Lok Sabha Question No. 102 (UNSTARRED), answered on 2018-02-02
Subject: Anaemia Cases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: BHAGIRATH PRASAD, ANJU BALA, Tejpratap Singh,Yadav, B. SREERAMULU

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

## LOK SABHA UNSTARRED QUESTION NO. 102 TO BE ANSWERED ON 2 ND FEBRUARY, 2018

## ANAEMIA CASES

## 102. DR. BHAGIRATH PRASAD: SHRIMATI ANJU BALA: SHRI TEJ PRATAP SINGH YADAV: SHRI B. SRIRAMULU:

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

- (a)  whether  according  to  the  National Family  Health  Survey  data  the  overall prevalence  of anaemia is consistently high, at more than 50 per cent, in almos t all of the sub - groups of women;
- (b) if so, the details thereof along with the percentage of men, women and children with anaemia, State/UT - wise;
- (c) the details of mechanism put in place by the Government for rural women/ children suffering from anaemia particularly for women of the lower income groups and that of women with low body mass index have been successful and if so, details th reof;
- (d) whether the Government provides any assistance to States/UTs to establish diagnostic clinics for  test s  and  facilitate medication  to  provide  specialised  and sustained  treatment  of  anaemic women/ children and if so, the details thereof; and
- (e)  the  steps  taken  by  the  Government to  spread  awareness  of  such  diseases  in  the country particularly in the rural a nd tribal areas of the country?

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

## (SHRI ASHWINI KUMAR CHOUBEY)

- (a)& (b): Yes.  According  to  National  Family  Health  Survey  4  (2015 - 16),  in  India,  53.0 percent  women  aged  15 - 49  years  were  anaemic.  Prevalence  of  anaemia  among  different  sub groups of women are given in Annexure I. Further, State/UT wise percentage of men, wome and children with anaemia is given in Annexure II.
- (c): To  improve  the  situation,  t he  following  details  of  mechanism  put  in  place  by  the Government for women/ children suffering from anaemia:
- I. Ministry  of  Health  and  Family  Welfare  in  2013  launched  'National  I ron  Plus Initiative' as a comprehensive strategy to combat the public health challenge of Iron Deficiency  Anemia  prevalent  across  the  life  cycle.  There  are  age  speci interventions  with  Iron  and  Folic  Acid  Supplementation  and  Deworming  for improving the hemoglobin levels and reducing the prevalence of anemia for all ag groups, that is children 6 - 59 months, 5 -10 years, adolescent girls and boys (11 - 19 years), pregnant and lactating women and women in reproductive age group (20 -49 years).
- II. Universal screen ing of pregnant women for anaemia is a part of ante - natal care and all pregnant women are provided iron and folic acid tablets during their ante - natal visits through the existing network of sub -centres and primary health centres and other  health  facilities as  well  as  through  outreach  activities  at  Village  Health Nutrition Days (VHNDs).
- III. Every pregnant woman is given iron and folic acid, after the first trimester, taken one tablet daily for 6 months during ante - natal and post - natal period.  Pregnant women,  who  are  found  to  be  clinically  anaemic,  are  given  additional  tablets takin g two tablets daily
- IV. Government of India has given directions to the States for identification and tr of severely anaemic cases at all the Sub Centres and Primary Health Centres their timely management.
- V. To tackle the problem of anaemia due to m alaria particularly in pregnant women and children, Long Lasting Insecticide Nets (LLINs) and Insecticide Treated Bed N (ITBNs) are being distributed in endemic areas.

## Key Programmes and Schemes of Other Ministries

- Under the Integrated Child Developm ent Services (ICDS) Scheme of Ministry of Women and Child Development (M/oWCD), supplementary nutrition is provided to pregnant and lactating women at the rate of Rs. 5 per day per woman. This is meant to provide Kcal  and  18 -20  grams  of  protein.  Childr en  in  the  age  group  0 -6  years  receive supplementary nutrition, immunisation, preschool education, etc.
- Supplementary  food  is  also  provided  to  primary  school  children  through  the  Natio Programme of Nutritional Support to Primary Education (Mid - day Mealprogramme).
- Other schemes of the M/oWCD, for example SABLA, where supplementary nutrition is provided  to  Adolescent  Girls  (AGs)  in  the  form  of  take  home  rations  (THR)  or  h cooked meals. Under SABLA, each AG will be given at least 600 calories and 18 -20 grams of protein and the recommended daily intake of micronutrients, at Rs. 5 per per beneficiary, for 300 days in a year.

(d): The Central government provides financial assistant to states/UTs for Diagnostic Medications  and  for  buying  requi red  test  kits  from  outside  through  PIP  under  the  National Health Mission (NHM).

## (e): The following steps taken by the Government to spread awareness: -

Health and nutrition education through IEC (Information Education Communication) BCC (BehaviourChange Communication) to promote dietary diversification, inclusion of ir folate  rich  food  as  well  as  food  items  that  promotes  iron  absorption.    Health  Manag Information System & Mother Child Tracking System is being implemented   for reporting cases of anaemic and severely anaemic pregnant women.

Mother  Child  Protection  Card  and  Safe  Motherhood  Booklet  are  distributed  to  t pregnant women for educating them on dietary diversification and promotion of consumption IFA.

| Background characteristic    | Any anaemia (<12.0 g/dl) 2   |
|------------------------------|------------------------------|
| Age                          |                              |
| 15- 19                       | 54.0                         |
| 20- 29                       | 53.0                         |
| 30- 39                       | 52.4                         |
| 40- 49                       | 52.9                         |
| Marital status               |                              |
| Never married                | 52.3                         |
| Currently married            | 53.0                         |
| Widowed                      | 56.5                         |
| Divorced/separated/deserted  | 54.3                         |
| Maternity status             |                              |
| Pregnant                     | 50.3                         |
| Breastfeeding                | 57.9                         |
| Neither                      | 52.2                         |
| Number of children ever born |                              |
| 0                            | 51.6                         |
| 1                            | 52.3                         |
| 2- 3                         | 53.6                         |
| 4- 5                         | 54.7                         |
| 6+                           | 55.4                         |
| Residence                    |                              |
| Urban                        | 50.8                         |
| Rural                        | 54.2                         |
| Schooling                    |                              |
| No schooling                 | 56.3                         |
| <5 years complete            | 55.6                         |
| 5- 7 years complete          | 53.7                         |
| 8- 9 years complete          | 52.6                         |
| 10- 11 years complete        | 51.8                         |
| 12 or more years complete    | 48.7                         |
| Wealth index                 |                              |
| Lowest                       | 58.6                         |
| Second                       | 55.0                         |
| Middle                       | 53.2                         |
| Fourth                       | 50.9                         |
| Highest                      | 48.1                         |

Note: Table is based on women who stayed in the household the night before the interview. Prevalence i adjusted for altitude and for smoking status, if known, using formulae in CDC (1998). Haemoglobin in g/dl = grams per decilitre.

Source: National Family Health Survey (NFHS) 4 national report .

Annexure II hildren aged 6- 59 month s with anaemia by

Percentage of Women and M en age d 15- 49 years, C State/U nionTerritory, India, 2015 - 16

| India/ State/U nion territory   | Women Any anaemia (<12.0 g/dl) 53.0   | Men Any anaemia (<13.0 22.7   | Children g/dl) Any anaemia (<11.0 g/dl) 58.4   |
|---------------------------------|---------------------------------------|-------------------------------|------------------------------------------------|
| India North                     | Women Any anaemia (<12.0 g/dl) 53.0   | Men Any anaemia (<13.0 22.7   | Children g/dl) Any anaemia (<11.0 g/dl) 58.4   |
| Chandigarh                      | 75.9                                  | 19.3                          | 73.1                                           |
| Delhi                           | 54.3                                  | 21.6                          | 59.7                                           |
| Haryana                         | 62.7                                  | 20.9                          | 71.7                                           |
| Himachal Pradesh                | 53.5                                  | 20.1                          | 53.7                                           |
| Jammu & Kashmir                 | 40.6                                  | 15.6                          | 43.8                                           |
| Punjab                          | 53.5                                  | 25.9                          | 56.6                                           |
| Rajasthan                       | 46.8                                  | 17.2                          | 60.3                                           |
| Uttarakhand                     | 45.2                                  | 15.5                          | 59.8                                           |
| Central                         |                                       |                               |                                                |
| Chhattisgarh                    | 47.0                                  | 22.2                          | 41.6                                           |
| Madhya Pradesh                  | 52.5                                  | 25.5                          | 68.9                                           |
| Uttar Pradesh                   | 52.4                                  | 23.7                          | 63.2                                           |
| East                            |                                       |                               |                                                |
| Bihar                           | 60.3                                  | 32.3                          | 63.5                                           |
| Jharkhand                       | 65.2                                  | 29.9                          | 69.9                                           |
| Odisha                          | 51.0                                  | 28.4                          | 44.6                                           |
| West Bengal                     | 62.5                                  | 30.3                          | 54.2                                           |
| Northeast                       |                                       |                               |                                                |
| Arunachal Pradesh               | 43.3                                  | 18.6                          | 54.3                                           |
| Assam                           | 46.0                                  | 25.4                          | 35.7                                           |
| Manipur                         | 26.4                                  | 9.5                           | 23.9                                           |
| Meghalaya                       | 56.2                                  | 32.4                          | 48.0                                           |
| Mizoram                         | 24.8                                  | 12.1                          | 19.3                                           |
| Nagaland                        | 27.9                                  | 11.6                          | 26.4                                           |
| Sikkim                          | 34.9                                  | 15.7                          | 55.1                                           |
| Tripura                         | 54.5                                  | 24.7                          | 48.3                                           |
| West                            |                                       |                               |                                                |
| Dadra & Nagar Haveli            | 79.5                                  | 30.7                          | 84.6                                           |
| Daman & Diu                     | 58.9                                  | 23.6                          | 73.8                                           |
| Goa                             | 31.3                                  | 11.0                          | 48.3                                           |
| Gujarat                         | 54.9                                  | 21.7                          | 62.6                                           |
| Maharashtra                     | 48.0                                  | 17.6                          | 53.8                                           |
| South                           |                                       |                               |                                                |
| Andaman & Nicobar Islands       | 65.7                                  | 30.8                          | 49.0                                           |
| Andhra Pradesh                  | 60.0                                  | 26.9                          | 58.6                                           |
| Karnataka                       | 44.8                                  | 18.2                          | 60.9                                           |
| Kerala                          | 34.2                                  | 11.7                          | 35.6                                           |
| Lakshadweep                     | 46.0                                  | 11.4                          | 53.6                                           |
| Puducherry                      | 52.4                                  | 15.9                          | 44.9                                           |
| Tamil Nadu                      | 55.0                                  | 20.4                          | 50.7                                           |
| Telangana                       | 56.6                                  | 15.3                          | 60.7                                           |

Note: Table is based on persons who stayed in the household the night before the interview. Prevalence adjusted for altitude and for smoking status, if known, using formulas in CDC (1998). Haemoglobin in g/ = grams per decilitre.

Source: Nation al Family Health Survey (NFHS) 4 national report .