How credible is the 2020 Global Hunger Index?

Liga ba artigu ida ne'e iha Tetum

The 2020 Global Hunger Index (GHI) report has sparked debate and discussion in the media and civil society, partly because the report says that Timor-Leste’s malnutrition is among the highest in the world. This article aims to explain the report’s findings and suggests how Timor-Leste can overcome malnutrition. 

The GHI report was published by two international NGOs, Welte Hunger Hilfe and Concern Worldwide, and draws on data from UNICEF, the WHO and other UN agencies. In turn, those agencies used national-level data from the Government of Timor-Leste.

The report focuses on four dimensions of hunger and malnutrition: the percentage of the total population who are undernourished; the percentage of children under five years old who are stunted; the percentage of children under five years old who are wasted; and the rate of child mortality. After collecting relevant data from each nation, the researchers processed and analyzed the data so that results can be compared among countries. Each nation’s final value consists of rates of child mortality and overall malnutrition (which contribute the majority of the score), and rates of wasting and stunting.

The final results give a score to each country. A score of zero means that a nation has absolutely no malnutrition or hunger, while a score of 100 signifies that a nation has universal hunger. Timor-Leste received a score of 37.6, with only one nation - Chad - receiving a higher (worse) score. The report therefore notes that Timor-Leste faces an ‘alarming’ situation requiring serious action. Although some countries were not scored because of lack of data (including some in the midst of conflict and crises such as Yemen and Syria), the results demonstrate that of the 107 countries with sufficient data, only one faces a situation more grave than Timor-Leste.

The information contained in the report isn’t surprising. We already know that malnutrition here is a national problem that demands everyone’s attention. The Timor-Leste Demographic and Health Survey (DHS) in 2016 showed that only 13% of infants between 6 and 23 months old receive the minimal acceptable diet. The problem of malnutrition is not limited to children; the DHS also showed that 23% of women aged 15-49 suffer anemia. 

The GHI 2020 uses data that differ from the DHS, but broadly reflect the same malnutrition problems. The table at right shows the differences between the data used in the GHI to calculate Timor-Leste’s score, and data from the 2016 DHS.

The differences between DHS data and the data used in the GHI do not mean that the GHI results are not credible. La’o Hamutuk contacted the researchers who prepared the GHI report, to confirm how they obtained the data used. They explained that they use the UNICEF, World Bank and WHO data compiled in the Joint Malnutrition Estimates database, and the World Bank’s database on child nutrition. GHI then analyzed this data, and also referred to other indicators that are known to reflect levels of stunting and wasting. GHI has been using this model for five years and they are confident that it is accurate. If they had used DHS data directly, this would have shown Timor-Leste’s malnutrition problem to be even worse; using DHS data, Timor-Leste would receive a score of 41.4, compared to 37.6 it receives using the GHI data. Whichever data source is used, it is clear that people in Timor-Leste face a very serious situation.

The reality is that many Timorese people, especially children, do not have access to enough nutritious food. This situation has a grave impact on the next generation. Lack of proper nutrition has consequences for their future health, education, productivity and capacity. This situation is complex and not easy to resolve. The availability of nutritious food is exacerbated because agricultural production is not a national priority, by reliance on rice consumption and lack of food diversity, and by the prohibitive cost of nutritious foods [reference].

In Timor-Leste, only 25% of the population lives with food security [reference]. Health conditions such as diarrhea also impact nutrition. Diarrhea is often caused by unavailability of clean water and sanitation; according to the 2016 DHS, only 50% of households have access to improved sanitation facilities (a toilet or a pit latrine), and only 58% of people in rural areas have access to potable water (which can be made safe to drink by boiling) in or close to their homes.

To address this serious situation, Timor-Leste must invest adequately in water and sanitation. We should promoting production and consumption of diverse local foods, including fishing and aquaculture to make fish available and affordable. The Ministry of Health has published recommendations about healthy diets based on foods that can be grown locally, including foods for energy such as yams, taro, rice and pumpkins; proteins such as fish, eggs, and beans; and immune-system-building foods such as healthy greens and fruits.

La’o Hamutuk continues to urge everyone, including the relevant authorities, to work together to combat malnutrition. Although we may debate the numbers in different reports, we all need to work with a clear goal and realistic plan so that more people in our beloved nation are better nourished.