Undernourishment

Also called: Prevalence of undernourishment, PoU · Topic: Measuring Development: Income, HDI and Sustainability · NCERT: Class 10, Ch 1 "Development"; Class 10, Ch 2 "Sectors of the Indian Economy"; Class 11, Ch 8 "Comparative Development Experiences of India and its Neighbours"

Meaning

Undernourishment means a person's usual (habitual) food intake does not give enough dietary energy (calories) for a normal, active, healthy life. The Food and Agriculture Organization (FAO) measures it as the Prevalence of Undernourishment (PoU), which is the share of a country's people who are undernourished:

PoU (%) = (people whose usual calorie intake is below their minimum energy need ÷ total population) × 100

It matters because PoU is the official hunger measure for SDG 2.1 (end hunger). It is also one of the four indicators of the Global Hunger Index (GHI). So it shapes how India's hunger record is judged around the world.

Explanation

How it is measured

• Who measures it: FAO. It publishes PoU in its yearly State of Food Security and Nutrition in the World (SOFI) report.
• What it counts: only calories. The question is simple: does a person's normal diet give enough energy for an active life?
• "Habitual" matters: PoU looks at what people usually eat. One missed meal is not counted.
• Worked example (illustrative): a country has 10 crore people. 1.7 crore of them usually eat less energy than their bodies need.
• PoU = 1.7 crore ÷ 10 crore × 100 = 17%
• This matches India's figure in NCERT keec108 (India 17%, China 3%, Pakistan 19%).

Where the indicator is used

• SDG 2.1: PoU is the indicator for the target on ending hunger.
• Global Hunger Index: PoU is one of four indicators. The other three are:
• child stunting (too short for age)
• child wasting (too thin for height)

• child mortality

• So PoU is the only GHI indicator that covers the whole population. The other three cover only children.

What makes it rise or fall

The main cause is access to food, not availability. A country can have plenty of food and still have many hungry people.

• Poverty and prices:
• poor households cannot buy enough food, even when markets have plenty

• so their intake stays below what they need.

• A weak Public Distribution System (PDS): the PDS is the network of ration shops that sell subsidised grain. Where it works badly, poor families lose their safety net.

• Poor sanitation and disease:
• dirty water and open defecation → frequent diarrhoea and gut infections
• → the body cannot absorb nutrients

• → the person stays undernourished even after eating enough.

• Amartya Sen's entitlement approach:

• hunger comes from the failure of a person's command over food (through income, production, trade or state support), not only from a shortage of food
• this is why famines have happened even when food stocks were adequate.

Limits of the measure

• Calories only: a person can get enough calories and still lack iron, vitamins or protein. This is called hidden hunger, and PoU does not show it.
• Energy is not the same as body outcomes: PoU estimates intake. It does not measure a person's height, weight or blood (for example, anaemia).

In India

• The paradox: India has surplus food, yet about one adult in five is underweight. NCERT Class 10 Ex. 13(ii) asks why. The answer is access, not availability: poverty, PDS gaps and poor sanitation.
• The NCERT international comparison (keec108): PoU is India 17%, China 3%, Pakistan 19%.
• Body-based data from the National Family Health Survey (NFHS) show the same problem in a different way:
• women (15–49) with BMI below normal: 22.9% (NFHS-4, 2015-16) → 18.7% (NFHS-5, 2019-21) [2]

• children under 5, NFHS-4 → NFHS-5: stunting 38.4% → 35.5%, wasting 21.0% → 19.3%, underweight 35.8% → 32.1% [2].

• Gaps between states (Class 10, Ex. 13): adults aged 15–49 with BMI below 18.5:

• Kerala: 8.5% of men, 10% of women
• Madhya Pradesh: 28% for both
• All India: 20% of men, 23% of women.
• Kerala's lead comes from strong public health services, a working PDS and high female literacy. This shows that public action matters, not just income.

• NCERT labelling error: the table says NFHS-5 (2019-21), but its figures match NFHS-4 (2015-16).

• Hidden hunger in India: in NFHS-5 Phase I, more than half of children and women were anaemic in 13 of the 22 States/UTs surveyed. Anaemia among pregnant women rose in half of these States/UTs, even though more of them took iron-folic acid (IFA) tablets [3].

• Water and sanitation programmes also fight undernourishment because a healthy gut absorbs food better:
• Swachh Bharat Mission-Gramin: all villages were declared ODF (open defecation free) on 2 October 2019.
• Jal Jeevan Mission (launched 15 August 2019): rural tap-water coverage rose from 16.71% at launch to over 81% by 22 October 2025 [4].

Don't confuse with

• Undernutrition (BMI, stunting, wasting): these measure the body's outcome, such as weight, height or thinness. PoU measures calorie intake. NFHS gives the body data; FAO gives PoU.
• Hidden hunger: a lack of micronutrients (iron, vitamins) or protein. A person can have enough calories, so they are not counted in PoU, and still suffer hidden hunger.
• Child underweight: too light for age, and only for children under 5 (NFHS-5: 32.1% [2]). PoU covers the whole population and is about calories.
• Food availability: national food supply can be in surplus while PoU stays high. Undernourishment is about access and absorption, not supply alone (Sen's entitlement approach).

Prelims Hooks

• PoU is estimated by FAO and published in the SOFI report, not by WHO, UNICEF or the UNDP.
• PoU is the indicator for SDG 2.1 (end hunger). Do not confuse it with SDG 3 (health) or SDG 6 (water and sanitation).
• GHI's four indicators: undernourishment, child stunting, child wasting and child mortality. Trap: adult BMI and anaemia are not GHI indicators.
• PoU measures dietary energy (calories) only. It does not capture micronutrient deficiency (hidden hunger).
• keec108 PoU: India 17%, China 3%, Pakistan 19%.
• NFHS-5: women with low BMI 18.7% (NFHS-4: 22.9%) [2]. That is a body measure, not PoU.

Mains Points

• Hunger amid plenty: India has surplus food, yet about one adult in five is underweight. Hunger is a problem of access (poverty, prices, PDS gaps) and absorption (sanitation, disease), not supply. This is Sen's entitlement view. It means SBM-G and Jal Jeevan Mission are also nutrition programmes, alongside the PDS (GS-II/III).
• Calories are not nutrition: PoU counts only energy, so it misses hidden hunger. Anaemia persists despite IFA supply [3], and undernutrition exists alongside rising overweight (the double burden of malnutrition). Policy has to move from calories to nutrition quality, through dietary diversity and fortification.
• Know the measure: PoU (FAO, calorie-based), NFHS (body-based, Indian survey) and GHI (a mix of four indicators) answer different questions. Good policy and fair debate on India's hunger ranking need clear definitions, consistent data over time and the right source named. Kerala versus Madhya Pradesh shows that public provisioning reduces undernutrition more than income growth alone.

Related concepts

• Infant Mortality Rate
• Maternal mortality rate
• Life expectancy
• Mortality rate
• Body Mass Index
• Access to sanitation and drinking water

Read more

• Health and nutrition indicators: reading the numbers