UNICEF’s latest report, Child Food Poverty: Nutrition Deprivation in Early Childhood, spotlights a critical gap in the progress the world has made: millions of parents and families worldwide struggle to provide nutritious and varied food essential for young children’s growth, development, and learning.¹ This problem, termed “child food poverty,” is catalysed by increasing economic inequality, conflicts, climate crises, rising food prices, the prevalence of unhealthy foods, harmful marketing practices, and poor child feeding practices.

According to UNICEF’s Report, 440 million children under five years worldwide live in child food poverty, of whom 181 million live in severe food poverty. Despite some progress, severe child food poverty rates have stagnated for over a decade. In the 92 countries from which data are available, the proportion of children living in severe child food poverty ranges from 1 per cent in Belarus to 63 per cent in Somalia. Almost two-thirds of affected children live in just 20 countries. Only seven countries have a higher proportion of children living in severe child food poverty than India (40 per cent).

UNICEF defines child food poverty as the lack of access to and consumption of a nutritious and varied diet in early childhood, that is, during the first five years of life. This condition is assessed using the dietary diversity score developed by UNICEF and the World Health Organization (WHO). To meet the minimum dietary diversity for healthy growth and development, children need to consume foods from at least five out of the eight defined food groups, namely, (i) breastmilk; (ii) grains, roots, tubers, and plantains; (iii) pulses, nuts, and seeds; (iv) dairy products; (v) flesh foods (meat, poultry, and fish); (vi) eggs; (vii) vitamin A-rich fruits and vegetables; and (viii) other fruits and vegetables.

If children are fed:

• 0–2 food groups a day, they are living in severe child food poverty – according to the Report, 40 per cent of Indian children belong to this group;
• 3–4 food groups a day, they are living in moderate child food poverty – according to the Report, 36 per cent of Indian children belong to this group; and
• 5 or more food groups a day, they are not living in child food poverty – according to the Report, 24 per cent of Indian children belong to this group.

According to the Report, in India, only one out of four children (24 per cent) is not living in child poverty. Forty per cent of Indian children are living in severe child food poverty, and 36 per cent in moderate child poverty.

The National Family Health Survey (NFHS) gathers information on minimum acceptable diets among children aged 6–23 months. The requirements of a child in this age-group includes breastmilk, other milk or milk products, minimum dietary diversity, and minimum meal frequency as per WHO guidelines. According to NFHS-5, in 2019–21, only 11 per cent of India’s 6- to 23-month-old children received a minimum acceptable diet.

The proportion of children aged 6–23 months who received a minimum acceptable diet was 10.4 per cent among Other Backward Classes, 10.8 per cent among Scheduled Castes, 11.2 per cent among Scheduled Tribes, and 12.6 per cent among Others. The proportion of children aged 6–23 months who received a minimum acceptable diet was 10.6 per cent among Hindus, 11.9 per cent among Sikhs, 12.2 per cent among Muslims, and 17.5 per cent among Christians.

Two findings from the UNICEF report are indisputable. First, child food poverty is not a matter of national (or State) income per capita alone. To illustrate, in 2019–21, 35 per cent of children below five were stunted in four Indian States, where the per capita State Domestic Product (in 2021–22) varied from Rs 102,965 in Assam and Rs 120,704 in Chhattisgarh to Rs 215,233 in Maharashtra and Rs 265,623 in Karnataka. Similarly, only 23 per cent of children below five were stunted in Kerala and Manipur, even though in 2021–22, Manipur’s per capita income at Rs 91,560 was less than 40 per cent of Kerala’s per capita income of Rs 233,855.

At the same time, and somewhat counterintuitively, there are very small differences in minimum acceptable diet patterns across wealth quintiles. In 2019–21, the proportion of children aged 6–23 months who received a minimum acceptable diet was 10.2 per cent in the lowest quintile, 9.8 per cent in the second quintile, 12 per cent in the fourth quintile, and 12.7 per cent in the highest wealth quintile.

Secondly, the UNICEF Report points out that severe child food poverty significantly contributes to child undernutrition, with higher rates in countries with prevalent stunting. This is true of India as well where low dietary diversity significantly correlates with faltering growth among children. The analysis by Saha et al. using data from the National Family Health Survey-4 for 2015–16, for instance, shows that inadequate minimum dietary diversity (less than four food groups) markedly raises the risk of stunting, wasting, and being underweight among children aged 6–23 months.² The study also highlights the fact that children who do not consume dairy products, eggs, and a variety of fruit and vegetables are more prone to severe forms of stunting, wasting, and being underweight.

There are other important factors, including the nutritional status of mothers and access to safe drinking water and proper sanitation, that affect child nutrition.

The Government of India has decided that, in addition to the entitlement of subsidised food under the National Food Security Act, it shall provide free food grain to about 814 million beneficiaries under the Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY) for a period of five years with effect from January 1, 2024. This is an acknowledgment that high economic growth in itself is not sufficient to ensure benefits to a large majority of the population – especially the poorest and most deprived sections of the population.

Three lessons emerge from a careful reading of the UNICEF and NFHS-5 reports. First, “rich” Indian States cannot become complacent and ignore the problem of child food poverty or under-nutrition among children. Secondly, “poor” States do not have to become “rich” in order to end child food poverty or reduce stunting among children. Thirdly, if India has to become viksit (developed) by 2047, one of its most important goals should be to eliminate stunting among children.