Lok Sabha Question No. 4902 (UNSTARRED), answered on 2016-12-16
Subject: Malnutrition in India
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAJESH RANJAN  (PAPPU  YADAV), SUSHMITA DEV, KIRTI (JHA) AZAD, RANJEET RANJAN

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

LOK SABHA UNSTARRED QUESTION NO. 4902 TO BE ANSWERED ON 16 TH DECEMBER,

## MALNUTRITION IN INDI A

## 4902. SHRI RAJESH RANJAN:

KUMARI SUSHMITA DEV:

SHRI KIRTI AZAD:

SHRIMATI RANJEET RANJAN:

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

- (a) whether the Government is aware that despite having various schemes like Integrated Development  Services  (ICDS),  Mid - Day  Meal  Scheme  (MDMS),  Public  Distribution  System (PDS) and the National Food Security Act in place, the levels of malnutrition across India is very high, if so, the details thereof;
- (b)  whether  it  is  true  that  malnutrition  contributes  to  more  than  one  third  deaths children, if so, the details thereof and steps being taken by the Government to check th for the h igh infant mortality rate India on account of malnutrition;
- (c) whether the National food Security Act has been implemented across India, if so, the thereof and if not, the reasons therefor;
- (d) the monitoring system being used by the Governmen t for cross validation and to calculate impact of these schemes over time;
- (e) whether the Government is planning to use Aadhaar linked tracking of malnutrition, have all ration cards been digitized and seeded with Aadhaar cards; and
- (f)  whether the  Union  Government  has  reduced  funding  for  National  Rural  Health  Mission (NRHM) under National Health Mission (NHM) budget reduced by 11 per cent from 2014 - 15 to 79 per cent in 2015 - 16, if so, the details thereof?

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

(SHRI FAGGAN SINGH KULASTE)

- (a) : As per the Rapid Survey of Children (2013 - 14), 29.4 per cent children below five years are underweight, 38.7 per cent are stunted and 15.1 per cent are wasted.

Contd……

(b) : Malnutrition is not a direct cause of death among children but can increase morbidi mortality by reducing the resistance to infections. However, it is estimated that malnut contributing  factor  in  about  one - third  of  all  deaths  in  under - fi ve  children  in  India,  as  per CHERG (2010) Report.

The  Government  of  India  is  implementing  various  schemes  all  across  the  country  f reducing infant mortality on account of malnutrition:

- i. Provision of Supplementary food to children aged 6 - 36 months und er Integrated Child Development Project (ICDS).
- ii. Promotion  of  Institutional  deliveries  through  cash  incentive  under  Janani  Surak Yojana  (JSY)  and  Janani  Shishu  Suraksha  Karyakaram  (JSSK)  which  entitles  all pregnant  women  delivering  in  public  health  insti tutio to  absolutely  free  and  no expense ante - natal check - ups, delivery including Caesarean section, post - natal care and treatment of sick infants till one year of age.
- iii. Strengthening of delivery points for providing comprehensive and quality Reproducti Maternal,  Newborn,  Child  and  Adolescent  Health  (RMNCH+A)  Services,    ensuring essential newborn care at all delivery points, establishment of Special Newborn Units  (SNCU),  Newborn  Stabilization  Units  (NBSU)  and  Kangaroo  Mother  Care (KMC) units for car e of sick and small babies. Home Based Newborn Care (HBNC) is being provided by ASHAs to improve child rearing practices.
- iv. Early initiation and exclusive breastfeeding for first six months and appropriate and Young Child Feeding (IYCF) practices are promoted in convergence with Ministry of Women and Child Development. Village Health and Nutrition Days (VHNDs) are observed for provision of maternal and child health services and creating awarenes maternal  and  child  care  including  health  and  nutriti on  education.Government  has recently launched 'MAA' programme in order to increase awareness on breastfeeding and build capacities of the health workers on IYCF practices.
- v. Universal Immunization Programme (UIP) is being supported to provide vaccination t children against many life threatening diseases such as Diphtheria, Pertussis, Te Poliomyelitis,  Tuberculosis,  Measles,  Hepatitis  B,  Meningitis  and  Pneumonia  due Haemophilus Influenzae type B.
- vi. Rashtriya  Bal  Swasthya  Karyakram  (RBSK)  for  health  s creening,  early  detection  of birth defects, diseases, deficiencies, development delays including disability and intervention services has been operationalized to provide comprehensive care to al children in the age group of 0 - 18 years in the com munity.
- vii. Some other important interventions are Iron and folic acid (IFA) supplementation for prevention of anaemia among the vulnerable age groups, Vitamin - A  Supplementation for children 6 - 59 months, home visits by ASHAs to promote exclusive breast f eeding and promote use of ORS and Zinc for management of diarrhoea in children,
- viii. Nutrition  Rehabilitation  Centres  are  established  at  Government  Health  facilitie manage severe acute malnutrition.

Contd......

(c) : The National Food Security Act, 2013 is being implemented in all the States/Union Territories  (UTs).  State/UT - wise  detail  of  coverage  determined  under  the  Act  for  receiving highly  subsidized  foodgrains  and  the  current  coverage,  based  on  identification  of  e households reported by States/UTs and their detail on the PDS portal, is at Annexure.

(d) : ICDS Scheme is a Centrally Sponsored Scheme implemented by States/UTs across the country. Periodical assessment of progress/achievements made by the States/UTs improvement in fu nctioning of various components of the scheme is an on - going and continuous process. This is done largely through monitoring reports and review meetings.

a

Mid - Day Meal scheme has an elaborate monitoring system at different levels includ Steering - cum - monitoring  committee  at  National,  State  and  District  levels.  At  village  l Village Education Committees, Parent Teacher Associations and School Management Committee monitor the quality of services under MDM on a regular basis.

To evaluate the impact of these schemes on the target beneficiaries and to plug loo in implementation, evaluation studies on functioning are beingconducted by the Government.

(e) : Under the Integrated Child Development Services (ICDS) Scheme, Aa dhar enrolment of children below 5  years  has been taken up with  States/ Union Territories. As per infor available from UIDAI, Aadhaar saturation among children below 5 years of age is 30.7% as 15.11.2016.

Under  the  NFSA,  States/UTs  are  being  enco uraged  to  set  up  AADHAR  based authentication of beneficiaries for distribution of food grains in order to ensure prope of  eligible  persons.  As  per  the  available  information,  60%  of  the  Ration  Cards  have digitized and seeded with Aadhar Card s.

(f) : There is no reduction by the Union Government in funding of National Rural Heal Mission (NRHM) under National Health Mission (NHM). The Budgetary Outlay for the F.Y. 2015- 16 was Rs. 18,295.00 crorewhich is 3.78% higher than the Budgetary Outlay for the F.Y. 2014- 15 i.e. Rs. 17,627.82 crore .

Further, from F.Y. 2015 -16 onwards, upon acceptance of the 14th Finance Commission's recommendations and in view of the devolution of revenues from 32 percent to 42 percent Centre - State funds shari ng pattern under National Health Mission has been revised from 75:25 t 60:40. Hence, more funds are being generated under National Health Mission (NHM).

…………….

## ANNEXURE

| STATEMENT INDICATING STATE/UT - WISE COVERAGE UNDER NFSA   | STATEMENT INDICATING STATE/UT - WISE COVERAGE UNDER NFSA   | STATEMENT INDICATING STATE/UT - WISE COVERAGE UNDER NFSA   | STATEMENT INDICATING STATE/UT - WISE COVERAGE UNDER NFSA   |
|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|
| S. No.                                                     | (Numbers of States/ UTs                                    | persons in lakhs) Coverage determined under NFSA           | Current actual coverage under NFSA                         |
| 1                                                          | Andhra Pradesh                                             | 268.23                                                     | 268.21                                                     |
| 2                                                          | Arunachal Pradesh                                          | 8.71                                                       | 8.21                                                       |
| 3                                                          | Assam                                                      | 251.9                                                      | 251.63                                                     |
| 4                                                          | Bihar                                                      | 871.16                                                     | 857.12                                                     |
| 5                                                          | Chhattisgarh                                               | 200.77                                                     | 200.77                                                     |
| 6                                                          | Delhi                                                      | 72.78                                                      | 72.73                                                      |
| 7                                                          | Goa                                                        | 5.32                                                       | 5.32                                                       |
| 8                                                          | Gujarat                                                    | 382.84                                                     | 357.81                                                     |
| 9                                                          | Haryana                                                    | 126.49                                                     | 126.49                                                     |
| 10                                                         | Himachal Pradesh                                           | 36.82                                                      | 28.64                                                      |
| 11                                                         | Jammu & Kashmir                                            | 74.13                                                      | 74.13                                                      |
| 12                                                         | Jharkhand                                                  | 264.25                                                     | 263.7                                                      |
| 13                                                         | Karnataka                                                  | 401.93                                                     | 401.93                                                     |
| 14                                                         | Kerala                                                     | 154.8                                                      | 154.8                                                      |
| 15                                                         | Madhya Pradesh                                             | 546.42                                                     | 529.61                                                     |
| 16                                                         | Maharashtra                                                | 700.17                                                     | 700.17                                                     |
| 17                                                         | Manipur                                                    | 25.06                                                      | 21.19                                                      |
| 18                                                         | Meghalaya                                                  | 21.46                                                      | 21.4                                                       |
| 19                                                         | Mizoram                                                    | 7.06                                                       | 6.68                                                       |
| 20                                                         | Nagaland                                                   | 14.79                                                      | 14.05                                                      |
| 21                                                         | Odisha                                                     | 326.21                                                     | 321.97                                                     |
| 22                                                         | Punjab                                                     | 141.45                                                     | 141.45                                                     |
| 23                                                         | Rajasthan                                                  | 446.62                                                     | 446.62                                                     |
| 24                                                         | Sikkim                                                     | 4.06                                                       | 3.78                                                       |
| 25                                                         | Tamil Nadu                                                 | 364.7                                                      | 357.34                                                     |
| 26                                                         | Telangana                                                  | 191.7                                                      | 191.62                                                     |
| 27                                                         | Tripura                                                    | 25.02                                                      | 25.01                                                      |
| 28                                                         | Uttar Pradesh                                              | 1520.61                                                    | 1469.96                                                    |
| 29                                                         | Uttarakhand                                                | 61.94                                                      | 61.94                                                      |
| 30                                                         | West Bengal                                                | 601.84                                                     | 601.84                                                     |
| 31                                                         | Andaman & Nicobar Islands                                  | 0.63                                                       | 0.55                                                       |
| 32                                                         | Daman & Diu                                                | 1.19                                                       | 1.08                                                       |
| 33                                                         | Dadra & Nagar Haveli                                       | 2.36                                                       | 1.82                                                       |
| 34                                                         | Lakshadweep                                                | 0.22                                                       | 0.22                                                       |
| 35                                                         | Chandigarh                                                 | 4.96                                                       | 2.46                                                       |
| 36                                                         | Puducherry                                                 | 6.34                                                       | 6.15                                                       |
|                                                            | Total                                                      | 8134.94                                                    | 7998.38                                                    |