Lok Sabha Question No. 4351 (UNSTARRED), answered on 2019-12-13
Subject: Anaemia
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Reddeppa Nallakonda Gari, Geetha Viswanath Vanga

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA UNSTARRED QUESTION NO. 4351

TO BE ANSWERED ON 13.12.2019

## ANAEMIA

4351.  SHRI N.REDDEPPA: SHRIMATI VANGA GEETHA VISHWANATH:
2. (a) whether the Government is aware that 51 percent of women between ages 15-49 years are suffering with anaemia, if so, the details thereof and the reasons therefor;
3. (b) whether it is also a fact that this figure is the highest in the world, if so, the details thereof;
4. (c) whether it is also a fact that children of more than 38 percent are suffering from deficiencies in their mental growth and physical development and one in  two  are  suffering  from  anaemia,  if  so,  the  details  thereof,  State-wise including Andhra Pradesh and the reasons therefor;
5. (d) whether  it  is  also  a  fact  that  through  the  National  Nutrition  Mission,  the Government has identified 315 districts in the first year, 235 districts in the 2 nd year and by third year, all the districts in the country are proposed to be covered by the schemes of NNM, if so, the details thereof particularly in Andhra Pradesh;
6. (e) whether the Government proposes to converge all the existing schemes for  below six  years children, lactating mothers and pregnant women into one scheme under NNM to strengthen it as the existing ICDS scheme has not given the desired results;
7. (f) if  so, the details thereof and the progress made so far in view of the fact that  more  than  30  percent  of  the  children  are  born  with  low  nutritional status; and
8. (g) whether countries like Ghana and Togo are better than Andhra Pradesh in this regard, if so, the details thereof?

## ANSWER

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

(a) As  per  National  Family  Health  Survey  (NFHS)-4  conducted  in  2015-16, 53.1% women in the age group of 15-49 years are anaemic, which is a reduction from  the  previous  NFHS-3  conducted  in  2005-06,  which  reported  55.3%  being anaemic  in  this  age  group.  There  are  multiple  reasons  which  can  cause  anemia among  women,  most  important  among  them inter  alia include  iron  loss  during menstruation, poor iron stores from infancy, iron loss due to post-partum haemorrhage, increased requirements during pregnancy, teenage pregnancy, repeated pregnancies with less than 2 years' interval, etc.

- (b) As per WHO report on worldwide prevalence of anaemia (1993-2005), in India the proportion of non-pregnant women of reproductive age (15-49.9 years) who are anaemic  (Hb<12g/dl)  is  at  52.  Other  countries  with  higher  or  equal  proportion  of anaemic non-pregnant women of reproductive age are Angola (52.3), Benin (63.2), Bhutan (54.8), Cambodia (57.3), Chad (52.4), Congo (52.8), Ethiopia (52.3), Gambia (59.1%), Guinea-Bissau (52.9), Guyana (53.9) and Haiti (54.4). Moreover, as per

NFHS-3 (2005-2006) 55.2% non-pregnant women (age 15-49 years)were anaemic as compared to 53.1% as per NFHS-4 (2015-16), which shows a reduction.

(c) As per NFHS- 4, 38.4% children under 5 years of age are stunted and 58.5% have  anemia.  However,  the  levels  have  reduced  further  as  reported  under  the Comprehensive National Nutrition Survey (2016-18), which reported 34.7% children under 5 years as stunted and 40.5% anaemic.The detailed State-wise prevalence of stunting and anemia among children under 5 years of age is annexed.

There are various causes for anemia among children, which inter alia include low iron stores at birth due to maternal anaemia, non-exclusive breastfeeding, poor complementary feeding practices, insufficient quantity of iron and iron enhancers in diet  such  as  foods  rich  in  Vitamin-C,  increased  iron  requirements  related  to  rapid growth and development during infancy and childhood, iron losses due to parasite load (e.g. malaria, intestinal worms), unsafe drinking water and inadequate personal hygiene and poor environmental sanitation, etc.

(d) Government has  set  up  POSHAN Abhiyaan  on  18.12.2017  for a  three  year time frame commencing from 2017-18 and to ensure a holistic approach with a goal to achieve improvement in nutritional status of Children from 0-6 years, Adolescent Girls,  Pregnant Women and Lactating Mothers in a time bound manner. POSHAN Abhiyaan was rolled out in a phased manner, viz., 315 districts in the first year, 235 districts  in  the  2 nd year  and  subsequently  all  the  districts  in  the  country  including Andhra Pradesh.

(e)  &  (f)  The  salient  features  of  the  POSHAN  Abhiyaan  inter-alia  include  ensuring convergence  with  various  programmes;  incentivizing  States/  Union  Territories  for achieving  targeted  goals;  Information  and  Communication  Technology  enabled Integrated  Child  Development  Services-Common  Application  Software;  Evaluation by NITI Aayog; Setting up of National Nutrition Resource  Centre (NNRC) at National level  and  State  Nutrition  Resource  Centre  (SNRC)  in  each  State/Union  Territory; Community Mobilization & Behaviour Change & Communication, Awareness Advocacy    and  Information  Education  Communication;  Jan  Andolan  by  educating people on nutritional aspects; Innovation; Strengthening human resource; measuring height and weight of children below 6 years of age for early detection of stunting and wasting;  strengthening of Training & Capacity Building etc. POSHAN Abhiyaan  and  Anganwadi  Services  Scheme  are  mutually  complementary  and support each other.

(g) As  per  the  report  of  State  of  the  World's  Children,  2019,  published  by UNICEF,  in  Ghana,  19%  children  (0-4  years  of  age)  are  stunted  and  5%  are wasted and in Togo, 28% are stunted and 17.2% are wasted. As per the report of NFHS-4  conducted  in  2015-16,  in  the  State  of  Andhra  Pradesh,  31.4%  children under 5 years of age are stunted and 17.2% are wasted. As per the recent report of Comprehensive National Nutrition Survey (CNNS) (2016-18), in the State of Andhra Pradesh, 31.5% children are stunted and 17.1% are wasted.

*******

Statement referred in  reply  to  part  (c)  of  Lok  Sabha  Unstarred  Question  No. 4351  for  answer  on  13.12.2019  raised  by  Shri  N.  Reddeppa,  Shrimati  Vanga Geetha Vishwanath

Prevalence of Stunting and Anaemia among children under 5 years of age as per NFHS-4 (2015-16) and CNNS (2016-18)

| S. No.   | State              | Stunting (%)   | Stunting (%)   | Anaemia (%)   | Anaemia (%)   |
|----------|--------------------|----------------|----------------|---------------|---------------|
|          |                    | NFHS-4         | CNNS           | NFHS-4        | CNNS          |
| 1        | Andaman & Nicobar  | 23.3           | -              | 49            | -             |
| 2        | Andhra Pradesh     | 31.4           | 31.5           | 58.6          | 39.6          |
| 3        | Arunachal Pradesh  | 29.4           | 28             | 54.2          | 28.3          |
| 4        | Assam              | 36.4           | 32.4           | 35.7          | 33.7          |
| 5        | Bihar              | 48.3           | 42             | 63.5          | 43.7          |
| 6        | Chandigarh         | 28.7           | -              | 73.1          | -             |
| 7        | Chhattisgarh       | 37.6           | 35.4           | 41.6          | 40.8          |
| 8        | Delhi              | 31.9           | 28.8           | 59.7          | 47            |
| 9        | Dadra Nagar Haveli | 41.7           | -              | 84.6          | -             |
| 10       | Daman & Diu        | 23.4           | -              | 73.8          | -             |
| 11       | Goa                | 20.1           | 19.6           | 48.3          | 22.1          |
| 12       | Gujarat            | 38.5           | 39.1           | 62.6          | 38.2          |
| 13       | Haryana            | 34             | 34.9           | 71.7          | 48.3          |
| 14       | Himachal Pradesh   | 26.3           | 28.4           | 53.7          | 29.7          |
| 15       | Jammu & Kashmir    | 27.4           | 15.5           | 54.5          | 27.1          |
| 16       | Jharkhand          | 45.3           | 36.2           | 69.9          | 43.7          |
| 17       | Karnataka          | 36.2           | 32.5           | 60.9          | 34.7          |
| 18       | Kerala             | 19.7           | 20.5           | 35.7          | 12.5          |
| 19       | Lakshadweep        | 27             | -              | 53.6          | -             |
| 20       | Madhya Pradesh     | 42             | 39.5           | 68.9          | 53.5          |
| 21       | Maharashtra        | 34.4           | 34.1           | 53.8          | 41.6          |
| 22       | Manipur            | 28.9           | 28.9           | 23.9          | 10            |
| 23       | Meghalaya          | 43.8           | 40.4           | 48            | 32.9          |
| 24       | Mizoram            | 28.1           | 27.4           | 19.3          | 24.4          |
| 25       | Nagaland           | 28.6           | 26.2           | 26.4          | 8             |
| 26       | Odisha             | 34.1           | 29.1           | 44.6          | 37.2          |
| 27       | Punjab             | 25.7           | 24.3           | 56.6          | 39.8          |
| 28       | Puducherry         | 23.7           | -              | 44.9          | -             |
| 29       | Rajasthan          | 39.1           | 36.8           | 60.3          | 32.4          |
| 30       | Sikkim             | 29.6           | 21.8           | 55.1          | 33            |
| 31       | Tamil Nadu         | 27.1           | 19.7           | 50.7          | 27.3          |
| 32       | Telangana          | 28.1           | 29.3           | 60.7          | 37.8          |
| 33       | Tripura            | 24.3           | 31.9           | 48.3          | 33            |
| 34       | Uttar Pradesh      | 46.3           | 38.8           | 63.2          | 43            |
| 35       | Uttarakhand        | 33.5           | 29.9           | 59.8          | 32.4          |
| 36       | West Bengal        | 32.5           | 25.3           | 54.2          | 45.7          |
|          | India              | 38.4           | 34.7           | 58.5          | 40.5          |