According to Kul C. Gautam, former UNICEF Deputy Executive Director, "the 'hidden hunger' caused by micronutrient deficiency does not produce hunger as we know it." You may not feel it in your stomach, but it affects your overall health and vitality."
Our priority should be to ensure that everyone has enough food to eat. However, we must also address a type of hunger that goes unnoticed, known as hidden hunger, which, unlike the gnawing hunger of a lack of food, is often silent. Hidden hunger can have devastating consequences, resulting in mental impairment, poor health, low productivity, and even death.
The poor around the world have less varied and monotonous cereal-based diets that are deficient in essential minerals and vitamins. Food insecurity is caused by the inability to obtain food through sources such as self-production, purchase, social protection, or private charity. Rising food prices force the poor to cut back on non-essential purchases or reduce their food expenditure. Inadequate diets are linked to a 'dislocation of food supply' and food system disruptions as people lose access to farms, forests, and commons.
The gravity of the issue of nutritional security along with food security in India
According to FAO estimates in the report 'The State of Food Security and Nutrition in the World, 2020,' 189.2 million people in India are malnourished. According to this metric, 14 per cent of India's population is malnourished. In addition, 51.4 per cent of women between the ages of 15 and 49 are anaemic. Furthermore, according to the report, 34.7 per cent of children under the age of five in India are stunted (too short for their age), while 20 per cent are wasted (their weight is too low for their height). Malnourished children are more likely to die from common childhood illnesses like diarrhoea, pneumonia, and malaria.
India accounts for a quarter of the global hunger burden, with nearly 195 million undernourished people. Because of chronic malnutrition or stunting, nearly 47 million children in India, or four out of every ten, are not reaching their full human potential. Stunting has ramifications such as reduced learning capacity, poor school performance, lower earnings, and an increased risk of chronic diseases. Malnourished girls and women frequently give birth to low-birth-weight infants, which has a multigenerational impact. In India, the prevalence of overweight and obesity in children and adolescents has also increased, with life-long consequences of noncommunicable diseases in adulthood.
The government has large food security and anti-poverty programmes but there are critical gaps in terms of inclusion and exclusion errors. Women and girls are particularly disadvantaged. Despite the achievement of national food self-sufficiency, new challenges have emerged: Slowing agriculture growth, climate change, land degradation and shrinking biodiversity. Large tracts of farmlands in India have become barren due to imbalanced fertiliser use and excessive use of a single fertiliser, urea.
According to the National Family Health Survey (NFHS) 2019-21, the 5th in the series India has seen no significant improvement in health and nutritional status among her population. The latest data shows, that 7.7% of children are severely wasted, 19.3% are wasted and 35.5% are stunted. At the same time, 3.4% of children are overweight which was 2.1% in NFHS-4. Anemia among children under-5 has become significantly worse with the current prevalence as 67.1% compared to 58.6% according to NFHS-4. 57% of women of reproductive age are anaemic in the country.
The nutrition profile of Indian States/UTs presents wide variations among the different regions. Generally, data and literature reveal that the condition of poor families (children, women and men), with respect to the intake of calories, proteins, and micro-nutrients, is inferior in rural areas, poorer States, and city slums. On the other hand, the middle- and high-income populations, concentrated in Indian cities, are becoming more susceptible to so-called ‘lifestyle diseases’ and ‘binge-eating disorders’ caused by the increased availability of processed and sugary foods and drinks.
The United Nations Sustainable Development Goal (SDG) 2 has an ambitious aim to end all forms of malnutrition, including stunting and wasting in children under five years of age, and address the nutritional needs of adolescent girls, and pregnant and lactating women, and older persons. The NITI Aayog, on its part, has selected three out of the eight SDG targets under Zero Hunger to measure the country’s progress.
In the past two decades, India has made significant efforts to curb hunger and ensure food security for its people. The National Food Security Act was designed to cover the entire life cycle of food insecurity. The ambitious National Nutrition Mission(Poshan) aims at addressing stunting, anaemia, and low birth weight. Similarly, the ‘National Programme of Mid-Day Meal in Schools, as it is known today, was launched in 1995 by the Govt. of India to enhance enrolment, retention, and attendance while simultaneously improving nutritional levels among children. However, much remains to be done.
Coupling nutrition with social and economic growth
Stillbirths and infant mortality are caused by poor nutrition, whereas more biodiverse and resilient agricultural production systems can help foster improved food security and nutrition among rural populations. These interconnections can be realised by providing widespread and universal health coverage to individuals at a low cost, ensuring that no one is left behind as we move forward.
An inclusive approach centred on positioning expansive mobile healthcare service networks linked with primary health care centres as hubs, with a special emphasis on women, children, and the elderly, is critical to this approach. Businesses, regardless of their core purpose, have a clear imperative to redirect their capitals and capacities to the most underserved areas of the country; in specialised interventions with cohorts most at risk, as laid out in the SDG India Index 2020 and the SDG Investors Map 2020 published by NITI Aayog.
Hunger begins early in life when anaemic mothers are more likely to have underweight children, who continue to suffer from malnutrition due to their families' poverty. Reducing gender inequalities and social exclusion should thus be either a means to or a result of improved food security and nutrition.
And, just as a lack of trained teachers, insufficient learning materials, makeshift classrooms, and inadequate sanitation facilities make learning difficult for many children, others arrive at school too hungry, sick, or exhausted from work or household tasks to benefit from their lessons. Migration is another emerging cross-cutting factor that not only affects educational outcomes, access to health care, and acquiring market-relevant skills but also exacerbates these inequalities.
Rather than focusing solely on health, education, or employment, addressing all aspects of such multifaceted challenges is critical.
Despite rapid urbanisation and increased livelihood diversification, agriculture employs more than 60% of India's population. There is an unmistakable link between biodiversity conservation, agricultural production, and poverty in India. Land degradation is a critical issue affecting resource productivity because of increased fragmentation, overuse, unsustainable yield increased practices soil and water pollution, and surface erosion affecting one-third of Indian soil. This has a direct impact on food production systems, particularly for marginal landholders who frequently till the land for subsistence. The degradation of forests and water bodies not only creates problems with human-wildlife conflict and resource scarcity but also threatens the very existence of food production systems.
Businesses must collaborate closely with small land-holding farmers to foster a resilient food security system in communities. Agri production can be scaled for both small and marginal farmers by providing adequate water supply, as well as small productive activities such as home gardens, fruit trees, and small off-season vegetable plots, in conjunction with capacity building and imparting a package of farming practises. Furthermore, incorporating the best natural resource management practices centred on land development, soil erosion control, regenerating catchment areas for water bodies, plantation management, and forest conservation is critical for long-term agricultural sustainability.
With the shared value vision already embedded in many companies' business strategies, implementing contextual outcome-based programmes to address the growing challenge of food insecurity should not be a monumental task. The emphasis, however, must be on empowering underserved groups, such as smallholder families, through agriculture productivity enhancement programmes, particularly to encourage women farmers to grow their food, provide the best nutrition possible for their children, and go beyond subsistence to augment their disposable incomes and purchasing power to ensure a better quality of life.
What more can be done?
Today the problem is not about hunger it’s more about hidden hunger that leads to stunting in children and anaemia in women and less productivity in men accompanied with various illnesses. Today, the emphasis should be on feeding nutritious and high-quality food rather than merely feeding people. Malnutrition, rather than starvation, is the elephant in the room that must be addressed.
An overview of the malnutrition situation in India reveals that a sizable proportion of the country's population is malnourished and anaemic, and this is due to a variety of factors. Some of these factors directly cause malnutrition in people, while many others have an indirect impact. Poverty, unemployment, ignorance and a lack of education, an unhealthy lifestyle, a lack of access to nutritious food, safe water, sanitation, and hygiene, a lack of reliable and timely data, and sufficient funds, and a lacklustre performance by the government in the implementation of schemes are all significant. This, in turn, leads to the kind of nutritional deficiencies seen in Indian children.
It is worth noting that, while India has complete food security. Foodgrain production has been phenomenal in recent decades. However, access to high-quality, nutritious food remains a challenge for low-income and disadvantaged households.
According to the findings of a recent study, three out of every four people in rural areas are unable to afford the cheapest possible diet that adheres to the dietary standards established by the government's arch body.
It was expected that the fifth round of NFHS findings would reflect the improved sanitation outcomes facilitated by the Swachh Bharat Mission over the previous quinquennium. Based on the preliminary findings of NFHS-5, that appears to be a far-fetched hope.
India already has several policies in place to address the complex web of factors affecting nutrition and food security. The need of the hour is to shift the emphasis of these policies away from quantity and toward the quality of foods produced in India.
Investing in agriculture, particularly in economically disadvantaged states, can set off a chain reaction that benefits nutrition.
This can be ensured by discarding the siloed organisational structure, the pre-requisite for which is coordinated efforts by all levels of the government.