Compared to other South Asian countries, India fares poorly in terms of food and nutrition security, indicates SOFI 2020 report

Compared to other South Asian countries, India fares poorly in terms of food and nutrition security, indicates SOFI 2020 report

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published Published on Sep 19, 2020   modified Modified on Sep 22, 2020


In his Mann ki Baat speech delivered on 30th August, 2020, Prime Minister Shri Narendra Modi said that the month of September 2020 will be observed as Nutrition Month (POSHAN Maah) in the entire nation. In his address to the nation on that day, he highlighted that for children to be well-nourished, the mother should receive proper and adequate nutrition.

In this context, it is important to discuss the 11 different indicators related to food and nutrition security that the report entitled The State of Food Security and Nutrition in the World 2020: Transforming Food Systems for Affordable Healthy Diets (released in July 2020) points out.

The indicators pertaining to food and nutrition security that have been talked about by the SOFI 2020 report are as follows:

1. Prevalence of Undernourishment in the Total Population (in percentage) and Number of Undernourished People (in millions).

2. Prevalence of Severe Food Insecurity in the Total Population (in percentage) and Number of Severely Food-Insecure People (in millions).

3. Prevalence of Moderate or Severe Food Insecurity in the Total Population (in percentage) and Number of Moderately or Severely Food-Insecure People (in millions).

4. Prevalence of Wasting in Children below 5 years of age (in percentage) and Number of Children below 5 years of age affected by Wasting (in millions).

5. Prevalence of Stunting in Children below 5 years of age (in percentage) and Number of Children below 5 years who are Stunted (in millions).

6. Prevalence of Overweight in Children below 5 years of age (in percentage) and Number of Children below 5 years who are Overweight (in millions).

7. Prevalence of Obesity in the Adult Population (in percentage) and Number of Adults who are Obese (in millions).

8. Prevalence of Anaemia among Women of Reproductive Age (in percentage) and Number of Women of Reproductive Age affected by Anaemia (in millions).

9. Prevalence of Exclusive Breastfeeding among Infants (in percentage) and Number of Infants 0-5 months of age Exclusively Breastfed (in millions).

10. Prevalence of Low Birthweight (in percentage) and Number of Babies with Low Birthweight (in millions).

11. Cost and Affordability of the Three Diets by Country and Region

a. Cost and affordability of energy sufficient diet;
b. Cost and affordability of nutrient adequate diet; and
c. Cost and affordability of healthy diet.

Readers should note that there exists a plethora of information and data related to hunger and nutrition inside the 320-page SOFI 2020 report, on which the mainstream media has not thrown enough light. In this news alert, we will discuss these 11 food and nutrition related indicators one by one.

Undernourishment in the Total Population
 
Barring some countries for which data is either not available or not reported, one can find from table-1 that the highest decline in the prevalence of undernourishment in the total population between 2004-06 and 2017-19 has been observed for Myanmar (-13.8 percentage points), followed by Nepal (-10.8 percentage points) and India (-7.7 percentage points).  

Table 1: Situation of Undernourishment in 2004-06 and 2017-19

Source: The State of Food Security and Nutrition in the World 2020: Transforming Food Systems for Affordable Healthy Diets (released in July 2020), please click here to access
Note: China is part of Eastern Asia region and Myanmar is part of South-eastern Asia region, as per the SOFI 2020 report. However, for the sake of comparison we have included these two countries in the table. In the original report, South Asia includes Afghanistan, Bangladesh, Bhutan, India, Iran (Islamic Republic of), Maldives, Nepal, Pakistan and Sri Lanka. Iran’s data is not shown in the table. Please note that <0.1 means less than 1 lakh people.
Please click here to view the data in spreadsheet.

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Table-1 shows that the highest decline in the number of undernourished people between 2004-06 and 2017-19 has been noticed for India (-60.2 millions), followed by Myanmar (-6.1 millions) and Nepal (-2.6 millions). Almost 74.3 percent of South Asia's undernourished people resided in India during 2017-19 as opposed to 78.4 percent in 2004-06.

According to the SOFI 2020 report, undernourishment is defined as the condition of an individual whose habitual food consumption is insufficient to provide, on average, the amount of dietary energy required to maintain a normal, active and healthy life.

The indicator is reported as a prevalence and is denominated as “prevalence of undernourishment” (PoU), which is an estimate of the percentage of individuals in the total population that are in a condition of undernourishment, says the SOFI 2020 report. National estimates are reported as three-year moving averages, to control for the low reliability of some of the underlying parameters, such as the year-to-year variation in food commodity stocks, one of the components of the annual FAO Food Balance Sheets for which complete, reliable information is very scarce. Regional and global aggregates, on the other hand, are reported as annual estimates, on account of the fact that possible estimation errors are expected not to be correlated across countries.

Severe Food Insecurity in the Total Population

Although the data related to the number of severely food-insecure people in India is not provided in table-2 (data taken directly from SOFI 2020 report), one can compute that by taking the difference between the number of severely food-insecure people in South Asia and the number of severely food-insecure people in South Asia (excluding India). The number of severely food-insecure people in the country was 202.8 millions in 2014-16, which expanded to 234.6 millions in 2017-19 i.e. by 31.8 millions.

India's population in 2014-16 and 2017-19 are found (please click here to see the calculations done by the Inclusive Media for Change team) to be approximately 1311.06 millions and 1354.4 millions, respectively.  

So, the prevalence of severe food insecurity in the country was 15.5 percent in 2014-16, which climbed up to reach 17.3 percent in 2017-19. Kindly note that the Bharatiya Janata Party (BJP) led National Democratic Alliance was elected to power at the Centre during the 2014 Lok Sabha elections. Among other things, the 2014 election manifesto of the BJP had promised addressing the issue of under-nutrition and malnutrition. The manifesto also said that 'universal food security' is integral to national security as per the party.

Table 2: Situation of Severe Food Insecurity in 2014-16 and 2017-19

Source: Same as for table-1
Note: Same as for table-1

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One can further find that nearly 76 percent of South Asia's severely food-insecure people lived in our country during 2014-16 as opposed to 77.3 percent in 2017-19.

Moderate or Severe Food Insecurity in the Total Population

Although the data related to the number of moderately or severely food-insecure people in the country is not provided in table-3 (data taken directly from SOFI 2020 report), one can compute that by taking the difference between the number of moderately or severely food-insecure people in South Asia and the number of moderately or severely food-insecure people in South Asia (excluding India). The number of moderately or severely food-insecure people in the country stood at 364.4 millions in 2014-16, which grew to 426.5 millions in 2017-19 i.e. by 62.1 millions.

India's population in 2014-16 and 2017-19 have been estimated to be about 1311.06 millions and 1354.4 millions (please click here to find the calculations), respectively.  

So, the prevalence of moderate or severe food insecurity in the country was 27.8 percent in 2014-16, which increased to reach 31.5 percent in 2017-19 i.e. a rise by +3.7 percentage points. In contrast to India, the prevalence of moderate or severe food insecurity in South Asia (without India) fell marginally from 38.6 percent to 38.1 percent between 2014-16 and 2017-19 i.e. a decline by -0.5 percentage points. These results pertaining to prevalence of moderate or severe food insecurity in the country and in South Asia (excluding India) during 2014-16 and 2017-19 matches with what has been observed by Vaishali Bansal in her article entitled More evidence of India’s food insecurity, dated 24th August, 2020.  

Table 3: Situation of Moderate or Severe Food Insecurity in 2014-16 and 2017-19

Source: Same as for table-1
Note: Same as for table-1

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It can be observed from table-3 that nearly 64.6 percent of South Asia's moderately or severely food-insecure people lived in India during 2014-16 as opposed to 67.3 percent in 2017-19.

According to the SOFI 2020 report, food insecurity as measured by this indicator refers to limited access to food, at the level of individuals or households, due to lack of money or other resources. The severity of food insecurity is measured using data collected with the Food Insecurity Experience Scale survey module (FIES-SM), a set of eight questions asking to self-report conditions and experiences typically associated with limited access to food. Using sophisticated statistical techniques based on the Rasch measurement model, the information obtained in a survey is validated for internal consistency and converted into a quantitative measure along a scale of severity, ranging from low to high. Based on their responses to the FIES-SM items, the individuals or households interviewed in a nationally representative survey of the population are assigned a probability to be in one of three classes: food secure or only marginally insecure, moderately food insecure and severely food insecure as defined by two globally set thresholds. Based on FIES data collected over three years from 2014 to 2016, FAO has established the FIES reference scale, which is used as the global standard for experience-based food-insecurity measures, and to set the two reference thresholds of severity.

In the SOFI 2020 report, FAO provides estimates of food insecurity at two different levels of severity: moderate or severe food insecurity and severe food insecurity. For each of these two levels, two estimates are reported:

a. the prevalence (%) of individuals in the population living in households where at least one adult was found to be food insecure;

b. the estimated number of individuals in the population living in households where at least one adult was found to be food insecure.

Since 2014, the eight-question FIES survey module has been applied in nationally representative samples of the adult population (defined as aged 15 or older) in more than 140 countries included in the Gallup® World Poll (GWP), covering 90 percent of the world population. In most countries, samples include about 1,000 individuals, with larger samples of 3,000 individuals in India and 5,000 in mainland China.

In her article entitled More evidence of India’s food insecurity, Vaishali Bansal states that "[u]nlike most other countries, the government of India neither conducts official FIES surveys nor accepts estimates based on FAO-GWP surveys. Although FAO-GWP surveys are conducted in India, India is among the few countries that do not allow publication of estimates based on these surveys. Consequently, as in the past years, estimates of PMSFI for India are not published in SOFI."

Wasting in Children below 5 years of age

From the available data given in table-4, it can be observed that the prevalence of wasting (i.e. too thin for height) in children below 5 years of age during 2019 was the highest in India (17.3 percent), followed by Sri Lanka (15.1 percent) and Nepal (9.6 percent).

Table 4: Situation of Wasting among Children below 5 years of age in 2019

Source: Same as for table-1
Note: Same as for table-1

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Around four-fifth (i.e. 79.8 percent) of South Asia’s children below 5 years of age affected by wasting resided in our country during 2019.

According to the SOFI 2020 report, wasting (i.e. low weight-for-height) is an indicator of acute weight loss or a failure to gain weight and can be the consequence of insufficient food intake and/or an incidence of infectious diseases, especially diarrhoea. Wasting is reported as the percentage of children aged 0–59 months who are below -2 SD from the median weight-for-height of the WHO Child Growth Standards.

Stunting in Children below 5 years of age

Table-5 indicates that the prevalence of stunting (i.e. too short for age) in children below 5 years of age during 2019 was the highest in Afghanistan (38.2 percent), followed by Pakistan (37.6 percent) and Nepal (36.0 percent). The highest reduction in the prevalence of stunting in children below 5 years of age between 2012 and 2019 was noticed for India (-13.1 percentage points), followed by Bangladesh (-10.5 percentage points) and Myanmar (-5.7 percentage points). In Sri Lanka, the prevalence of stunting in children below 5 years of age between 2012 and 2019 has gone up.

Table 5: Situation of Stunting among Children below 5 years of age in 2012 and 2019

Source: Same as for table-1
Note: Same as for table-1

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About 72.1 percent of South Asia’s stunted children below 5 years of age lived in India during 2019. This figure was close to 90 percent in 2012.

According to the SOFI 2020 report, stunting (i.e. low height-for-age) is an indicator that reflects the cumulative effects of undernutrition and infections since and even before birth. It may be the result of long-term nutritional deprivation, recurrent infections and lack of water and sanitation infrastructures. Stunting is reported as the percentage of children aged 0–59 months who are below -2 SD from the median height-for-age of the WHO Child Growth Standards.

Overweight in Children below 5 years of age  

Table-6 shows that the prevalence of overweight in children below 5 years of age during 2019 was the highest in Afghanistan (4.1 percent), followed by Pakistan (2.5 percent) and Bangladesh (2.2 percent). The highest reduction in the prevalence of overweight in children below 5 years of age between 2012 and 2019 was noted for Pakistan (-3.9 percentage points), followed by Myanmar (-1.1 percentage points) and India and Nepal (each -0.3 percentage point). In Bangladesh and Sri Lanka, the prevalence of overweight in children below 5 years of age between 2012 and 2019 has risen.

Table 6: Situation of Overweight among Children below 5 years of age in 2012 and 2019

Source: Same as for table-1
Note: Same as for table-1

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It can be seen from table-6 that nearly 54.3 percent of South Asia's overweight children below 5 years of age were found in India during 2012 in contrast to 42.2 percent in 2019.

According to the SOFI 2020 report, overweight reflects excessive weight gain for height generally due to energy intakes exceeding children’s energy requirements. Overweight is reported as the percentage of children aged 0–59 months who are above +2 SD from the median weight-for-height of the WHO Child Growth Standards.

Obesity in the Adult Population

From the available data given in table-7, it can be found that the prevalence of obesity in the adult population (of age 18 years and above) during 2016 was the highest in Maldives and Pakistan (each 8.6 percent), followed by Bhutan (6.4 percent) and China (6.2 percent).

The prevalence of obesity in the adult population (of age 18 years and above) has increased for all the countries between 2012 and 2016, with the highest rise exhibited by Maldives (1.9 percentage points) and the lowest jump shown by India, Bangladesh and Nepal (each 0.8 percentage point).

Table 7: Situation of Obesity among Adults (18 years and above) in 2012 and 2016

Source: Same as for table-1
Note: Same as for table-1

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From table-7, we get that closely 50.7 percent of South Asia's obese adult people resided in India during 2012, which escalated to 52.4 percent in 2016.

According to the SOFI 2020 report, the body mass index (BMI) is the ratio of weight-to-height commonly used to classify the nutritional status of adults. It is calculated as the body weight in kilograms divided by the square of the body height in metres (kg/m2). Obesity includes individuals with BMI equal to or higher than 30 kg/m2. It is reported as the percentage of population over 18 years of age with BMI ≥ 30.0 kg/m2 standardized by age and weighted by sex.

Anaemia among Women of Reproductive Age

Table-8 shows that the prevalence of anaemia among women of reproductive age (15-49 years) during 2016 was the highest in Pakistan (52.1 percent), followed by India (51.4 percent) and Myanmar (46.3 percent).

Countries like Bangladesh (-0.4 percentage points), Bhutan (-3.6 percentage points) and Nepal (-0.3 percentage points) were able to reduce the prevalence of anaemia among women of reproductive age between 2012 and 2016.

Table 8: Situation Anaemia among Women of Reproductive Age (15-49 years) in 2012 and 2016

Source: Same as for table-1
Note: Same as for table-1

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From table-8, it can be said that about 75.8 percent of South Asia's anaemic women of reproductive age resided in the country during 2012, which fell marginally to around 75 percent in 2016.

According to the SOFI 2020 report, anaemia is defined as a haemoglobin concentration below a specified cut-off point, which can change according to the age, sex, physiological status, smoking habits and altitude at which the population being assessed lives.

Anaemia in women of reproductive age is reported as the percentage of women of reproductive age (15 to 49 years old) with haemoglobin concentration below 110 g/L for pregnant women and below 120 g/L for non-pregnant women.

Exclusive Breastfeeding among Infants

From the available data given in table-9, it can be seen that the prevalence of exclusive breastfeeding among infants (0-5 months) during 2019 was the highest in Sri Lanka (82.0 percent), followed by Nepal (65.2 percent) and Bangladesh (65.0 percent).

The highest increment in the prevalence of exclusive breastfeeding among infants between 2012 and 2019 was noticed in Myanmar (27.6 percentage points), followed by Maldives (17.7 percentage points) and India (11.6 percentage points).   
 
Table 9: Situation of Exclusive Breastfeeding among Infants (0-5 months) in 2012 and 2019

Source: Same as for table-1
Note: Same as for table-1

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Table-9 shows that although the number of exclusively breastfed infants has fallen for China between 2012 and 2019, it increased for India during the same time span. The number of exclusively breastfed infants has gone up by 2.7 millions between 2012 and 2019 i.e. from 11.2 millions to 13.9 millions.

According to the SOFI 2020 report, exclusive breastfeeding for infants less than 6 months of age is defined as receiving only breastmilk and no additional food or drink, not even water. Exclusive breastfeeding is a cornerstone of child survival and is the best food for newborns, as breastmilk shapes the baby’s microbiome, strengthens the immune system and reduces the risk of developing chronic diseases.

Breastfeeding also benefits mothers by preventing postpartum haemorrhage and promoting uterine involution, decreasing risk of iron-deficiency anaemia, reducing the risk of various types of cancer and providing psychological benefits.

Exclusive breastfeeding is reported as the percentage of infants aged 0–5 months who are fed exclusively on breastmilk with no additional food or drink, not even water, in the 24 hours preceding the survey.

Low Birthweight among Babies

Table-10 indicates that the prevalence of low birthweight among babies during 2015 was the highest in Bangladesh (27.8 percent), followed by Nepal (21.8 percent) and Myanmar (12.3 percent).

The prevalence of low birthweight among babies has reduced between 2012 and 2015 in almost all the countries for which data is available.

Table 10: Situation of Low Birthweight among Babies in 2012 and 2015

Source: Same as for table-1
Note: Same as for table-1

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In South Asia, the number of babies with low birthweight has fallen down from 10.3 millions in 2012 to 9.8 millions in 2015 i.e. by -0.5 millions.

According to the SOFI 2020 report, low birthweight is defined as a weight at birth of less than 2,500 grams (less than 5.51 lbs), regardless of gestational age. A newborn’s weight at birth is an important marker of maternal and foetal health and nutrition.

Low birthweight is reported as the percentage of newborns weighing less than 2,500 grams (less than 5.51 lbs) at birth.

Cost and Affordability of the Three Different Kinds of Diet

The average cost of energy sufficient diet in India during 2017 was US$ 0.79 per person per day, which is about 27.3 percent of food expenditure. Roughly 0.9 percent of the Indian population could not afford energy sufficient diet.

The average cost of nutrient adequate diet in India during 2017 was US$ 1.90 per person per day, which is about 66.0 percent of food expenditure. Around 39.1 percent of the population of India could not afford nutrient adequate diet.

Table 11: Cost and Affordability of the Three Diets by Country and Region in 2017

Source: Same as for table-1
Note: Same as for table-1

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The average cost of healthy diet in India during 2017 was US$ 3.41 per person per day, which is about 118.2 percent of food expenditure. Almost 77.9 percent of the country's population could not afford it.

Higher rates of obesity is found in countries due to the relative inexpensiveness of energy-dense foods high in fat, sugar and salt. Both high-income countries as well as transitional economies, such as China, India and urban Africa exhibit this phenomenon, says the SOFI 2020 report.

The prevalence of overweight in lower-middle-income countries is happening on account of rapid changes in food systems, particularly the availability of cheap, highly processed food and sugar-sweetened beverages, shows new research.

According to the SOFI 2020 report, the energy sufficient diet provides adequate calories for energy balance for work each day, achieved using only each country’s basic starchy staple (e.g. maize, wheat, or rice). In the report, the benchmark requirements for an energy sufficient diet and the other two diets refer to the dietary needs of an adult reference non-pregnant and non-lactating woman aged 30 doing moderate physical activity.

The cost of the energy sufficient diet is computed to identify the absolute lowest cost of meeting calorie needs from the cheapest starchy staple available in a country. The cost of the energy sufficient diet is not intended to create a realistic or typical cost of a diet; rather it represents the absolute lowest cost of calorie sufficiency. In fact, the purpose of calculating this hypothetical benchmark is to establish a lower bound on the cost of short-term survival at each place and time, and to identify the additional cost required to achieve longer-term goals specified in the other two diets. This benchmark is used in the report as a point of comparison for discussing affordability of the cost of nutrient adequate and healthy diets.

A 30-year-old woman is chosen as a reference to cost the three diets since preliminary analyses show that each country’s weighted average of the cost of the diets, obtained by calculating age- and sex-specific calorie and nutrient requirements, is very close to the cost for this reference woman.

The energy intake of the reference population is estimated to be 2,329 kcal per day by the SOFI 2020 report. This calorie content is applied across all three diets and all countries for comparability.

The cost of the diets is compared with the typical daily per capita food expenditures in each country. Under this measure, affordability is defined when the cost of each diet per person per day is lower or equal to the average food expenditure in each country. When the cost of each diet is greater than this threshold, denoting unaffordability, this measure tells how many times a diet is more expensive than the average country-specific food expenditure per person per day.

The cost of the diets is compared with the average income in each country using income distributions from the World Bank PovcalNet interface. A diet is considered unaffordable when its cost exceeds the 63 percent of the average income in a given country. Based on this threshold, this measure identifies the percentage of people for whom the cost of a specific diet is unaffordable. These proportions are multiplied by the 2017 population in each country using the World Development Indicators (WDI) of the World Bank, to obtain the number of people who cannot afford a given diet in a given country. Note that, out of the 170 countries in the analysis done by the SOFI 2020 report, information on the percentage and number of people who are not able to afford the diets is available for 143 countries.

Sustainable Development Goal-2

Please click here to check India's performance in achieving the Sustainable Development Goal-2 (SDG-2). The data is extracted from the report entitled Sustainable Development Goals National Indicator Framework Progress Report, 2020 (Version 2.1) by the National Statistical Office (NSO) of the Ministry of Statistics and Programme Implementation (MoSPI).

SDG-2 aims to end hunger, achieve food security and improved nutrition and promote sustainable agriculture.

References:

The State of Food Security and Nutrition in the World 2020: Transforming Food Systems for Affordable Healthy Diets (released in July 2020) by Food and Agriculture Organization (FAO) and other agencies of the United Nations, please click here to access

More evidence of India’s food insecurity -Vaishali Bansal, The Hindu, 24 August, 2020, please click here to access

2014 Bharatiya Janata Party Election Manifesto, please click here to access

Sustainable Development Goals National Indicator Framework Progress Report, 2020 (Version 2.1), National Statistical Office (NSO), Ministry of Statistics and Programme Implementation (MoSPI), please click here to read more

 

Image Courtesy: Inclusive Media for Change/ Shambhu Ghatak



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