Lok Sabha Question No. 2976 (UNSTARRED), answered on 2018-12-28
Subject: Severe Acute Malnutrition
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: B.V. NAYAK, JAGDAMBIKA PAL

2976. SHRI B.V. NAIK:

SHRI JAGDAMBIKA PAL:

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

- (a) whether  the  Ministry  has  prepared  any  guidelines  to  tackle  Severe  Acute  Malnutrition  (SAM)  in children and if so, the details thereof along with the total number of children in the country suffering from SAM, State/UT-wise;
- (b) whether the World Health Organization (WHO) has laid down any dietary standards for children suffering from SAM and if so, the details thereof;
- (c) whether the guidelines prepared by the Ministry in 2018 on SAM meets the dietary standards set by WHO and if so, the details thereof and if not, the reasons thereof;
- (d) whether it is a fact that the Central Government has given clearance to the State Governments for providing Ready to Use Therapeutic Food (RUTF) to children suffering from SAM; and
- (e) whether the Government has raised concerns regarding the use of RUTF in the management of SAM children due to which the nutrition policy of Government stands to be changed and if so, the details thereof?

## ANSWER

## MINISTER OF STATE IN THE MINISTRY OF WOMEN AND CHILD DEVELOPMENT (DR. VIRENDRA KUMAR)

- (a) to (c): As per the National Family Health Survey-4 (2015-16), 7.5% children under 5 years of age have severe acute malnutrition in the country. The state-wise details are annexed .

As per the WHO Guidelines, SAM children who are clinically well should be treated as outpatients and those with medical complications should be treated as in-patients.

Accordingly, SAM children with medical complications are managed at the facility level in the country, the guidelines for which have been issued by Ministry of Health and Family Welfare. The document provides the basis for a consistent set of principles that can be used by all states for facility  based  management  of  children  with  SAM.  The  Operational  Guideline  focuses  on  the Facility/Hospital based approach for the management of SAM children under-5 years of age based on the WHO and revised Indian Academy of Paediatrics (IAP) protocols.

For  the  management  of  SAM  Children  without  medical  complications  at  the  community level,  the  guidelines  have  been  drafted  by  the  Ministry  based  on  the  recommendations  of  the technical group comprising of representatives from NITI Aayog, line ministries, experts and other stakeholders; taking into considerations the available scientific evidence and  programme experience in the country and in consultation with National Technical Board on Nutrition.

- (d) & (e): The Government has, as of now, advised States/UTs that for the management of children with Severe Malnutrition, the decision to provide RUTF may be taken by the individual States/UTs in consultation with the National Technical Board on Nutrition under the Chairmanship of Member, NITI Aayog.

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 2976

TO BE ANSWERED ON 28.12.2018

## SEVERE ACUTE MALNUTRITION

| Severe Wasting: As per NFHS-4   | Severe Wasting: As per NFHS-4   | Severe Wasting: As per NFHS-4   |
|---------------------------------|---------------------------------|---------------------------------|
| S. No.                          | Name of State/UT                | Severe Wasting (%)              |
| 1                               | Andaman & Nicobar Islands       | 7.5                             |
| 2                               | Andhra Pradesh                  | 4.5                             |
| 3                               | Arunachal Pradesh               | 8                               |
| 4                               | Assam                           | 6.2                             |
| 5                               | Bihar                           | 7                               |
| 6                               | Chandigarh                      | 3.9                             |
| 7                               | Chhattisgarh                    | 8.4                             |
| 8                               | Delhi                           | 4.6                             |
| 9                               | Dadra & Nagar Haveli            | 11.4                            |
| 10                              | Daman & Diu                     | 11.9                            |
| 11                              | Goa                             | 9.5                             |
| 12                              | Gujarat                         | 9.5                             |
| 13                              | Haryana                         | 9                               |
| 14                              | Himachal Pradesh                | 3.9                             |
| 15                              | Jammu & Kashmir                 | 5.6                             |
| 16                              | Jharkhand                       | 11.4                            |
| 17                              | Karnataka                       | 10.5                            |
| 18                              | Kerala                          | 6.5                             |
| 19                              | Lakshadweep                     | 2.9                             |
| 20                              | Madhya Pradesh                  | 9.2                             |
| 21                              | Maharashtra                     | 9.4                             |
| 22                              | Manipur                         | 2.2                             |
| 23                              | Meghalaya                       | 6.5                             |
| 24                              | Mizoram                         | 2.3                             |
| 25                              | Nagaland                        | 4.2                             |
| 26                              | Odisha                          | 6.4                             |
| 27                              | Punjab                          | 5.6                             |
| 28                              | Puducherry                      | 8.0                             |
| 29                              | Rajasthan                       | 8.6                             |
| 30                              | Sikkim                          | 5.9                             |
| 31                              | Tamil Nadu                      | 7.9                             |
| 32                              | Telangana                       | 4.8                             |
| 33                              | Tripura                         | 6.3                             |
| 34                              | Uttar Pradesh                   | 6                               |
| 35                              | Uttarakhand                     | 9                               |
| 36                              | West Bengal                     | 6.5                             |
|                                 | INDIA                           | 7.5                             |