On hunger and child mortality
DESPITE rapid strides in macro-economic liberalisation, and huge expansion of anti-poverty programmes, Indias track record in mitigating the scourge of hunger remains worse than that of the poorest countries in Sub-Saharan Africa.
India has recorded an unprecedented growth in recent years. GDP per capita grew at 3.95% annually during 1980-2005, and at 5.4% annually from 2000 to 2005. Real per capita consumption growth also accelerated from 2.2% a year in the 1980s, at 2.5% a year in the 1990s, and at 3.9% a year from 2000 to 2005. Although household surveys register slower growth rates of consumption, there has been a significant reduction in poverty since the early 1980s. Yet per capita calorie intake has declined, as also of many other nutrients. More than three quarters of the population live in households whose per capita calorie intake is less than 2,100 in urban areas and 2,400 in rural areas calorie intakes regarded as minimum requirements in India. A related concern is that anthropometric indicators tell an equally dismal story. Some of these indicators are the worst in the world. Besides, improvements in these indicators are sluggish despite impressive economic growth. Indeed, according to the National Family Health Survey, the proportion of underweight children remained virtually unchanged between 1998-99 and 2005-06 from 47-46% for the age-group 0-3 years.
A recent study (Menon, P, A Deolalikar and A Bhaskar (2009) India State Hunger Index: Comparisons of Hunger Across States, Washington DC: IFPRI) draws pointed attention to stark failure in mitigating this scourge. Using a low calorie cut-off of 1,632 kcals per person (on the tenuous basis of comparability of their hunger index with the IFPRI Global Hunger Index), the average for India worked out to be 20% in 2004-05. Just three states were well above the average (viz., Tamil Nadu (29.1%), Kerala (28.6%), and Karnataka (28.1%). The average proportion of underweight children under five years denoting the proportion of children in each state whose weight-for-age was less than two standard deviations below the WHO reference was as high as 42.5%. Bihar (56.1%), Jharkhand (57.1%) and MP (59.8%) were among the worst performers. The third indicator, under-five mortality rate (deaths per hundred), averaged 7.4, with UP (9.6), Jharkhand (9.3) and MP (9.4) among those with the most dismal performance.
Building on this analysis, we focus in greater detail on the factors underlying each of these facets of hunger. Our remarks, however, are confined to under-five mortality rates. Not surprisingly, the higher the proportion of underweight children, taking into account its own endogeneity, the higher was the under-five mortality rate. Also, the larger the increase in the Consumer Price Index for Agricultural Labourers (CPIAL), the greater was the mortality rate. If wages adjust with a lag to rising food prices, real wages fall, as also nutrient intake. For child mortality to be higher, the intake of micronutrients (e.g., iron, zinc, vitamin A and iodine) must be lower. As the latter is already low especially in large segments of the rural populations even a mild income shock could precipitate a rise in child mortality.
What is indeed surprising is the strong positive effect of income inequality. Our simulations suggest that if the Gini coefficient of income inequality reduces by 30% a magnitude of reduction that may not be feasible without a drastic reordering of the existing social and economic arrangements the under-five mortality rate falls from 7.4% to 5.15% (a reduction of about 30%). What is implicit in this relationship is that high income inequality is in many cases synonymous with acute and pervasive deprivation (e.g., tottering rural infrastructure of medical services, dismal hygiene and sanitary standards, and abysmally low female literacy).
In the so-called BIMARU states, for example, not only have living standards persisted at very low levels but they are also characterised by high inequality. Thus deprivation in some of its brutishness retains its salience in these states. Analysis of residual variation in under-five mortality rates unravels a striking result: the greater the exposure to the mass media, the lower is the mortality rate. So, while the scourge of hunger is a daunting one, the prospects of success in the battle against it in an open democratic regime are far from bleak.
RAGHAV GAIHA VISITING FELLOW AT HARVARD CENTRE FOR POPULATION AND DEVELOPMENT STUDIES. CO-AUTHORED BY S KULKARNI, LECTURER IN SOCIOLOGY, HARVARD UNIVERSITY.