Achieving Zero Hunger in India

At the time of its independence, India did not have enough production of food grains to meet its domestic demand and had to depend on imports. The Indian government’s policy response then naturally laid priority on increasing aggregate food production by launching the green revolution in the late 1960s. Once production became adequate, attention of public policy for providing food and nutritional security to the people shifted to several other areas such as household access to adequate food, enhancing purchasing power, composition of food basket, production of protein- and vitamin-intensive food items, clean drinking water, and sanitary conditions. This paper begins with a discussion of the concepts of nutritional adequacy, food security, and poverty. It then documents the evolutionary process in Indian policy response since the 1950s in SDG-2-related areas like hunger, nutrition, and food security. This is followed by an examination of the state of food and nutritional securities using several key indicators. The paper also briefly discusses how lives could be saved using a nationally functioning public distribution system and employment guarantee schemes during the COVID-19 pandemic. The paper concludes with a discussion of current efficiency and environmental concerns and possible way forward.

A puzzling aspect of India's nutrition story is that deficiencies in calorie intake and anthropometric health outcomes across states are not significantly correlated. One potential explanation is inaccurate accounting of the calorie needs of people living in different states of India. There are significant variations in the disease environments, health infrastructure, and mechanization of economies across states which necessitate different levels of calorie consumption. Using consumption survey data collected by the National Sample Survey Office in 2011–2012, and utilizing multilevel models, we show that these factors are important determinants of calorie intakes across states. Then we calculate state-adjusted calorie norm for Indian states and use them to recalibrate their prevalence of undernourishment (PoU). In addition, we show that the correlations between calorie intakes, determined by the state-adjusted calorie norms and anthropometric health outcomes, are strong and significant. Our findings suggest that for a diverse country like India, a uniform national calorie intake norm is inappropriate, leading to inaccurate estimates of calorie intake deficiencies across states.

The paper draws from the district-level food security atlases of rural Bihar and Jharkhand prepared by the Institute for Human Development (IHD). The atlases explore the dimensions and approach to measuring food security as well as the linkages with the component indicators. Food availability, access to food, and utilization of food are the three dimensions that have been delved into in detail. It identifies the ‘priority indicators’ and ‘priority districts’ which are the most food-insecure regions in both the states. The government programmes relevant to food insecurity have been briefly analysed and policy interventions have been suggested to improve the food security situation, especially in the food insecure regions of the two states. Female literacy rate, dependency ratio, disease and health behaviour, access to toilet facilities, availability of non-agricultural employment opportunities, and extent of irrigation have emerged as crucial policy variables for overall food security in Bihar. On the other hand, in Jharkhand, the value of agricultural output, availability of health institutions, and dependency ratio have emerged as priority indicators related to food security. Special welfare programmes targeted at vulnerable communities and food-insecure regions are suggested in both states to tackle food insecurity. There is also an imperative need to increase the availability and accessibility of health institutions in both states. At the same time, an increase in agricultural productivity by enhancing irrigation coverage is a crucial aspect, common for both states. An increase in dietary diversity through community and individual kitchen gardens is also suggested for improving the status of malnourishment in rural areas of Bihar and Jharkhand.

Bihar is among the poorest states in the country with a very high incidence of poverty. Although in recent years it has witnessed a high rate of growth, the state continues to be among the economically most backward states, with one of the lowest per capita incomes. During the year 2020–21, the per capita net state domestic product (NSDP) of Bihar (Rs. 46,292) was only 36 per cent of India (Rs. 128,829).

In rural areas where most of the food production takes place, nutritional deprivations are also high. In 2015–16, only 38% (45%) of 6–23-month-old children in rural (urban) India reported milk consumption at least once in the previous day with an average of 2.5 times among those who consumed. Though dairy milk plays a very important role in the growth of young children, very few studies have analysed the pattern of consumption as in this study, which also provides an understanding of its associated factors and relationship with a child’s height for age Z-score. The zero-inflated Poisson model estimates show that girls are less likely to be given milk but irrespective of gender, milk consumption increases with age. Breastfeeding affects both milk consumption and its frequency while other food items except eggs and other dairy reduce the chance of milk consumption but not its frequency. Mother’s education, economic status of the household, ownership of bovine, and higher supply of milk at the district level have differing effects on milk consumed compared to the frequency of milk consumed. Milk consumption and its frequency is positively associated with a child’s height provided it is an endogenous variable. Policies that strengthen affordability, availability, and awareness towards milk consumption would reduce large disparities in child stunting in India and improve its abysmally low global ranking.

In this chapter, the prevalence of child and adult malnutrition in India is assessed using the latest National Family Health Survey-5 (2019–21) data. Though the country has made a moderate improvement in reducing the incidence of stunting, wasting, and underweight in children and the incidence of thin adults, the issue of obesity and anaemia has emerged as significant concerns. We identified the northern and southern regions of the country to be better nourished in general than the eastern and western regions and pointed out the malnutrition hotspots using district-level maps. The determinants of malnutrition incidences are identified using multivariate regression analysis. Among different methods to combat the issue of malnutrition, biofortification is a promising one. We estimated the potential of biofortified crops to improve the nutritional outcomes in children and women using a systematic review and meta-analysis. Further, an ex ante health benefits assessment of biofortification was done using rice biofortification with zinc and iron. Finally, since awareness and perception are crucial in improving the adoption of biofortified crops, we extracted the consumer perception of biofortification and their willingness to pay through a cross-sectional survey.

Improving maternal and child health is one of the top objectives of Sustainable Development Goals (SDG). The use of maternal services can help improve both maternal and child health. However, the factors influencing such utilizations are complex and can be determined by several factors. This paper aims to examine the role of crop insurance on health-seeking behaviour among women of reproductive age. We also examine the nutritional outcome of children below 5 years. We use two nationally representative data sets and combine them using district as the common identification level. To capture the health-seeking behaviour, we use several measures of antenatal care use, safe delivery, and postnatal care as outcome variables. We use multilevel regression to find that women in districts with higher crop insurance adoption seek more antenatal care than their counterparts with lower crop insurance adoption. Further, we observe that these groups of women are more likely to opt for institutional delivery and receive postnatal care in a private facility. Apart from secondary data analysis, we also conduct a pilot survey in the two districts of Bihar. Using a sample size of 400 households, we find that households who are beneficiaries of the Government of India’s recently launched income support programme (PM-Kisan Samman Niddhi Yojna) report a greater level of food security. Women from these households seek higher early antenatal care. Finally, children from the benefited households received higher immediate postnatal care. Therefore our finding suggests that crop insurance and income support programmes for the farmers not only provide a hedge against crop loss by ensuring some degree of certainty and ensuring income smoothing but also positively impact food security for the households, improve healthcare-seeking practices by women in their reproductive age and improves child nutritional outcomes.

Achieving gender equality and empowerment has been a global goal for many years and since 2015 has been the focus of Sustainable Development Goals (SDGs) as well. Given the challenges in reducing gender inequality, there was a global consensus that national budgets should specifically focus on gender. Australia was the first country to initiate gender budgeting or gender-responsive budgeting (GRB) and presented a Women’s Budget Statement at a meeting of the Organization for Economic Co-operation and Development (OECD) Working Party on Women and the Economy in February 1985.

The second goal of Sustainable Development Agenda set in 2015 by the United Nations General Assembly seeks to end hunger and all forms of malnutrition, and double agricultural productivity by 2030. It has been laid down that sustainable access to nutritious food would require sustainable agricultural production and practices. The pathways through which agriculture affects nutritional outcomes have been well-documented; the linkages operate through improving access to food, affecting agricultural incomes and prices, and ‘feminising’ the agricultural workforce.

Despite the socio-economic development, food insecurity and malnutrition are two evils found unexpectedly high around the globe hampering one of the most important human rights, the right to health. The conditions of health of people living in poverty are disproportionately worse than others. India’s obligation to ensure food security and health for all has its roots in International Law. Similarly, the country is also bound to provide these rights under the Constitution of India and the other national legal frameworks. However, India’s position in the recent Food Security Index, as well as Health Index, highlights the inadequacies in the nation’s obligation to guarantee the availability and accessibility of quality food to ensure physical well-being to all. This socio-legal research analysed the status of food insecurity in the State of Gujarat and its impact on urban poor living in the state. The study also has analysed the journey of ‘right to food’ as a fundamental human right under the Indian Legal system and the efficacy and success ratio of the Government initiatives with reference to Sustainable Development Goals. The study found that there is a huge gap in the system as the government schemes lack accessibility and as a result, the majority of the surveyed population are out of ration and also are not utilizing other government schemes for their benefits, hence leading a miserable life.

Human desire to attain the state of being well has existed since the beginning of man’s social life. Within and across cultures, people conceptualize wellbeing differently because of its multidimensional nature. Even though the perspective towards wellbeing is totally relative, it is basically connected with one’s attitude towards quality of life and life circumstances. Among the women in fisherfolk, decrease in marine resources, institutional changes, occupational diversification, and the role of Kudumbasree initiatives have created significant changes in attitudes towards being well. This anthropological research analyses the mediating effect of three socio-cultural domains such as life experience, attitude, and life satisfaction on different aspects of subjective wellbeing. Three hundred and ten women from the marine fisherfolk families in Kozhikode district of Kerala participated in the study. The structural equation modelling proposed in the study revealed the significant influence of above three domains on subjective wellbeing with the support of thirteen sub domains including health and hunger. The model also reflects the signifiers relevant to the life satisfaction of women in a particular socio-cultural, economic, and environmental setting. The findings of the study have ethical and applied implications, if subjective dimensions of wellbeing are considered in the preparation of public policies for women and thereby attaining a life circumstance where there is zero hunger.