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Diversity in Calorie Sources and Undernourishment during Rapid Economic Growth

This paper compares the experiences of India and Vietnam in dietary diversity and undernourishment from the early 1990s to the middle of the first decade of the new millennium. Both these countries recorded high economic growth rates and large poverty reductions during the late 1990s following a set of economic reforms. However, while Vietnam recorded large reductions in its undernourishment rates, the reverse was true for India. The Vietnamese, with their intervention programmes aimed at nutrient enhancement, have managed their growth process ensuring a positive association between reduction in expenditure-based poverty and calorie-based under-nutrition, in a manner that has lessons for other high growth achievers such as India.

SPECIAL ARTICLEEconomic & Political Weekly EPW february 23, 200851Diversity in Calorie Sources and Undernourishment during Rapid Economic GrowthRanjan RayThis paper compares the experiences of India and Vietnam in dietary diversity and undernourishment from the early 1990s to the middle of the first decade of the new millennium. Both these countries recorded high economic growth rates and large poverty reductions during the late 1990s following a set of economic reforms. However, while Vietnam recorded large reductions in its undernourishment rates, the reverse was true for India. The Vietnamese, with their intervention programmes aimed at nutrient enhancement, have managed their growth process ensuring a positive association between reduction in expenditure-based poverty and calorie-based under-nutrition, in a manner that has lessons for other high growth achievers such as India. The issue of nutritional adequacy of existing food consump-tion patterns, and the calorific implications of dietary changes in countries experiencing significant political and economic reforms has recently attracted considerable attention in the nutrition literature [Hop 2003; Meenakshi and Vishwanathan 2003; Dien, Nguyen and Bentley 2004; Thang and Popkin 2004] and, more generally, among welfare econo-mistsworking in the areas of poverty and undernourishment [Svedberg 2000; Molyneaux and Rosner 2004; Radhakrishna 2005; Ray and Lancaster 2005; Sen 2005; Ray 2007; Suryanaray-ana and Silva 2007]. Thanks largely to increased information on food consumption patterns at a fairly disaggregated level of food items provided by several nationwide household expenditure surveys, the interest in food and nutrition security in the context of poverty has extended from development economists to nutri-tion experts and dieticians. The affinity between the subjects of poverty, development, agriculture and nutrition has been strengthenedby the growing realisation that lifestyle changes unleashed in the process of economic transformation can lead to significant dietary changes that, in turn, have major developmentalandnutritional implications. The analytical im-petusfortheblurringof the dividing line between the fields of poverty studies and nutrition has come from the fact that in several developing countries (for example, India, Indonesia and Vietnam), the poverty line was originally anchored to a calorie norm defined as the minimum calorie requirement for subsistence living. The calorie-based poverty lines were originally derived from the calorie costs based on the food expenditure pattern in a given year. While these poverty lines have been periodically adjusted upwards to account for food price inflation without revisiting their original calorie basis, there has not been any systematic attempt to investigate whether the original nexus between the calorie norm and poverty line has remained intact in the face of large dietary changes.Evidence from India reported in Ray and Lancaster (2005) sug-gests a wide divergence between the rate of prevalence of under-nutrition (POU) and the rate of expenditure poverty (POV). Such a divergence is caused by dietary changes leading to changes in calorie composition by food item source that result in a dis-sonance between calorie price inflation and food price inflation. Consequently, there have been several attempts by investigators involved in poverty analysis to undertake analysis of dietary changes and their nutritional implications. The present study is in this tradition. While there are examples of individual country studies [for example, Dien et al (2004) on Vietnam, Sen (2005) on India, Molyneaux and Rosner (2004) on Indonesia], there is Financial support for this study, provided by a discovery grant from the Australian Research Council, and the research assistance of Vinod Mishra and Elkana Ngwenya are gratefully acknowledged. An earlier version was presented at an international seminar on poverty in Patna, in July 2007, organised by the Institute of Human Development, Delhi and at the Nutrition Society of Australia (Tasmanian branch) in Hobart in August 2007.Ranjan Ray (Ranjan.Ray@utas.edu.au) is at the School of Economics and Finance at the University of Tasmania.
SPECIAL ARTICLEfebruary 23, 2008 EPW Economic & Political Weekly52Table 2: Per Capita Consumption of Food Items and Their Shares of Food Expenditure in VietnamFood Item Rural Urban 1992-93 1997-98 2002 20041992-93 1997-98 2002 2004Per capita consumption (kg/month) Rice 18.31 17.75 19.01 18.45 14.73 12.93 14.56 13.91 Wheat 0.18 0.30 0.39 0.12 0.85 0.72 0.76 0.30 Othercereals 1.08 1.03 1.08 1.39 0.91 1.14 0.96 1.47 Vegetables 7.58 5.18 4.54 3.97 5.55 5.10 4.29 3.73 Fruits 1.61 1.89 1.24 1.22 2.86 2.60 1.64 1.54 Meats 1.00 1.48 1.69 1.79 1.75 2.18 2.55 2.37Fish 1.26 1.51 1.75 1.751.78 1.60 1.921.89 Dairy 0.01 0.04 0.23 0.10 0.08 0.19 0.48 0.39 Alcoholicbeverages 0.44 0.63 0.65 0.92 0.52 0.70 0.46 1.05 Otheritems1(a) 0.61 0.69 5.12 2.48 0.65 0.74 7.76 2.94Share of total food expenditure (%) Rice 73.92 69.42 36.65 33.74 82.29 79.89 22.16 20.33 Wheat 0.33 0.59 0.84 0.35 0.83 0.69 1.09 0.65 Othercereals 2.53 2.08 2.51 2.99 0.65 0.83 1.82 2.46 Vegetables 4.55 4.16 6.24 3.08 1.72 1.88 5.50 2.94 Fruits 2.34 3.04 2.86 1.49 4.91 3.83 3.93 2.10 Meats 8.13 10.26 18.88 19.97 4.19 5.53 22.07 21.78 Fish 4.30 4.94 9.72 9.62 2.70 2.56 9.83 10.03 Dairy 0.05 0.16 1.68 0.67 0.12 0.48 3.12 1.90 Alcoholicbeverages 1.23 1.70 1.84 2.29 0.90 1.23 1.18 2.48 Other items2(b) 2.62 3.50 17.04 18.25 1.68 2.53 18.48 18.04 Eating out (c) 0.00 0.14 6.49 7.54 0.0004 0.56 16.74 17.29(a) Other items1 include items which cannot be categorised into any of the main categories but quantity information was available for them, for example, cake, candid fruits, sweets, salt, sugar, coffee, etc. (b) Other items2 include all commodities under other items1 plus those commodities for which quantity information was not given but only the expenditure figures were given (for example, other sea food, carbonated beverages, items classified as “others” in questionnaire) but excluding food eaten outside.(c) Eating out refers to the food consumed outside home, i e, purchased pre-cooked meal.Source: Author’s calculations.a relative lack of studies that compare the dietary experiences of countries experiencing rapid economic growth. Such a compara-tive analysis is the principal motivation of this paper. This exercise has chosen two countries, notably India and Vietnam, which have experienced some of the highest rates ofGNP growth and poverty reduction in the 1990s. Moreover, both these countries have undertaken significant economic reforms after ex-periencing sluggish economic growth and little improvement in living standards in the early 1980s. Further, both these countries have, in proximate years, nationwide household expenditure sur-veys providing disaggregated quantity information on food con-sumption and corresponding calorie intake levels. As this study concludes, there are some significant differences between the Indian and Vietnamese experiences that can provide policy lessons for other contexts.The rest of this paper is organised as follows. Section 1 describes the data sets and compares the per capita consumption of food items between the two countries. Section 2 compares the calorie shares of the food items between India and Vietnam. Section 3 provides comparative evidence on the magnitude of under-nourishment and changes in the POU rates during the 1990s in the two countries. Section 4 provides Vietnamese evidence on some of the principal determinants of the calorie shares andthecalorieintake levels. The paper ends on the concluding note of Section 5.1 Data Sets and Food Consumption PatternsThe Indian data sets used in our analysis are from the 43rd (July 1987 – June 1988), 50th (July 1993 – June 1994), 55th (July1999 – June 2000) and 57th (July 2001 – June 2002) rounds of the National Sample Survey (NSS). The 55th round data pro-vides information, at the household level, on calorie intake. These were used to calculate calorie conversion factors that, in conjunction with those provided in Gopalan et al (1999), were used to calculate the calorie intake levels from the various food items in the other NSS rounds. To calculate the POU rates, we used the age gender specific daily calorie requirements for rural Indians that are available from the web site, www.medindia.net. Theseestimates are close to, though not exactly the same as, the energy allowances recommended by an expert group of the Indian Council of Medical Research [ICMR 2002]. The corre-sponding urban figures were obtained by scaling down these numbers by a factor of 0.875, consistent with the rural/urban differential in calorie norms used by India’s Planning Commis-sion in the setting up of India’s poverty lines. A household is classified as “undernourished” if its observed calorie intake is less than its required amount, given its household size and composition. The POU is, then, measured as the percentage of households who are unable to meet their daily calorie require-ment. The POU measure has been used extensively by the Food and Agricultural Organisation (FAO) in worldwide calculations of hunger [FAO 1992].The Vietnamese data on food consumption is contained in the two Vietnamese living standard surveys (VLSS) that were carried out in 1992/93 and 1997/98, and the Vietnamese household living standard surveys (VHLSS), 2002 and 2004. These surveys Table 1: All-India Mean Consumption and Expenditure SharesFood Items Urban Rural 1988 2002Change1988 2002Change (Round 43) (Round 57) (%) (Round 43) (Round 57) (%)Consumption/capita (kg/30 days) Rice 5.65 4.85 -14.2 7.35 6.79 -7.7 Wheat 4.57 4.03 -11.70 4.80 4.05 -15.7 Other cereals 0.83 0.56 -32.5 2.59 1.38 -46.8 Total cereals 11.05 9.44 -14.5 14.74 12.22 -17.2 Pulses 1.06 0.86 -18.8 0.97 0.77 -20.9 Dairy 4.52 5.25 16.2 3.34 3.94 17.9 Edibleoils 0.56 0.69 23.6 0.35 0.51 45.4 Meat/fish/eggs 2.01 2.49 23.8 0.91 1.50 65.6 Veg/fruit 11.46 13.44 17.3 6.99 9.48 35.6 Sugar/spices 1.63 1.46 -10.4 1.53 1.34 -12.7Share of total food expenditure (%) Rice 16.33 14.06 -13.9 24.97 21.32 -14.6 Wheat 9.07 8.70 -4.1 10.99 9.58 -12.8 Other cereals 1.80 1.18 -34.4 5.87 2.83 -51.7 Total cereals 27.20 23.94 -12.0 41.83 33.73 -19.3 Pulses 6.16 5.66 -8.1 6.48 6.31 -2.6 Dairy 13.23 15.71 18.7 9.87 12.02 21.8 Edibleoils 8.65 6.55 -24.4 7.41 6.53 -11.9 Meat/fish/eggs 5.37 5.58 4.0 4.27 5.34 25.1 Veg/fruit 12.29 15.03 22.3 10.32 14.56 41.1 Sugar/spices 8.12 7.44 -8.4 8.73 8.36 -4.2 Processed food 13.59 13.49 -0.7 8.28 9.31 12.5 Beverages 5.38 6.61 22.8 2.83 3.83 35.5Share of total expenditure (%) All food 66.1 50.0 -24.4 72 60.9 -16.1Source: Own calculations based on NSS Rounds 43, 57, reported in Ray (2007).
SPECIAL ARTICLEEconomic & Political Weekly EPW february 23, 200853of total food expenditure between 1988 and 2002. Table 2 (p 52) presents the corresponding informa-tion for Vietnam between 1992/93 and 2004. There are some significant differences between the food consumption patterns in the two countries. Rice, both in terms of physical consumption and expendi-ture shares, is of much greater importance in the Vi-etnamese diet than in the Indian case. The reverse is the case for vegetables and fruits. Dairy products hardly figure in the Vietnamese diet, yet (in both quantity and expenditure share terms) they are as important as rice in the Indian diet. Note, inciden-tally, that the aggregated Indian figures at the all India level hide significant regional variation in food habits, as reported in Ray (2007). One point of similarity between the Indian and Vietnamese expe-riences is that both countries recorded a decline in the consumption of rice during the 1990s in favour of meat and fish. However, the decline in the expendi-ture share of rice has been much higher in Vietnam, than in India, especially in the late 1990s and dur-ing the turn of the century. In other words, though the Indian diet is much less dependent on the cereal items, especially rice, there has been much greater diversification away from rice in case of Vietnam dur-ing the late 1990s. However, even in the new millen-nium, rice alone constituted a much greater share of food expenditure in Vietnam than all the cereal items together in the case of India.2 Calorie Shares of Food ItemsThe above discussion raises the question of whether the expenditure shares of various food items in the two countries match the calorie composition of the Indian and Vietnamese di-ets. Evidence on this is contained in Tables 3 and 4, which report thecalorieshares of the various food items in India and Vietnam, respectively. The earlier discussion is consistent with these tables. Rice enjoys a much higher calorie importance in Vietnam than in India, though the difference narrowed markedly in the new mil-lennium. However, one point of departure from the earlier re-sults is that while there was a marked decline in the calorie share of rice in the 1990s in both rural and urban Vietnam, though of a smaller order than its share of food expenditure, there was an increase in the calorie share of rice in rural India. In both coun-tries, the nutritional importance of rice, as reflected in its calorie share, is of much higher order than that suggested by its expendi-ture share. This confirms that, in both countries, rice and other cereal items were performing a useful role as an inexpensive calorie source, especially for poorer households.This is underlined by the Indian evidence presented in Table 5, which reports the calorie shares of food items in rural and urban India in 2001-02 by the three expenditure percentiles. In both sec-tors, the calorie importance of rice and the other cereal items in the Indian diet decreases, quite sharply in case of the latter,as we move to the more affluent households. In contrast, while there is a marginal increase in the calorie shares of vegetables/fruits Table 3: Changes in the Calorie Share in Food Items in India(1987-88 and 2001-02,in %)NSS Round Rice Wheat Other Pulses Dairy Edible Meat/Fish Veg/ Sugar/ Processed Beverages Total CerealsOilsEggsFruitSpicesFoodCerealsRural shares Round 43 (1987-88) 38.0 22.40 12.90 4.6 5.0 4.4 0.7 4.0 5.8 2.0 0.1 73.32 Round 57 (2001-02) 42.98 18.04 7.07 4.03 6.48 7.27 1.02 5.73 5.87 1.31 0.20 68.09Urban shares Round 43(1987-88) 31.4 24.0 4.6 5.4 7.5 7.6 1.0 5.7 7.2 5.2 0.3 60.08 Round 57 (2001-02) 29.42 25.59 2.59 4.80 9.37 9.92 1.13 6.94 6.87 3.03 0.36 57.60Source: Ray (2007).Table 5: Calorie Share of Food Items in India by Expenditure Class(2001-02,in %)Expenditure Class Rice Wheat Other Pulses Dairy Edible Meat/Fish Veg/ Sugar/ Processed Beverages CerealsOilsEggsFruitSpicesFood Rural Bottom30% 46.28 17.10 9.82 3.69 3.52 6.75 0.78 5.42 5.36 0.94 0.32 Middle40% 43.22 18.14 6.18 4.07 6.21 7.48 1.04 5.90 5.97 1.54 0.25Top 30% 35.84 18.03 3.97 4.53 9.83 8.421.31 6.856.80 4.11 0.31Urban Bottom30% 33.03 27.48 4.19 4.17 5.41 8.77 0.91 6.89 6.29 1.95 0.91 Middle40% 28.69 24.50 1.75 4.83 9.07 10.39 1.16 7.18 6.95 4.99 0.50 Top 30% 20.76 20.13 0.65 5.11 12.78 10.47 1.27 7.96 6.92 13.17 0.79Source: Ray (2007).Table 4: Share of Calories in Food Items in Vietnam(in %)Region Rural Urban 1992-931997-98 2002 20041992-931997-98 20022004Rice 81.93 80.63 76.02 65.91 75.65 71.35 61.10 55.19Wheat 0.640.990.390.413.603.051.021.12Other cereals 4.37 4.08 1.80 4.26 3.77 4.81 0.79 4.76Vegetables 4.682.511.081.602.272.170.361.26Fruits 0.841.040.090.672.031.880.110.91Meats 2.603.924.154.245.506.966.636.32Fish 0.810.970.830.911.291.250.971.04Dairy 0.010.030.910.060.080.201.200.28Alcoholic beverages 1.60 2.27 2.17 2.61 2.17 2.81 1.63 3.33Other items2 2.52 3.48 6.38 13.96 3.63 5.16 10.44 13.99Eating out 0.00 0.07 6.16 5.37 0.001 0.37 15.72 11.80Source: Author’s calculations.were part of the living standards measurement study (LSMS) household surveys that were conducted in a number of develop-ing countries with technical assistance from the World Bank.1 TheVLSS 1992-93 data provided food expenditure and quantity information on 4,800 households, and the VLSS 1997-98 data set provided corresponding information on 6,000 households. The VHLSS 2002 and 2004 data sets contained similar expenditure and quantity information on 30,000 and 9,189 households, res-pectively. The present study utilised information on the purchas-es of 45 food items, which were collected separately for the Tet and other holiday periods, and the rest of the year. The original list of 45 food items was aggregated into a 10-item food classifica-tion to enable comparison with the Indian evidence. The quanti-ties consumed were converted into calorie intake by applyingFAO conversion factors. In case of some minor food items (for exam-ple, “other food”, “carbonated beverages”, etc) and “eating out” for which quantity information is not available, we followed the practice, adopted by Dien, Thang and Bentley (2004), of convert-ing the available expenditure information on these items into calories by using the average price of calories to the household from the rest of the food items, i e, those for which the quantity information is available.Table 1 (p 52) reports the changes in India in the monthly per capita consumption of the principal food items and their share
SPECIAL ARTICLEfebruary 23, 2008 EPW Economic & Political Weekly54Table 6: Share of Calories in Food Items in Vietnam(in %)Region RuralUrban 1992-931997-98 200220041992-931997-98 20022004For poor households Rice 82.56 82.07 83.14 73.24 77.32 71.27 82.61 69.86 Wheat 0.31 0.67 0.14 0.13 1.68 2.00 0.43 0.69 Othercereals 5.40 4.18 2.68 4.73 3.39 4.49 0.72 3.74 Vegetables 4.64 2.96 1.64 2.09 1.95 2.07 0.31 1.16 Fruits 0.60 0.93 0.07 0.47 1.68 2.54 0.18 0.50 Meats 2.08 3.09 2.68 2.31 3.49 4.79 2.86 3.44 Fish 0.60 0.78 0.57 0.67 1.18 1.26 0.60 0.82 Dairy 0.00 0.01 0.66 0.02 0.02 0.11 0.98 0.05 Alcoholicbeverages 1.34 1.95 1.73 1.44 1.87 2.88 1.29 1.69 Otheritems2 2.47 3.29 4.65 13.45 7.42 7.52 6.46 13.91 Eatingout 0.00 0.06 2.01 1.44 0.00 1.07 3.56 4.15For non-poor households Rice 81.74 80.18 74.08 64.86 75.59 71.35 59.98 53.51 Wheat 0.74 1.09 0.46 0.45 3.67 3.09 1.05 1.17Othercereals 4.06 4.05 1.564.19 3.794.83 0.794.87 Vegetables 4.69 2.38 0.92 1.53 2.28 2.17 0.36 1.27 Fruits 0.91 1.08 0.09 0.70 2.04 1.85 0.11 0.96 Meats 2.76 4.17 4.56 4.52 5.58 7.05 6.83 6.65Fish 0.87 1.030.91 0.94 1.291.25 0.991.06 Dairy 0.01 0.04 0.98 0.07 0.08 0.21 1.21 0.31 Alcoholicbeverages 1.68 2.37 2.28 2.77 2.18 2.80 1.65 3.52Other items2 2.54 3.54 6.86 14.03 3.49 5.06 10.64 14.00Eating out 0.00 0.07 7.29 5.94 0.001 0.34 16.36 12.68Source: Author’s calculations.Table 7: Percentage of Rural Indian Households Undernourished (POU) (in %)State Head Count POU Rates POU Rates Poverty Rates in NSS in NSS in NSS Round 43 Round 57 Round 43 (1987-88) (2001-02) (1987-88)(a)Andhra Pradesh 40.0 52.34 73.50Assam 27.7 60.57 73.06Bihar 48.7 49.14 50.91Gujarat 28.456.56 77.31Haryana 13.924.8063.23Himachal Pradesh NA 22.46 40.83Karnataka 41.254.5277.39Kerala 19.765.8571.04Madhya Pradesh 49.6 45.78 77.61Maharashtra 40.656.3567.10Orissa 53.056.2268.60Punjab 9.6 31.45 54.53Rajasthan 31.831.7453.85Tamil Nadu 44.3 67.31 84.03Uttar Pradesh 42.9 36.30 56.94West Bengal 36.6 53.58 68.90All India 39.0 48.16 66.90POU measures the prevalence of under-nutrition.(a)These poverty rates were calculated using National Poverty Line. Source: Ray (2007).Table 8: Percentage of Urban Indian Households Undernourished (POU)(in %)State Head Count POU Rates POU Rates Poverty Rates in NSS in NSS in NSS Round 43 Round 57 Round 55(1987-88) (2001-02) (1987-88)(a)Andhra Pradesh 45.7 37.35 57.70Assam 28.7 34.65 47.84Bihar 57.9 30.46 43.58Gujarat 32.143.0457.58Haryana 36.929.0356.31Himachal Pradesh NA 12.08 26.05Karnataka 45.137.71 50.63Kerala 38.248.0049.02Madhya Pradesh 40.9 34.28 58.63Maharashtra 30.638.6651.47Orissa 39.229.3939.94Punjab 21.031.9741.35Rajasthan 36.930.3741.55Tamil Nadu 38.9 51.19 63.84Uttar Pradesh 48.6 32.80 52.30West Bengal 39.7 41.17 50.68All India 38.7 36.97 51.00POU measures the prevalence of under-nutrition.(a) These poverty rates were calculated using National Poverty Line.Source: Ray (2007).and sugar/spices, that of processed food increasessharply with household affluence, especially in urban areas. Table 6 compares the calorie shares in Vietnam between households below and above the food poverty line, as specified by Vietnam’s General Sta-tistical Office (GSO) [Tung not dated]. The difference in the calorie importance of rice and the other cereal items between poor and non-poor households in Vietnam is less sharp than in India though, by the middle of the first decade of the new millennium, a more distinct difference was beginning to emerge in Vietnam.Another interesting contrast, that is apparent from Tables 5 and 6, is that the rural/urban divide in calorie shares is much sharper in India than in Vietnam though, even here, the divide in Vietnam became more marked in the new millennium, especially in case of meals consumed by eating out. Note, incidentally, from Table 6 that the dietary changes in Vietnam in the new millennium, as re-flected in the movement in calorie shares, were much larger for non-poor households than for those living below the GSO poverty line. For example, non-poor urban households experienced a spectacu-lar increase during the turn of the century in the calorie share of meals eaten out but this increase was of a much smaller order of magnitude for the poor urban households.3 Comparison of Prevalence of Under-NutritionLet us recall that thePOUis measured as the percentage of house-holds who are unable to meet their daily minimum calorie re-quirement. The POU measure is regarded as a “direct” method of measuring poverty unlike the more commonly used expenditure based poverty rates (POV) that are referred to as “indirect” methods. The estimates of POU in rural and urban India inNSS rounds 43 (1987-88) and 57 (2001-02) are presented in Tables 7 and 8, respectively. These estimates are much higher than the POV estimates using the official poverty line [Ray and Lancaster 2005]. This suggests a weakening of the link between the official poverty lines and calorie requirements due to the changes in dietary practices in India that have been reported above.Tables 7 and 8 suggest that in India over the period, 1987-88 to 2001-02, there has been rising hunger, i e, an increasing failure to meet calorie requirements at the household level. This upward trend is a continuation of thatobservedbetweenNSS rounds 43 (1987-88) and round 55 (1999-2000), reported in Coondoo et al (2005). The rise in undernourishment in India stands in sharp contrast to muchofthe evidencebased on thePOV suggesting a decline in poverty over this period.As the calculations reported in Coondoo et al (2005) show, the POU rates,which measure calorie depriva-tion, exceeded thePOV ratesin each of the three large survey rounds ofthe NSS, namely rounds 43 (1987-88), 50 (1993-94) and 55 (1999-2000). Tables7 and 8 show that theunder-statement byPOV of the true extent of undernour-ishment is particularly serious in rural areas, though less so in urban areas. These tablesalso reveal sharp regional dif-ferences in India in chang-es to thePOU rates, with states such as (rural) As-sam and (rural) Bihar im-proving their record of undernourishment, while Andhra Pradesh and Orissa have fared badly in both rural and urban areas.The contrast between the Indian and Vietnamese experiences is highlighted by Table 9 (p 55) which presents the POU rates in Vietnam, disaggregated by regions, over the period covered by the four Viet-namese household surveys considered in this study. The VietnamesePOU rates fell sharply in the late 1990s after exhibiting lit-tle movement in the first half of that decade. Unlike
Kcal per capita 1992 93 Kcal per capita 2002 Kcal per capita 2004
Kcal per capita 1992 93 Kcal per capita 2002 Kcal per capita 2004
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