Lok Sabha Question No. 35 (UNSTARRED), answered on 2019-06-21
Subject: Severe Acute Malnutrition (SAM)
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Pritam Gopinath Munde, Shrirang Appa Barne, Shrikant Eknath Shinde

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO.35 TO BE ANSWERED ON 21.06.2019

## SEVERE ACUTE MALNUTRITION (SAM)

## 35.    DR. PRITAM GOPINATHRAO MUNDE:

## SHRI SRIRANGA APPA BARNE:

DR. SHRIKANT EKNATH SHINDE:

Will the Minister of WOMEN AND CHILD DEVELOPMENT be pleased to state:

- (a) whether India has twice the number of underweight children than sub Saharan Africa and if so, the details thereof;
- (b) whether food fortification has proved to be one of the most effective ways to supplement the nutrition needs of the population and if so, the details thereof;
- (c) whether packaged fortified food has shown remarkable result in treating patients with Severe Acute Malnutrition (SAM) in Africa but has proved much less effective in trials conducted in India, if so, the reasons therefor;
- (d) whether the Government has also received concerns from the experts cautioning against 'quick fixes' of buying commercial products instead of focusing on sustainable measures such as care and support for mothers, clean drinking water and food security in this regard, if so, the details thereof; and
- (e) the steps taken by the Government for the awareness of malnutrition and protective method to eradicate this problem?

## ANSWER

## MINISTER OF WOMEN AND CHILD DEVELOPMENT (SHRIMATI SMRITI ZUBIN IRANI)

- (a) As per the UNICEF report entitled 'The State of the World's Children' 2016, 19% children under 5 years were underweight in Sub-Saharan Africa and as per National Family Health Survey (NFHS) 4 conducted by Ministry of Health and Family Welfare in 2015-16, 35.7% children under 5 years are underweight in India.
- (b) Food fortification is a 'Complementary strategy' and 'not a replacement of balanced, diversified diets' to address malnutrition.
- (c) This  Ministry  is  not  aware  of  any  such  trial.  However,  in  India  children  with  Severe  Acute Malnutrition are treated at the Nutrition Rehabilitation Centres established by the Ministry of Health and Family Welfare.
- (d) The Government has accorded high priority to the issue of malnutrition and is implementing several  schemes/programmes  of  different  Ministries/Departments  through  States/UTs  to  address various aspects related to nutrition. This Ministry is implementing schemes like Anganwadi Services, Scheme for Adolescent Girls and Pradhan Mantri Matru Vandana Yojna under the Umbrella Integrated Child  Development  Services  Scheme  as  direct  targeted  interventions  to  address  the  problem  of malnutrition in the country. Care and support for mothers, clean drinking water and food security are some of the components to treat malnutrition.
- (e) Government has set up POSHAN Abhiyaan on 18.12.2017 for a three year time frame commencing from 2017-18 with an overall budget of Rs. 9046 Crore. To ensure a holistic approach, all 36 States/UTs and districts have been covered. The goals of POSHAN Abhiyaan are to achieve improvement in nutritional status of Children from 0-6 years, Adolescent Girls, Pregnant Women and Lactating Mothers in a time bound manner during the three years with fixed targets as under:

|   S.No | Objective                                                                                         | Target        |
|--------|---------------------------------------------------------------------------------------------------|---------------|
|      1 | Prevent and reduce Stunting in children (0- 6 years)                                              | By 6% @2%p.a. |
|      2 | Prevent and reduce under-nutrition (underweight prevalence) in children (0-6 years)               | By 6% @2%p.a. |
|      3 | Reduce the prevalence of anemia among young Children(6-59 months)                                 | By 9% @3%p.a. |
|      4 | Reduce the prevalence of anemia among Women and Adolescent Girls in the age group of 15-49 years. | By 9% @3%p.a. |
|      5 | Reduce Low Birth Weight (LBW).                                                                    | By 6% @2%p.a. |

The  Abhiyaan  aims  to  reduce  malnutrition  in  the  Country  in  a  phased  manner,  through  a  life  cycle approach, by adopting a synergised and result oriented approach. The Abhiyaan will ensure mechanisms for timely service delivery and a robust monitoring as well as intervention infrastructure. Target is to bring down stunting of the children in the age group of 0-6 years from 38.4% to 25% by the year 2022. The major works undertaken under this Abhiyaan are ensuring convergence with various other programmes; Information  Technology enabled  Common Application Software for  strengthening  service  delivery  and interventions; Community Mobilization and Awareness Advocacy leading to Jan Andolan- to educate the people on nutritional aspects; Capacity Building of Frontline Functionaries, incentivizing States/ UTs for achieving goals etc.

Anganwadi Services, which aims to improve the nutritional and health status of children in the age-group 0-6  years,  pregnant  women  &  lactating  mothers  and  reduce  the  incidence  of  mortality,  morbidity  and malnutrition. Under the Scheme, a package of six services is provided through a network of Anganwadi Centers,  which  include  supplementary  nutrition,  pre-school  non-formal  education,  nutrition  &  health education, immunization, health check-up and referral services.

Pradhan Mantri  Matru  Vandana  Yojana,  which  is  a  centrally  sponsored  Conditional  Maternity  Benefit scheme of the Ministry for pregnant and lactating women. Under the scheme, cash incentives are provided partly compensating for their wage loss subject to fulfilment of health and nutrition conditions.

Ministry of Health and Family Welfare is implementing various Child Health Programmes at national level such as Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakaram ( JSSK), Special Newborn Care  Units  (  SNCU),  Newborn  Stabilization  Units  (  NSBU)  ,  Kangaroo  Mother  Care  (  KMC)  units, Comprehensive Lactation Management Centers, Home Based Newborn Care, Village Health and Nutrition Days, MAA Programme, Universal Immunization Programme, etc.

Food and Nutrition Board under this Ministry, through its regional field units,  conducts  training programmes  in  nutrition  and  generates  awareness  through  nutrition  education  programmes  on  the importance  of  healthy  balanced  diets  especially  through  the  use  of  locally  available  foods,  mass awareness campaigns and use of electronic and print media.

Behaviour change communication and nutrition education is also addressed through different Government programmes such as POSHAN Abhiyaan, Anganwadi Services, Mothers' Absolute Affection (MAA), etc.

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