercially produced foods. To reach the needy especially poor people fortification must be subsidized. Otherwise, they may buy cheaper nonfortified alternatives.
  • Biofortification: Biofortification is a relatively new intervention that involves breeding food crops using conventional or transgenic methods to increase their micronutrient content. Biofortified crops that have been released so far include vitamin A orange sweet potato, vitamin A maize, vitamin A cassava, iron beans, iron pearl millet, zinc rice and zinc wheat. While biofortified crops are not available in all developing countries biofortification is expected to grow significantly in the coming years. Biofortified foods could provide a steady and safe source of certain micronutrients for people not reached by other interventions. They can help close the micronutrient intake gap and increase the daily intake of vitamins and minerals throughout a person’s life.
  • Supplementation: Vitamin A supplementation is one of the most cost-effective interventions for improving child survival as they typically target only vulnerable populations between six months and five years old. Programs to supplement vitamin A are often integrated into national health policies because they are associated with a reduced risk of all-cause mortality and a reduced incidence of diarrhoea.

Consequences/ Impacts of Malnutrition

The problem of malnutrition is complex, multi-dimensional and inter-generational in nature. Malnutrition affects people in every country. Some of the impacts are as under.

  • Around 1.9 billion adults worldwide are overweight while 462 million are underweight. An estimated 41 million children under the age of 5 years are overweight or obese while some 159 million are stunted and 50 million are wasted. Adding to this burden are the 528 million or 29% of women of reproductive age around the world affected by anaemia for which approximately half would be amenable to iron supplementation.
  • The worst damages of malnutrition happen during pregnancy and early childhood from conception to two years i.e., the first 1000 days. Undernourished children have weaker immune systems and are thus more susceptible to infections and illnesses.
  • Long-term insufficient nutrient intake and frequent infections can cause stunting whose effects in terms of delayed motor and cognitive development are largely irreversible.
  • Extreme food shortages common childhood diseases such as diarrhoea and pneumonia or both can lead to acute malnutrition or wasting which can quickly lead to death if left untreated.
  • Malnutrition also slows economic growth and perpetuates poverty. Mortality and morbidity associated with malnutrition represent a direct loss in human capital and productivity for the economy.
  • Undernutrition in early childhood also makes an individual more prone to non-communicable diseases later in life including diabetes and heart disease significantly increasing health costs in resource constrained health systems.
  • Many families cannot afford or access enough nutritious foods like fresh fruit and vegetables legumes meat and milk while foods and drinks high in fat sugar and salt are cheaper and more readily available leading to a rapid rise in the number of children and adults who are overweight and obese in poor as well as rich countries. It is quite common to find undernutrition and overweight within the same community household or even individual – it is possible to be both overweight and micronutrient deficient for example.
  • Vulnerability of Children and elderly: The effect of childhood malnutrition last a lifetime and even into succeeding generations. Vitamin and mineral deficiencies are not noticed easily and can severely affect the physical and mental growth of children. Also, elderly people are disproportionately vulnerable to hunger and malnutrition in both industrial and developing nations. Population of elderly people is increasing as they live longer due to better medical facilities. However , with changing lifestyle and family structures the elderly in many countries receive less care from the family. Strategies to care for the elderly needs to be looked at immediately.

SDG Goal 2 Targets

  • SDG Goal 2.1 By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round.
  • SDG Goal 2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.
  • SDG Goal 2.3 By 2030, double the agricultural productivity and incomes of small-scale food producers, in particular women, indigenous peoples, family farmers, pastoralists and fishers, including through secure and equal access to land, other productive resources and inputs, knowledge, financial services, markets and opportunities for value addition and non-farm employment.
  • SDG Goal 2.4 By 2030, ensure sustainable food production systems and implement resilient agricultural practices that increase productivity and production, that help maintain ecosystems, that strengthen capacity for adaptation to climate change, extreme weather, drought, flooding and other disasters and that progressively improve land and soil quality.
  • SDG Goal 2.5 By 2020, maintain the genetic diversity of seeds, cultivated plants and farmed and domesticated animals and their related wild species, including through soundly managed and diversified seed and plant banks at the national, regional and international levels, and promote access to and fair and equitable sharing of benefits arising from the utilization of genetic resources and associated traditional knowledge, as internationally agreed.
  • SDG Goal 2.A Increase investment, including through enhanced international cooperation, in rural infrastructure, agricultural research and extension services, technology development and plant and livestock gene banks in order to enhance agricultural productive capacity in developing countries, in particular least developed countries.
  • SDG Goal 2.B Correct and prevent trade restrictions and distortions in world agricultural markets, including through the parallel elimination of all forms of agricultural export subsidies and all export measures with equivalent effect, in accordance with the mandate of the Doha Development Round.
  • SDG Goal 2.C Adopt measures to ensure the proper functioning of food commodity markets and their derivatives and facilitate timely access to market information, including on food reserves, in order to help limit extreme food price volatility.

India’s Initiatives to Tackle Malnutrition

In recent times, India has taken several measures to tackle malnutrition especially among children and mothers. Some of the important measures are as follows:

  • The Government notified the National Food Security Act in 2013 with the objective to provide for food and nutritional security in human life cycle approach by ensuring access to adequate quantity of quality food at affordable prices to people to live a life with dignity.
Direct InterventionIndirect Intervention
The Integrated Child Development Services (ICDS).Targeted Public Distribution System (TPDS).
National Rural Health Mission (NRHM).National Horticulture Mission.
Mid-Day Meal Scheme (MDM), Rajiv Gandhi Schemes for Empowerment of Adolescent Girls (RGSEAG) namely SABLA.National Food Security Mission.
Indira Gandhi Matritva Sahyog Yojna (IGMSY).Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), Nirmal Bharat Abhiyan National Rural Drinking Water Programme.
  • NITI Aayog in consultation with stakeholders has formulated and released National Nutrition Strategy emphasizing importance on interdepartmental convergence setting up clear targets and real time monitoring.
  • National Nutrition Mission (NNM) has been conceptualized and sent for approval to bring in desired convergence among different Ministries/Departments and expand digital monitoring to all districts. It is proposed to constitute a Technical Secretariat under NITI Aayog to support in its monitoring and providing technical guidance.
  • Government has launched Pradhan Mantri Matru Vandan Yojana, PMMVY has been launched for maternity benefit to pregnant women and lactating mothers. It will provide Rs. 5,000 Cash transfers on fulfillment of necessary conditions related to health and nutrition.
  • The cost norm for supplementary nutrition has been increased. The Government has provided an additional Rs. 12000 Crores to fight malnutrition over next three years in the country by revising cost norms for supplementary nutrition provided in Anganwadis and in the scheme for adolescent girls. The cost norms have now also been linked to the Food Price Index which will enable the Government to increase the cost norms annually without any hindrance.
  • Fortification of food provided under Government welfare programmes like ICDS, MDM and PDS has been made mandatory.
  • Steps have been taken to ensure collective and coordinated monitoring of programs related to different ministries at field level to ensure the desired nutrition outcomes. In this regard a joint letter has been signed by three Secretaries from Ministry of Women and Child Development. Ministry of Health and Family Welfare and Ministry of Drinking Water and Sanitation.
  • The Ministry of Women and Child Development has started digitalization of MIS and Monitoring under ICDS. In this regard, ICDS-CAS system has been developed and piloted.
  • The ICDS-Systems Strengthening & Nutrition Improvement Project (ISSNIP) has been approved to extend it to 162 districts in next three years for real time monitoring of ICDS and its outcomes. Also, in convergence with MNREGS, more than 1.1 lakhs of Anganwadi Centres constructed for effective delivery of ICDS services under ICDS. In addition, 113 most backward districts (on nutrition parameters) have been identified for taking up action in mission mode.
  • Specific interventions targeted towards the vulnerable groups include children below 6 years. The Integrated Child Development Services (ICDS) Scheme provides a package of six services namely supplementary nutrition pre-school non-formal education nutrition & health education immunization health check-up and referral services.
  • Promotion of appropriate infant and young child feeding practices that include early initiation of breastfeeding exclusive breastfeeding till 6 months of age and appropriate complementary feeding after 6 months of age. Treatment of children with severe acute malnutrition at special units called the Nutrition Rehabilitation Centres (NRCs) set up at public health facilities.
  • Specific program to prevent and combat micronutrient deficiencies of Vitamin A and Iron & Folic Acid (IFA) in under-five children of 5 to 10 years of age, and adolescents.
  • Village Health and Nutrition Days and Mother and Child Protection Card are the joint initiative of the Ministries of Health & Family welfare and the Ministry of Woman and Child for addressing the nutrition concerns in children, pregnant women and lactating mothers.
  • To deal with the problem of malnutrition, government has focused on improving food grains management in view of increased procurement and storage needs. Consequently, storage capacity with Food Corporation of India (FCI) has increased substantially to deal with hunger.
POSHAN Abhiyaan

POSHAN (Prime Minister’s Overarching Scheme for Holistic Nutrition) Abhiyaan is India’s flagship programme to improve nutritional outcomes for children, adolescents, pregnant women and lactating mothers by leveraging technology, a targeted approach and convergence. It directs the attention of the country towards the problem of malnutrition and address it in a mission-mode. With the overarching aim to build a people’s movement (Jan Andolan) around malnutrition, POSHAN Abhiyaan intends to significantly reduce malnutrition in the next three years.

For implementation of POSHAN Abhiyaan the four point strategy/pillars of the mission are:

  • Inter-sectoral convergence for better service delivery.
  • Use of technology (ICT) for real time growth monitoring and tracking of women and children.
  • Intensified health and nutrition services for the first 1000 days.
  • Jan Andolan.

What are the Specific Goals:

  • POSHAN Abhiyaan targets to reduce stunting, undernutrition, anemia (among young children, women and adolescent girls) and reduce low birth weight by 2%, 2%, 3% and 2% per annum respectively.
  • Although the target to reduce Stunting is at least 2% p.a., Mission would strive to achieve reduction in Stunting from 38.4% (NFHS-4) to 25% by 2022 (Mission 25 by 2022).
Components of POSHAN Abhiyaan
Nutritional Security and Millets

Nutrition security

Nutritional Security implies awareness and access at affordable cost to balanced diet, safe environment and drinking water and health care outreach. Millets contribute towards balanced diet as well as safe environment. They are nature’s gift to humankind.

The term millet includes a number of small-grained cereal grasses. Based on the grain size, millets have been classified as major millets which include sorghum and pearl millet and several small grain millets which include finger millet (ragi), foxtail millet (kangni) ; kodo millet (kodo), proso millet (cheena), barnyard millet (sawan) and little millet (kutki).

Advantages of millets:

  • The advantages of cultivation of these crops include drought tolerance, crop sturdiness, short to medium duration, low labour requirement, minimal purchased inputs, resistance to pests and diseases.
  • Millets are C4 crops and hence are climate change compliant.
  • Millets sequestrate carbon and thereby reduce the burden of greenhouse gas.
  • Millets are a treasure-trove of micronutrients like B-complex vitamins and minerals whose deficiencies in India are rampant.
  • They also contain fibre and health promoting phytochemical which function as antioxidants, immune stimulants etc., and thus, have potential to mitigate degenerative diseases such as diabetes, CVD, cancer etc.
  • Millet cultivation is the mainstay of rain-fed farming on which 60% of Indian farmers depend. They provide food as well as fodder and can be mix-cultivated (polyculture) with pulses and vegetables.
Millets - Nutrition security

Despite these advantages, millets are losing their pride of place in production and consumption in India. In recent years, there has been some effort towards reviving millets.

Conclusion

Millets are drought, temperature and pest tolerant and hence are grains for the future in an environment of climate change and global warming. Scientific , technological and behavioural engineering involving convergence of efforts of agriculture scientists, food technologists, home scientists, policy makers, and media is needed to revalorise millets.

Suggestions

Direct InterventionIndirect Intervention
Expand the safety net through ICDS to cover all vulnerable groups.Ensure food security through increased production of food grains.
Fortify essential foods with appropriate nutrientsImprove dietary pattern by promoting production and increasing per capita availability of nutritionally rich food.
Popularise low cost nutritious food.Effecting income transfers (improve purchasing power of landless rural and urban poor; expand and improve public distribution system).
Control micronutrient deficiencies amongst vulnerable groups.Implement land reforms (tenure ceiling laws) to reduce vulnerability of poor; increase health and immunisation facilities and nutrition knowledge; prevent food adulteration; monitor nutrition programmes and strengthen nutrition surveillance; community participation.

Conclusion

Food scarcity with its dangers for survival and serious physical and psychological discomfort has been part of human experience and human culture form. Hunger is one piece of a complex of interrelated social ills. It is linked intricately to global economic, political and social power structures; modes of development and consumption; population dynamics; and social biases based on race, ethnicity, gender and age.

There are nearly 16 crore children in the country below the age of 6 years. In the years to come, these children will join our work-force as scientists, as farmers, as teachers, as data operators, as artisans, as service providers. Several of them will become social workers like many of you in this hall. The health of our economy and society lies in the health of this generation. We cannot hope for a healthy future for our country with a large number of malnourished children. The first step in addressing the challenge of malnutrition lies in understanding it clearly.

Though the ICDS continues to be our most important tool to fight malnutrition, we can no longer rely solely on it. We need to focus on districts where malnutrition levels are high and where conditions causing malnutrition prevail. Policy makers and programme implementers need to clearly understand many linkages between education and health, between sanitation and hygiene, between drinking water and nutrition and then shape their responses accordingly.

Behavior change communication that aims to improve women’s, infants’ and young children’s utilization of health services, clean water, good sanitation and hygiene to protect them from diseases that interfere with nutrient absorption.

Messaging that promotes best practices, such as early initiation of exclusive breastfeeding up to 6 months followed by breastfeeding up to 24 months with adequate and sufficient complementary food as an economic and sustainable way to prevent hidden hunger in children. Social protection that gives poor people access to nutritious food and shields them from price spikes; and A focus on empowering women by increasing access to education.

An overview of the malnutrition situation in India presented in this paper has shown that a sizeable proportion of the country’s population are malnourished and anaemic and for this numerous factors are responsible. Some of these factors directly cause malnutrition among people, whereas many others affect indirectly. Significant among these are poverty; unemployment; ignorance and lack of education; unhealthy lifestyle; lack of access to nutritious food, safe water, sanitation and hygiene; non-availability of reliable and timely data and sufficient funds; and unimpressive performance by the government in the implementation of schemes.

Many of the reasons for the occurrence of malnutrition as well as the solutions to overcome the challenge are known Attention however, needs to be paid to understanding what prevents the nation from achieving its goals related to nutrition. Undoubtedly, the agencies of State governments have to adopt a comprehensive and coordinated multisectoral approach which is formulated by taking into account the varied nature of local-level challenges. They have to demonstrate better governance, too. For its part, civil society must respond in a responsible manner. In particular, attention needs to be paid on building neighbourhood health and nutrition profiles and carrying out interventions based on identified needs.

Effective interventions to combat undernutrition are well known, but they need to be scaled up and integrated in both development and humanitarian policies. Nutrition-specific interventions, which directly impact an individual’s nutritional status include the promotion of practices to improve nutrition (e.g., increased rates of exclusive breastfeeding from 0-6 months and timely introduction of adequate complementary foods after 6 months), the reduction of micronutrients deficiencies (e.g., vitamin A supplements), and the prevention and community management of severe acute malnutrition. In addition, nutrition sensitive interventions are essential to address the underlying causes of malnutrition, which are embedded in the household and community level context. These range from improving food security to enhancing the status of women.


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Vishnnvikas

Valuable essay