Lok Sabha Question No. 1340 (UNSTARRED), answered on 2018-02-09
Subject: Anaemia among Women
Ministry: HEALTH AND FAMILY WELFARE
Asked by: BHARTRUHARI MAHTAB, SANJAY SHAMRAO DHOTRE, RAHUL RAMESH SHEWALE, YERRAM VENKATA SUBBAREDDY

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1340 TO BE ANSWERED ON 9 TH FEBRUARY, 2018

## ANAEMIA AMONG WOMEN

## 1340. SHRI BHARTRUHARI MAHTAB:

SHRI SANJAY DHOTRE:

SHRI RAHUL SHEWALE:

SHRI Y.V. SUBBA REDDY:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether India has the largest number of Anaemic women in the world and if so, the details thereof and the reasons therefor;
- (b) whether the cases of Anaemia among women and adolescent girls and deaths therefrom have increased in the country despite several measures taken by the Government during each of the last three years and the current year, if so, the details thereof, State/UT -wise;
- (c) the details of the schemes/ programmes being implemented by the Government to address this problem and physical targets set and achieved along with funds provided therein during the saidperiod, State/UT - wise and Scheme/ Programme-wise;
- (d) whether th e cases of irregularities/ corruption in implementation of the schemes/programmes in the country have come to the notice of the Government during the said period, if so, the details thereof, State/UT - wise and scheme/ programme- wise; and

said

- (e) the other steps taken by the Government to tide over this challenge with special attention to women and adolescent girls suffering from Anaemia in the country?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

- (a):          As  per  Global  nutrition  report  2017,  India  has  the  largest  number  of  women  affecte anaemia, followed by China, Pakistan, Nigeria and Indonesia.

The  global  nutrition  report  covers  data  of  140  countries  evaluated  against  health  tar decided b y World Health Assembly. Globally, 61.4 crore women aged 15 - 49  years  are  affected by anemia. In India, 14.67 crore women are suffering from anaemia.

As per WHO report on the global prevalence of anaemia 2011, 50% cases of Anaemia are attributed to iron de ficiency. Other causes of anaemia include other micronutrient deficiencies (e. folate, riboflavin, vitamins A and B12), acute and chronic infections (e.g. malaria, cancer, tube and HIV), and inherited or acquired disorders that affect haemoglobin synthesis(e.g. haemoglobinopathies).

(b)  As per NFHS data, overall prevalence of anemia among women and  adolescent girls has not increased in country from 2005 - 06(NFHS - 3) to 2015 - 16(NFHS - 4).

However, following states have shown increase in prevalence of anaemia among non -pregnant women  (aged  15 - 49  years)  from  2005 - 6(NFHS - 3)  to  2015 - 16(NFHS - 4)  : - Uttar  Pradesh,  Kerala, Tamil Nadu, Haryana, Punjab, Delhi and Himachal Pradesh.

Himachal Pradesh has shown increase in cases of anemia among pregnant women from from 2005- 06(NFHS - 3) to 2015 - 16(NFHS - 4).

Following states has shown increase in prevalence of anaemia among adolescent girls from 2005- 06(NFHS - 3) to 2015 - 16(NFHS - 4): Delhi, Goa, Haryana, Himachal Pradesh, Kerala, Madhya Pradesh, Punjab, Tamil Nadu, Uttar Pradesh and West Bengal.

Data on deaths attributed to anaemia is not available for India.

(C)  The  Ministry  of  Health  and  Family  Welfare  has  implemented  National  Iron  Plus  Initiative prevent anaemia among women, children and adolescents. The pr ogram details out interventions for all life stages universally for given age group population in the country : -

1. Preschoolers (6m - 59 months) : Bi - weekly IFA syrup
2. School aged children (5 -10 years) : Pink coloured Weekly IFA tablet (WIFS Junior)
3. Adolescents (11 -19 years) : Blue coloured weekly IFA tablet (WIFS)
4. Women in Reproductive ages (20 -49 years) : Red coloured weekly IFA tablet
5. Pregnant and lactating women: 1 Tab daily for 180 days starting after 1st Trimester, 14- 16 weeksof gestation. To be repeated for 180 days post - partum.

Data  regarding  physical  targets  and  achievement  (Iron  Folic  Acid  supplementation)  for adolescent  girls  and  non - pregnant  women  is  not  maintained  centrally.  However,  information  for pregnant women as pe r HMIS is given at Annexure 1 .

Fund allocated to States and UTs under National Iron Plus Initiative is given at Annexure -2.

- (d) : No such cases have been reported by the states to Government of India

(e) : Government has also taken following measures which also interalia help in addressing challen of anaemia.

- National Deworming Day is organized to deworm all children aged 1 to 19 years.
- Supplementation of vitamin A syrup to children
- National Vector Born e Disease Control Programme
- National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke
- Revised National Tuberculosis Control Programme
- Prevention, Control and management of heamoglobinopathies

………………..

| Annexure -1   | Annexure -1          | Annexure -1                                                                                     | Annexure -1                                                                                     | Annexure -1                                                                                     | Annexure -1                                                                                     | Annexure -1                                                                                     | Annexure -1                                                                                     | Annexure -1                                                                                     | Annexure -1                                                                                     |
|---------------|----------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------|
| States/UTs    | States/UTs           | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women | Year and State wise Physical Target and Achievement of IFA supplementation among pregnant women |
|               |                      | 2017-18                                                                                         | 2017-18                                                                                         | 2016-17                                                                                         | 2016-17                                                                                         | 2015-16                                                                                         | 2015-16                                                                                         | 2014-15                                                                                         | 2014-15                                                                                         |
|               |                      | Physical Target                                                                                 | Achieve ment                                                                                    | Physical Target                                                                                 | Achieveme nt                                                                                    | Physical Target                                                                                 | Achieveme nt                                                                                    | Physical Target                                                                                 | Achievem ent                                                                                    |
|               | All India            | 21,934,063                                                                                      | 18,206,07 1                                                                                     | 28,440,723                                                                                      | 23,076,607                                                                                      | 28,240,593                                                                                      | 22,619,128                                                                                      | 28,379,62 5                                                                                     | 22,991,855                                                                                      |
| 1             | A & N Islands        | 1,061                                                                                           | 539                                                                                             | 5,672                                                                                           | 18,643                                                                                          | 5,489                                                                                           | 19,373                                                                                          | 5,939                                                                                           | 39,445                                                                                          |
| 2             | Andhra Pradesh       | 629,884                                                                                         | 668,298                                                                                         | 834,340                                                                                         | 824,509                                                                                         | 877,236                                                                                         | 896,200                                                                                         | 1,070,551                                                                                       | 1,033,355                                                                                       |
| 3             | Arunachal Pradesh    | 24,385                                                                                          | 8,779                                                                                           | 29,975                                                                                          | 30,703                                                                                          | 30,113                                                                                          | 18,628                                                                                          | 35,542                                                                                          | 21,692                                                                                          |
| 4             | Assam                | 515,329                                                                                         | 456,423                                                                                         | 725,046                                                                                         | 733,387                                                                                         | 740,884                                                                                         | 669,205                                                                                         | 751,185                                                                                         | 681,490                                                                                         |
| 5             | Bihar                | 2,371,195                                                                                       | 1,191,739                                                                                       | 2,935,167                                                                                       | 1,486,461                                                                                       | 2,736,333                                                                                       | 1,204,890                                                                                       | 2,634,925                                                                                       | 1,624,595                                                                                       |
| 6             | Chandigarh           | 49,507                                                                                          | 21,635                                                                                          | 60,667                                                                                          | 32,263                                                                                          | 58,564                                                                                          | 19,331                                                                                          | 37,395                                                                                          | 28,795                                                                                          |
| 7             | Chhattisgarh         | 477,387                                                                                         | 464,718                                                                                         | 621,076                                                                                         | 617,322                                                                                         | 651,449                                                                                         | 613,562                                                                                         | 674,811                                                                                         | 590,712                                                                                         |
| 8             | Dadra & Nagar Haveli | 6,041                                                                                           | 4,475                                                                                           | 8,502                                                                                           | 8,098                                                                                           | 9,547                                                                                           | 6,253                                                                                           | 16,015                                                                                          | 4,246                                                                                           |
| 9             | Daman & Diu          | 5,828                                                                                           | 3,843                                                                                           | 6,157                                                                                           | 5,496                                                                                           | 8,346                                                                                           | 5,300                                                                                           | 8,348                                                                                           | 4,947                                                                                           |
| 10            | Delhi                | 732,821                                                                                         | 350,130                                                                                         | 993,842                                                                                         | 524,760                                                                                         | 926,067                                                                                         | 520,981                                                                                         | 874,226                                                                                         | 482,855                                                                                         |
| 11            | Goa                  | 17,975                                                                                          | 11,083                                                                                          | 23,984                                                                                          | 14,517                                                                                          | 25,437                                                                                          | 18,209                                                                                          | 25,995                                                                                          | 20,063                                                                                          |
| 12            | Gujarat              | 1,114,393                                                                                       | 1,057,430                                                                                       | 1,381,764                                                                                       | 1,334,836                                                                                       | 1,405,981                                                                                       | 1,359,046                                                                                       | 1,405,807                                                                                       | 1,306,252                                                                                       |
| 13            | Haryana              | 574,525                                                                                         | 313,050                                                                                         | 570,462                                                                                         | 303,662                                                                                         | 590,615                                                                                         | 331,786                                                                                         | 582,804                                                                                         | 538,042                                                                                         |
| 14            | Himachal Pradesh     | 88,819                                                                                          | 46,781                                                                                          | 121,493                                                                                         | 105,625                                                                                         | 126,102                                                                                         | 103,507                                                                                         | 125,286                                                                                         | 101,329                                                                                         |
| 15            | Jammu & Kashmir      | 289,241                                                                                         | 156,410                                                                                         | 387,785                                                                                         | 166,560                                                                                         | 355,477                                                                                         | 97,763                                                                                          | 388,996                                                                                         | 116,483                                                                                         |
| 16            | Jharkhand            | 719,688                                                                                         | 509,025                                                                                         | 922,729                                                                                         | 712,544                                                                                         | 799,865                                                                                         | 588,284                                                                                         | 782,667                                                                                         | 465,821                                                                                         |
| 17            | Karnataka            | 830,012                                                                                         | 861,428                                                                                         | 1,127,674                                                                                       | 1,073,855                                                                                       | 1,220,076                                                                                       | 929,207                                                                                         | 1,196,698                                                                                       | 864,069                                                                                         |
| 18            | Kerala               | 637,458                                                                                         | 368,611                                                                                         | 488,095                                                                                         | 326,231                                                                                         | 477,820                                                                                         | 404,900                                                                                         | 495,716                                                                                         | 497,872                                                                                         |
| 19            | Lakshadweep          | 893                                                                                             | 809                                                                                             | 1,178                                                                                           | 960                                                                                             | 1,192                                                                                           | 709                                                                                             | 1,206                                                                                           | 737                                                                                             |
| 20            | Madhya Pradesh       | 1,432,788                                                                                       | 1,322,176                                                                                       | 1,841,458                                                                                       | 1,836,933                                                                                       | 1,847,691                                                                                       | 1,868,867                                                                                       | 1,900,801                                                                                       | 1,926,551                                                                                       |
| 21            | Maharashtra          | 1,704,777                                                                                       | 1,398,790                                                                                       | 2,185,798                                                                                       | 1,370,670                                                                                       | 2,172,145                                                                                       | 1,394,595                                                                                       | 2,119,476                                                                                       | 1,551,278                                                                                       |
| 22            | Manipur              | 42,225                                                                                          | 20,198                                                                                          | 60,132                                                                                          | 35,822                                                                                          | 70,899                                                                                          | 25,505                                                                                          | 79,090                                                                                          | 21,568                                                                                          |
| 23            | Meghalaya            | 100,749                                                                                         | 33,160                                                                                          | 133,880                                                                                         | 61,774                                                                                          | 131,908                                                                                         | 46,821                                                                                          | 129,575                                                                                         | 53,231                                                                                          |
| 24            | Mizoram              | 16,677                                                                                          | 4,132                                                                                           | 21,986                                                                                          | 12,636                                                                                          | 22,391                                                                                          | 10,135                                                                                          | 23,481                                                                                          | 15,458                                                                                          |

| 25            | Nagaland      | 28,934        | 3,118         | 47,172        | 11,922        | 48,846        | 14,131        | 44,588        | 15,081        |
|---------------|---------------|---------------|---------------|---------------|---------------|---------------|---------------|---------------|---------------|
| 26            | Odisha        | 533,957       | 430,500       | 748,325       | 585,563       | 805,828       | 601,715       | 816,619       | 588,415       |
| 27            | Puducherry    | 46,010        | 10,148        | 84,301        | 201,893       | 85,637        | 85,703        | 74,527        | 68,195        |
| 28            | Punjab        | 333,799       | 279,614       | 470,504       | 442,984       | 488,504       | 424,129       | 476,431       | 392,697       |
| 29            | Rajasthan     | 905,263       | 473,703       | 1,913,657     | 1,551,372     | 1,876,645     | 1,592,727     | 1,921,950     | 1,649,498     |
| 30            | Sikkim        | 6,575         | 4,187         | 8,457         | 6,847         | 8,939         | 7,290         | 9,375         | 7,574         |
| 31            | Tamil Nadu    | 952,161       | 874,587       | 1,027,000     | 888,597       | 1,028,316     | 973,017       | 1,087,207     | 660,037       |
| 32            | Telangana     | 967,603       | 1,006,150     | 942,232       | 886,932       | 876,839       | 929,919       | 829,983       | 790,173       |
| 33            | Tripura       | 57,348        | 24,154        | 76,813        | 58,807        | 75,760        | 48,801        | 77,290        | 46,465        |
| 34            | Uttar Pradesh | 4,302,742     | 4,603,335     | 5,659,485     | 4,951,460     | 5,679,116     | 4,877,767     | 5,535,650     | 4,926,736     |
| 35            | Uttarakhand   | 154,358       | 91,998        | 216,290       | 223,277       | 221,686       | 59,841        | 215,549       | 79,947        |
| 36            | West Bengal   | 1,261,655     | 1,130,915     | 1,749,055     | 1,497,498     | 1,733,561     | 1,566,831     | 1,866,097     | 1,521,857     |
| (Source HMIS) | (Source HMIS) | (Source HMIS) | (Source HMIS) | (Source HMIS) | (Source HMIS) | (Source HMIS) | (Source HMIS) | (Source HMIS) | (Source HMIS) |

| Anneuxre -2                                                                             | Anneuxre -2                                                                             | Anneuxre -2                                                                             | Anneuxre -2                                                                             | Anneuxre -2                                                                             | Anneuxre -2                                                                             |
|-----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------|
| Year and State wise approved fund under National Iron Plus Initiative (Amount in lakhs) | Year and State wise approved fund under National Iron Plus Initiative (Amount in lakhs) | Year and State wise approved fund under National Iron Plus Initiative (Amount in lakhs) | Year and State wise approved fund under National Iron Plus Initiative (Amount in lakhs) | Year and State wise approved fund under National Iron Plus Initiative (Amount in lakhs) | Year and State wise approved fund under National Iron Plus Initiative (Amount in lakhs) |
| Sr No.                                                                                  | States/Uts                                                                              | 2017- 18                                                                                | 2016- 17                                                                                | 2015- 16                                                                                | 2014-15                                                                                 |
| A. High Focus States                                                                    |                                                                                         |                                                                                         |                                                                                         |                                                                                         |                                                                                         |
| 1                                                                                       | Bihar                                                                                   | 7023.59                                                                                 | 3177.61                                                                                 | 3596.37                                                                                 | 13797.57                                                                                |
| 2                                                                                       | Chattisgarh                                                                             | 2985.00                                                                                 | 2105.38                                                                                 | 1354.38                                                                                 | 6444.76                                                                                 |
| 3                                                                                       | Himachal Pradesh                                                                        | 428.23                                                                                  | 0.00                                                                                    | 141.45                                                                                  | 569.68                                                                                  |
| 4                                                                                       | Jammu & Kashmir                                                                         | 1622.90                                                                                 | 340.59                                                                                  | 0.00                                                                                    | 1963.49                                                                                 |
| 5                                                                                       | Jharkhand                                                                               | 3440.35                                                                                 | 642.73                                                                                  | 245.54                                                                                  | 4328.62                                                                                 |
| 6                                                                                       | Madhya Pradesh                                                                          | 4235.87                                                                                 | 128.00                                                                                  | 481.60                                                                                  | 4845.47                                                                                 |
| 7                                                                                       | Orissa                                                                                  | 1340.76                                                                                 | 843.32                                                                                  | 66.26                                                                                   | 2250.34                                                                                 |
| 8                                                                                       | Rajasthan                                                                               | 5147.50                                                                                 | 1658.11                                                                                 | 548.18                                                                                  | 7353.79                                                                                 |
| 9                                                                                       | Uttar Pradesh                                                                           | 26166.24                                                                                | 1483.81                                                                                 | 1952.12                                                                                 | 29602.17                                                                                |
| 10                                                                                      | Uttarakhand                                                                             | 611.66                                                                                  | 28.06                                                                                   | 123.09                                                                                  | 762.81                                                                                  |
|                                                                                         | Sub Total                                                                               | 53002.10                                                                                | 10407.61                                                                                | 8508.99                                                                                 | 71918.70                                                                                |
| B. NE States                                                                            |                                                                                         |                                                                                         |                                                                                         |                                                                                         |                                                                                         |
| 11                                                                                      | Arunachal Pradesh                                                                       | 358.13                                                                                  | 0.00                                                                                    | 146.54                                                                                  | 504.67                                                                                  |
| 12                                                                                      | Assam                                                                                   | 3192.93                                                                                 | 757.25                                                                                  | 818.43                                                                                  | 4768.61                                                                                 |
| 13                                                                                      | Manipur                                                                                 | 22.67                                                                                   | 81.80                                                                                   | 38.00                                                                                   | 142.47                                                                                  |
| 14                                                                                      | Meghalaya                                                                               | 1094.40                                                                                 | 335.84                                                                                  | 64.61                                                                                   | 1494.85                                                                                 |
| 15                                                                                      | Mizoram                                                                                 | 189.60                                                                                  | 75.91                                                                                   | 46.50                                                                                   | 312.01                                                                                  |
| 16                                                                                      | Nagaland                                                                                | 126.43                                                                                  | 71.31                                                                                   | 38.83                                                                                   | 236.57                                                                                  |
| 17                                                                                      | Sikkim                                                                                  | 82.36                                                                                   | 34.50                                                                                   | 29.61                                                                                   | 146.47                                                                                  |
| 18                                                                                      | Tripura                                                                                 | 611.66                                                                                  | 19.18                                                                                   | 152.64                                                                                  | 783.48                                                                                  |
|                                                                                         | Sub Total                                                                               | 5678.18                                                                                 | 1375.79                                                                                 | 1335.16                                                                                 | 8389.13                                                                                 |
| C. Non-High Focus States                                                                |                                                                                         |                                                                                         |                                                                                         |                                                                                         |                                                                                         |
| 19                                                                                      | Andhra Pradesh                                                                          | 2581.36                                                                                 | 450.36                                                                                  | 519.25                                                                                  | 3550.97                                                                                 |
| 20                                                                                      | Goa                                                                                     | 29.72                                                                                   | 55.75                                                                                   | 59.29                                                                                   | 144.76                                                                                  |
| 21                                                                                      | Gujarat                                                                                 | 3002.52                                                                                 | 1068.45                                                                                 | 1195.08                                                                                 | 5266.05                                                                                 |
| 22                                                                                      | Haryana                                                                                 | 357.12                                                                                  | 49.71                                                                                   | 92.92                                                                                   | 499.75                                                                                  |
| 23                                                                                      | Karnataka                                                                               | 3994.75                                                                                 | 846.12                                                                                  | 1902.86                                                                                 | 6743.73                                                                                 |
| 24                                                                                      | Kerala                                                                                  | 1482.30                                                                                 | 424.03                                                                                  | 373.00                                                                                  | 2279.33                                                                                 |
| 25                                                                                      | Maharashtra                                                                             | 10167.50                                                                                | 3139.40                                                                                 | 2746.22                                                                                 | 16053.12                                                                                |
| 26                                                                                      | Punjab                                                                                  | 1931.28                                                                                 | 1080.49                                                                                 | 308.89                                                                                  | 3320.66                                                                                 |
| 27                                                                                      | Tamil Nadu                                                                              | 4491.96                                                                                 | 1170.35                                                                                 | 118.00                                                                                  | 5780.31                                                                                 |

| 28                  | Telangana                 | 4235.27   | 582.82   | 524.44   | 5342.53   |
|---------------------|---------------------------|-----------|----------|----------|-----------|
| 29                  | West Bengal               | 337.57    | 1907.87  | 1582.67  | 3828.11   |
|                     | Sub Total                 | 32611.35  | 10775.35 | 9422.62  | 52809.31  |
| D. Small States/UTs |                           |           |          |          |           |
| 30                  | Andaman & Nicobar Islands | 18.37     | 19.25    | 14.38    | 52.00     |
| 31                  | Chandigarh                | 243.22    | 7.10     | 0.00     | 250.32    |
| 32                  | Dadra & Nagar Haveli      | 50.37     | 106.31   | 48.41    | 205.09    |
| 33                  | Daman & Diu               | 12.65     | 3.78     | 3.66     | 20.09     |
| 34                  | Delhi                     | 114.00    | 0.00     | 0.00     | 114.00    |
| 35                  | Lakshadweep               | 9.26      | 21.19    | 24.22    | 54.67     |
| 36                  | Puducherry                | 210.79    | 92.42    | 53.68    | 356.89    |
|                     | Sub Total                 | 658.66    | 250.05   | 144.35   | 1053.06   |
|                     | Grand Total               | 91950.29  | 22808.79 | 19411.12 | 134170.20 |