2023 GLOBAL HUNGER INDEX

Frequently Asked Questions – India

1. What is the Global Hunger Index?

The Global Hunger Index (GHI) is a peer-reviewed report, published on an annual basis by Concern
Worldwide and Welthungerhilfe. The GHI is a tool designed to comprehensively measure and track
hunger at global, regional, and national levels, reflecting multiple dimensions of hunger over time.
The report aims to raise awareness and understanding of the struggle against hunger, provide 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.

2. How is the GHI calculated?

Each country’s GHI score is calculated based on a formula that combines four indicators that
together capture the multidimensional nature of hunger:
• Undernourishment: the share of the population whose caloric intake is insufficient;
• Child stunting: the share of children under the age of five who have low height for their age,
reflecting chronic undernutrition;
• Child wasting: the share of children under the age of five who have low weight for their
height, reflecting acute undernutrition; and
• Child mortality: the share of children who die before their fifth birthday, reflecting in part
the fatal mix of inadequate nutrition and unhealthy environments.
For more information visit the GHI methodology webpage.

3. What does the 2023 GHI tell us about the hunger situation in India?

India’s 2023 GHI score is 28.7, considered serious according to the GHI Severity of Hunger Scale. This
is a slight improvement from its 2015 GHI score of 29.2, also considered serious, and shows
considerable improvement relative to its 2000 and 2008 GHI scores of 38.4 and 35.5, respectively,
both considered alarming. India is ranked 111th out of 125 countries included in the ranking in the
2023 GHI report. India's child wasting rate, at 18.7 percent, is the highest child wasting rate in the
report; its child stunting rate is 35.5 percent; its prevalence of undernourishment is 16.6 percent;
and its under-five mortality rate is 3.1 percent.

4. Can the 2023 data and ranking be compared to data and rankings from previous reports?

The 2023 GHI report provides comparisons between countries for 2000, 2008, 2015, and 2023 GHI
scores and indicator values. It is not valid, however, to compare the data and ranking published in
the 2023 GHI report with the data and ranking published in the 2022 GHI report, or any other past
reports. This is because each year, the data are revised, the set of countries included in the ranking
changes, and the methodology may also be revised (see Appendix A of the 2023 GHI or the
explanation of the methodology on our website). Consequently, given the nature of the data
underlying the calculation of GHI scores, the 2000, 2008, 2015, and 2023 GHI scores and indicator
values published in the 2023 GHI report are the only historical data that can currently be used for
valid comparisons over time.

5. Which data were used to calculate the 2023 GHI score for India?
The following values for the GHI component indicators were used to calculate India’s 2023 GHI
score: The prevalence of undernourishment value is 16.6 percent, as reported in the 2023 State of
Food Security and Nutrition in the World (SOFI) report. The child mortality value is 3.1 percent, as
reported in the United Nations Inter-Agency Group for Child Mortality Estimation’s (UN IGME) latest
report, published in January 2023. The child stunting value is 35.5 percent, and the child wasting
value is 18.7 percent; these are the values from India’s National Family Health Survey (2019–2021)
(NFHS-5) as reported in the Joint Malnutrition Estimates Joint Data Set Including Survey Estimates
(2023 edition).

In the compilation of the stunting and wasting values, we prioritize and use survey estimates that
have been vetted for inclusion in the Joint Malnutrition Estimates and/or the WHO Global Database
on Child Growth and Malnutrition, wherever possible. The GHI uses the same data sources for all
countries to calculate the respective country scores. This ensures that all the rates used have been
produced using comparable methodologies. Introducing exceptions to this process for any country
or countries would compromise the comparability of the results and the ranking.

6. What changes would be needed to improve India’s ranking?

India has demonstrated significant political will to transform the food and nutrition landscape. Some
examples are the National Food Security Act, Poshan Abhiyan (National Nutrition Mission), PM Garib
Kalyan Yojna and National Mission for Natural Farming. However, there is still room for
improvement. India would likely see the greatest improvements in its GHI scores and ranking, as well
as in the on-the-ground well-being of its children, by addressing its high rates of child wasting and
child stunting. India’s child wasting rate, at 18.7 percent, is the highest of any country in the report,
and its child stunting rate, at 35.5 percent, is the 15th-highest in the report. Of course, a decrease in
India’s GHI score does not guarantee an improvement in its ranking if other countries reduce their
GHI scores by equal or greater amounts. For India to improve in the ranking, it would need to
improve more than other countries in the report. It is important to remember that the rankings in
GHI reports cannot be validly compared from year to year (see #4).

7. How does India compare with its neighboring countries?

To compare India with its neighboring countries individually, please see Appendix B and Appendix C
or the respective country pages on the GHI website to see how the GHI scores and indicator values
(prevalence of undernourishment, child stunting, child wasting, and child mortality) of these
countries compare with those of India.

Over the long term, GHI scores can reflect underlying conditions such as inequality, poverty,
governance, and demographic conditions, as well as shocks and crises such as economic downturns,
climate extremes and conflict. The effects of crises on the indicators used in the calculation of GHI
scores can vary from country to country. Depending on the preexisting vulnerability of the
population and a country’s social protection measures, an economic crisis may or may not manifest
as increases in the prevalence of undernourishment, child stunting, child wasting, and/or child
mortality, affecting the extent to which the crisis results in changes in GHI scores.

8. Why is the report called a “Hunger Index” and not a “Nutrition Index”?

To capture the complex problem of hunger, the GHI report reflects the consequences of deficiencies
in calories as well as deficiencies in micronutrients (known as “hidden hunger”). According to the
World Health Organization and the UN Food and Agriculture Organization, hidden hunger occurs
when the quality of food people eat does not meet their nutrient requirements, so that they are not
getting the essential vitamins and minerals they need for their growth and development.
Deficiencies in calories and micronutrients are reflected in the four component indicators used to
calculate the GHI (prevalence of undernourishment, child stunting, child wasting, and child
mortality). These deficiencies may result from a range of underlying factors, including household
food insecurity; inadequate maternal health or childcare practices; or inadequate access to health
services, safe water, and sanitation.

9. What is the difference between famine and hunger?

The problem of hunger is complex, and different terms are used to describe its various forms.
Undernourishment, as defined by the Food and Agriculture Organization of the United Nations
(FAO), is the habitual consumption of too few calories to provide the minimum dietary energy an
individual requires to live a healthy and productive life, given that person’s sex, age, stature, and
physical activity level. Undernutrition goes beyond calories and signifies deficiencies in any or all of
the following: energy, protein, and/or essential vitamins and minerals. Undernutrition is the result of
inadequate intake of food in terms of either quantity or quality, poor utilization of nutrients due to
infections or other illnesses, or a combination of these immediate causes.

While many countries experience widespread hunger, famine is a specific term defined by the UN as
occurring when certain conditions are met: when at least 20 percent of the population faces
extreme food shortages, acute child malnutrition rates exceed 30 percent— meaning that children
experience the most extreme and visible form of undernutrition—and two out of 10,000 people die
from starvation or the interaction of malnutrition and disease on a daily basis.

India has long fought to ensure that the country would have a sufficient food supply to avert the
devastation of famine experienced many decades ago. Indeed, the increases in rice and wheat yields
brought about during India’s Green Revolution largely helped to establish India’s steady food supply,
particularly of staple grains. These advances have ensured that famine in India has not been a threat
in recent history. However, the Global Hunger Index is a multidimensional measure of hunger that
reflects not only calorie deficiencies but also undernutrition, and it is child undernutrition, in
particular, that drives up India’s GHI score. There are huge opportunities for India to tackle the full
range of factors affecting all forms of hunger and undernutrition, just as it successfully tackled
famine in past decades.

10. What is the reason for the choice of GHI indicators, and how can it be representative of
the entire population if three out of the four indicators are related to the nutrition and
health of children?

The Global Hunger Index report is peer reviewed by external experts and the methodology has long
been established and tested. The GHI incorporates four indicators to reflect the multidimensional
nature of hunger. Together, they reflect deficiencies in calories as well as in micronutrients. These
indicators are part of the internationally recognized set of indicators designed to measure progress
toward the Sustainable Development Goals (SDGs), particularly SDG 2 “Zero Hunger,” upon which
the international community—including India—agreed. The prevalence of undernourishment is an
indicator for SDG 2.1, on ensuring access to safe, nutritious, and sufficient food for all. Child stunting
and wasting rates are indicators for SDG 2.2, on ending all forms of malnutrition. Reducing child
stunting and wasting by 2025 are also internationally agreed World Health Assembly targets.
Reducing preventable deaths of children under five years of age is listed as SDG 3.2.

By combining the proportion of undernourished in the population (1/3 of the GHI score) with the
indicators relating to children under age five (2/3 of the GHI score), the GHI captures both the food
supply situation of the population as a whole and the effects of inadequate nutrition within a
particularly vulnerable subset of the population.

Three out of four indicators used in the calculation of the Global Hunger Index relate primarily to
children because children are particularly vulnerable to nutritional deficiencies. A deficiency of
nutrients places them at high risk of physical and mental impairment and death. The most critical
time for good nutrition is the 1000-day window from the beginning of the mother's pregnancy to a
child's second birthday. Child stunting has been shown to be associated with impaired early motor
and cognitive development, with potentially life-long consequences for the individual and for society
as a whole. Child wasting is the most immediate, visible, and life-threatening form of malnutrition,
resulting from the failure to prevent malnutrition among the most vulnerable children. Child
mortality reflects that death is the most serious consequence of hunger, and children are the most
vulnerable. It also improves the GHI’s ability to reflect deficiencies of essential vitamins and
minerals. For many children who die from infectious diseases, the indirect cause of death is a
weakened immune system due to a lack of dietary energy, vitamins, and minerals. Since the first
three indicators—the proportion of undernourished and the prevalence of stunting and wasting in
children—do not capture premature death as the most tragic consequence of hunger, the under-five
mortality rate is also included.

11. How representative is the indicator “prevalence of undernourishment”?

The prevalence of undernourishment indicator is calculated by the experts of the Food and
Agriculture Organization of the United Nations (FAO) using several factors. Prevalence of
undernourishment takes into account the average per capita availability of food as obtained through
carefully constructed food balance sheets. Food balance sheets are based primarily on data officially
reported by the member countries, including India.

Prevalence of undernourishment also considers the calorie requirements of the population (based
on data on age distribution for males and females, distribution of heights, and other key
determinants of dietary energy requirements). Also, prevalence of undernourishment takes into
account the distribution of calorie intake in the population as estimated through official
consumption surveys conducted by governments. When governments do not provide recent
consumption survey data, changes in the distribution of calorie intake in the population are
estimated using the Food Insecurity Experience Scale (FIES) survey data, collected as part of the
Gallup World Poll, which has a sample size of 3,000 in India. India has not undertaken a household
consumption survey since 2011. The methodology for estimating prevalence of undernourishment is
described in FAO’s State of Food Security and Nutrition in the World 2023 report (Annex 1B).

Prevalence of undernourishment values calculated in this way are used to measure progress toward
the SDGs. Likewise, the GHI uses prevalence of undernourishment values reported by FAO whether
or not governments have provided official consumption survey data.

12. Why has India’s prevalence of undernourishment worsened if its per capita dietary energy
supply, as estimated by the Food and Agriculture Organization, has increased year-on-year
owing to enhanced production of major agricultural commodities in the country?

India’s per capita dietary energy supply has gone up somewhat in recent years. However, this
increase has been offset by increases in the incidence of caloric losses at the retail distribution level,
increased dietary energy requirements of the population, and an increased coefficient of variation (a
measure of the inequality of caloric intake across a given population). As a result, India’s prevalence
of undernourishment has increased somewhat each year between 2016–2018 and 2020–2022.
 13. Can height and weight of children even be compared between countries given genetic
differences?

Children are considered stunted or wasted if their height-for-age or weight-for-height, respectively,

deviates substantially from the internationally recognized global WHO Child Growth Standards.
Some have argued that India’s rates of child wasting and child stunting are high because Indian
children are genetically shorter and thinner than other children in the world.

The WHO Child Growth Standards are based on the WHO Multicentre Growth Reference Study
(MGRS), which generated curves for assessing the growth and development of children the world
over. The MGRS collected primary growth data and related information from healthy breastfed
infants and young children from diverse backgrounds and cultural settings, including India. After
data collection (which spanned five years to create a database for children growing in their first five
years of life), the data from the different parts of the globe were slightly but not statistically
significantly different, meaning there were no significant differences in how children were growing,
provided they grew up in an optimal environment. The WHO Child Growth Standards therefore
depict normal early childhood growth under optimal environmental conditions and can be used to
assess children everywhere, regardless of ethnicity, socioeconomic status, and type of feeding.
There is no doubt that genetic factors influence individual height. A wide variation in height can
therefore be observed among healthy, well-nourished children of any given age. The WHO Child
Growth Standards consider this by allowing for a range of heights around the age-specific middle
values in the growth curves. Children are considered stunted only if their height deviates
considerably from the middle value defined for their age (that is, their height-for-age is more than
two standard deviations below the median of the WHO Child Growth Standards).

Contact:

For any questions, please contact Miriam Wiemers, Senior Policy Advisor Global Hunger Index:
miriam.wiemers@welthungerhilfe.de

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