Poverty In Nepal
Anthropometric Indicators

By Shyam K. Upadhyaya

Poverty has economic as well as non-economic (social and human) dimensions. Different measures of poverty are needed to capture different aspects of poverty. One commonly used measure of income poverty is incidence of poverty or the head count ratio which is defined as the number of people as a percentage of total population whose income or expenditure falls below certain specific level of income known as poverty line.

Poverty

Poverty line, in turn, is defined as the minimum level of income required to buy minimum food calorie needs and other basic non-food needs like clothing, fuel, health, education, etc. In Nepal, the national poverty line income is specified as Rs. 4,404 per capita per year. This level of income is needed to buy 2, 124 kilocalories of food energy requirement per person per day as recommended by the National Institute of Nutrition of the Indian Council of Medical Research and to meet essential non-food needs. According to this definition 42 percent of the Nepalese people are living below poverty line.

Social indicators of poverty are used to complement income measures. The main social indicators include access to basic social services like education, health, safe drinking water, and sanitation. One could also add social exclusion (or inclusion), governance and political participation in this list. Nepal does not fare much better in social indicators either. For example, adult literacy rate and life expectancy at birth in 1997 was only 38.1 per cent and 57.3 years respectively. Similarly, the per cent of population with access to safe drinking water and sanitation in 1995 were 48 and 20 respectively.

The Human Development Reports of the United Nations Development Programme has combined income and non-income measures of poverty to devise several measures of human development and poverty. These include human development index (HDI), gender-related development index, gender empowerment measure, human poverty index, capability poverty measure, human deprivation measure, and poverty and deprivation index. For example, the HDI is constructed by combining life expectancy index, educational attainment index, and per capita income. In terms of HDI, Nepal ranked 144 out of 174 countries in 1997 with a HDI value of 0.463 out of 1.00.

Yet another set of indicators of poverty are anthropometric indicators. Three common anthropometric indicators are height-for-age, weight-for-height, and weight-for-age. Following the recommendations of the US National Centre For Health Statistics children from 6 up to 36 or 60 months old are respectively considered stunted, wasted and underweight when their height-for-age, weight-for-height, and weight-for-age fall two standard deviation
below the median of a reference population.

Stunting is an indicator of chronic malnutrition; wasting is an indicator of acute malnutrition; and underweight is an indicator of overall status of malnutrition. Although genetic factors play important role in determining the height of a person it has been argued that such factors start playing role during adolescence and that given the right environment all children have similar growth potential. In Nepal, 53 per cent of children aged 6-36 months are stunted, 16 per cent of them are wasted, and 48.6 per cent are underweight.

The economic, social, human development, and anthropometric indicators paint broadly similar picture on the status of poverty in Nepal. For example, all of these indicators show that poverty is higher in the mid-western and far-western regions and highest in the mountain. However, while income measure of poverty does not give any evidence of decline in poverty in Nepal in the past 20 years, other measures suggest some modest progress in poverty reduction.

A recent Nepal: Country Programme Evaluation (CPE) report by the International Fund for Agricultural Development (IFAD) argues that anthropometric indicators could be very useful for targeting, monitoring, and evaluating impact on beneficiaries of the development programmes in Nepal. Use of anthropometric indicators may also shed some additional insight on the nature and causes of poverty.

For example, a new International Food Policy Research Institute discussion paper Overcoming Child Malnutrition: Past Achievements and Future Choices by Lisa C. Smith and Lawrence Haddad identifies women’s education, per capita food availability, health environment, and women’s status as the main "underlying" determinants, and per capita GDP and democracy as "basic" determinants of child malnutrition as measured by the weight-for-age. Based on a cross country analysis of 63 countries over 1970-96 period, this study found that women’s education, per capita food availability, health environment, and women’s status explained 43, 26, 19, and 12 per cent reduction in child malnutrition respectively. In an another regression analysis, this study also found that the increase in per capita national income accounted for roughly 50 per cent of the total reduction in child malnutrition. The basic determinants have impact on malnutrition indirectly through their impact on underlying variables.

IFAD’s CPE mentioned above observed that stunting rates in Nepal are associated with illiteracy of mothers, violence against women, and limited frequency of feeding infants per day. The frequency of feeding, in turn, depends on the amount of food available in the household and time available to mothers for child-care. Based on the analysis of 1997 Nepal Multiple Indicator Surveillance (Fourth Cycle) data the report also finds that stunting rates are lower in mountain sites with IFAD’s Production Credit For Rural Women (PCRW) projects than in sites without projects and that wasting rates are lower in all sites with IFAD projects. The PCRW projects organized poor women into groups, empowered them through literacy, skill training, and awareness building programs, and helped them to undertake various income generation and community development activities by arranging credit and other support services and promoting mutual trust among them.

Policy

Although more careful research in the Nepalese context is needed before making generalization, the above observations taken together have important policy implications. They suggest that increase in income and food availability alone is not sufficient for alleviating poverty; an inter-sectoral approach is needed. They also imply that development interventions targeted to women have high marginal pay-offs. The above findings also lend support for promoting decentralised, democratic, participatory form of governance for poverty alleviation.