Lok Sabha Question No. 3008 (UNSTARRED), answered on 2019-12-06
Subject: Funds for Anaemia Control
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dayakar Pasunoori, Mala Roy, Reddeppa Nallakonda Gari

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

## LOK SABHA UNSTARRED QUESTION NO. 3008 TO BE ANSWERED ON 6 TH DECEMBER, 2019

## FUNDS FOR ANAEMIA CO NTROL

## 3008. SHRI PASUNOORI DAYAKAR: MS. MALA ROY: SHRI N. REDDEPPA:

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

- (a) whether it is a fact that a large population particularly women, children are faci diseases like anaemia and other mineral deficiencies in the country particularly in tribal/rural areas;
- (b) if so, the details thereof, State/UT - wise and reasons therefor;
- (c) the schemes being implemented and funds released/spent under each scheme during each the last three years and the current year, State/UT - wise; and
- (d) the corrective measures being taken by the Government to check anaemia epidemic and o mineral deficiencies in the country and achievements thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a)to (b) :

- As per the National Family Health Survey (NFHS) - IV (20015 - 16), 54.2 percent women (15 - 49  years)  and  59.5  percent  children  (6 - 59  months)  in  rural  area  of  the  country  are anaemic.
- As per Comprehensive National Nutrition Survey (2016 - 18), 19% children aged 1 - 4 years, 17 % children aged 5 - 9 years and 32% adolescents aged 10 - 19 years have zinc deficiency in the country.
- The most common cause of anaemia is iron deficiency, caused by in ad quate dietary iron intake  or  absorption,  increased  needs  for  iron  during  pregnancy  or  growth  periods increased  iron  losses  as  a  result  of  menstruation  and  helminth  (intestinal  w infestation.
- Other important causes of anaemia include hemoglobi nopathies such as Sickle Cell anemia, Thalassaemia etc, Malaria and Flurosis.
- The State/UT - wise detail of anaemia prevalence in women and children in rural areas as per NFHS - 4 is provided in Annexure - 1.

(c)to (d) : Government is implementing variou s schemes in order to reduce anaemia cases in the country. The details of these schemes/programmes are as below:

- The Ministry of Health & Family Welfare has launched 'Anemia Mukt Bharat' strategy for prevention and treatment of anaemia in children (6 - 59  months), pre - school children (5 - 9 years),  adolescents  girls  and  boys  (10 - 19  years),  pregnant  and  lactating  women  and  in women  of  reproductive  age  group  (15 - 49  years)  in  programme ode  through  life  cycle approach via Iron & Folic Acid (IFA) supplementation across life stages.
- Since the initiation of the strategy, various activities have been conducted. These a form  of  guidelines  and  dissemination,  training  package,  supply  chain  managemen assessment, quarterly dashboard report for monitoring and review of programme cov e a e.
- Universal  screening  of  pregnant  women  for  anaemia  is  a  part  of  ante -natal  c re  and  all severely anaemic mothers are line listed and followed up for comprehensive management higher facilities.
- Both  the  Health  Management  Information  System  &  Moth er  Child  Tracking  System  are reporting the cases of anaemic and severely anaemic pregnant women.
- In malaria endemic areas, to tackle the problem of anaemia due to malaria particula pregnant  women  and  children,  Long  Lasting  Insecticide  Nets  (LLINs)  an d  Insecticide Treated Bed Nets (ITBNs) are being distributed.
- Health  and  nutrition  education  through  IEC  &  BCC  to  promote  dietary  diversificati inclusion of iron folate rich food as well as food items that promotes iron absorption
- Safe Motherhood Bookl et is being distributed to the pregnant women for educating them o dietary diversification and promotion of consumption of IFA.
- The details of fund sanctioned and utilized for the anaemia prevention and control programme during the last three years and cu rrent year are provided in Annexure 2.

........................

Table 1: State wise Anaemia prevalence among women of reproductive age (15 - 49 years) -Rural

Source NFHS - IV

| Sr no   | State and UT                |   Any (< 12 gm/dl) |   Mild (10.0 - 11.9 gm/dl) |   Moderate (7.0 - 9.9 gm/dl) |   Severe (<7.00 gm/dl) |
|---------|-----------------------------|--------------------|----------------------------|------------------------------|------------------------|
| 1       | Andaman And Nicobar Islands |               65.9 |                       41.3 |                         23.2 |                    1.4 |
| 2       | Andhra Pradesh              |               61.2 |                       39.9 |                         19.4 |                    1.9 |
| 3       | Arunachal Pradesh           |               43.9 |                       34.3 |                          8.8 |                    0.8 |
| 4       | Assam                       |               46.3 |                       37.3 |                          8.4 |                    0.6 |
| 5       | Bihar                       |               60.6 |                       45.8 |                         14.1 |                    0.7 |
| 6       | Chandigarh                  |               92.3 |                       76.9 |                         15.4 |                    0   |
| 7       | Chhattisgarh                |               48.2 |                       38.6 |                          8.8 |                    0.8 |
| 8       | Dadra And Nagar Haveli      |               86.6 |                       63.8 |                         21.5 |                    1.3 |
| 9       | Daman And Diu               |               56.3 |                       43.1 |                         11.3 |                    1.9 |
| 10      | Goa                         |               32.1 |                       26.1 |                          5.1 |                    0.9 |
| 11      | Gujarat                     |               57.5 |                       41.3 |                         14.5 |                    1.7 |
| 12      | Haryana                     |               63.9 |                       43.1 |                         19.3 |                    1.5 |
| 13      | Himachal Pradesh            |               53.4 |                       39.6 |                         13.1 |                    0.7 |
| 14      | Jammu And Kashmir           |               48.5 |                       32.5 |                         14.5 |                    1.5 |
| 15      | Jharkhand                   |               67.3 |                       50.2 |                         16.2 |                    0.9 |
| 16      | Karnataka                   |               46.2 |                       33.5 |                         11.5 |                    1.2 |
| 17      | Kerala                      |               32.6 |                       28.1 |                          4.1 |                    0.4 |
| 18      | Lakshadweep                 |               51.6 |                       35   |                         16.1 |                    0.5 |
| 19      | Madhya Pradesh              |               53.8 |                       40.2 |                         12.5 |                    1.1 |
| 20      | Maharashtra                 |               47.8 |                       36.2 |                         10.6 |                    1   |
| 21      | Manipur                     |               26.3 |                       22.1 |                          3.9 |                    0.3 |
| 22      | Meghalaya                   |               59.6 |                       40.5 |                         17.6 |                    1.5 |
| 23      | Mizoram                     |               30   |                       25.7 |                          4.2 |                    0.1 |
| 24      | Nagaland                    |               29.5 |                       22.8 |                          5.8 |                    0.9 |
| 25      | Delhi                       |               78   |                       43.7 |                         32   |                    2.3 |
| 26      | Odisha                      |               51.8 |                       40.8 |                         10.2 |                    0.8 |
| 27      | Puducherry                  |               54.8 |                       41.4 |                         12.3 |                    1.1 |
| 28      | Punjab                      |               54.3 |                       42.6 |                         11.2 |                    0.5 |
| 29      | Rajasthan                   |               49   |                       35.7 |                         12.1 |                    1.2 |
| 30      | Sikkim                      |               35.1 |                       27.2 |                          7.3 |                    0.6 |
| 31      | Tamil Nadu                  |               56.8 |                       40.6 |                         14.4 |                    1.8 |
| 32      | Tripura                     |               54.1 |                       42.2 |                         11.4 |                    0.5 |
| 33      | Uttar Pradesh               |               52.3 |                       38.6 |                         12.6 |                    1.1 |
| 34      | Uttarakhand                 |               46.2 |                       34.6 |                         10.3 |                    1.3 |
| 35      | West Bengal                 |               64.3 |                       50.4 |                         13.2 |                    0.7 |
| 36      | Telangana                   |               58.1 |                       37.3 |                         18.3 |                    2.5 |
|         | All India                   |               54.2 |                       40.3 |                         12.8 |                    1.1 |

Table 2: State wise Anaemia prevalence among children (6 - 59 months) -Rural Source NFHS - IV

| Sr no   | State and UT                |   Any (< 11 gm/dl) |   Severe (<7.00 gm/dl) |   Mild (10.0 - 10.9 gm/dl) |   Moderate (7.0 - 9.9 gm/dl) |
|---------|-----------------------------|--------------------|------------------------|----------------------------|------------------------------|
| 1       | Andaman And Nicobar Islands |               50   |                    0.8 |                       22.5 |                         26.7 |
| 2       | Andhra Pradesh              |               60.8 |                    2.3 |                       30.6 |                         27.9 |
| 3       | Arunachal Pradesh           |               55   |                    1.1 |                       24.2 |                         29.7 |
| 4       | Assam                       |               36.5 |                    0.4 |                       11.7 |                         24.4 |
| 5       | Bihar                       |               64   |                    1.3 |                       32.2 |                         30.5 |
| 6       | Chandigarh                  |              100   |                   12.5 |                       62.5 |                         25   |
| 7       | Chhattisgarh                |               41.2 |                    0.5 |                       17   |                         23.7 |
| 8       | Dadra And Nagar Haveli      |               87.7 |                    2.2 |                       51.5 |                         34   |
| 9       | Daman And Diu               |               76.7 |                    1.3 |                       35.5 |                         39.9 |
| 10      | Goa                         |               41.2 |                    0.5 |                       14.8 |                         25.9 |
| 11      | Gujarat                     |               64.5 |                    1.9 |                       30.7 |                         31.9 |
| 12      | Haryana                     |               73   |                    3.2 |                       41.3 |                         28.5 |
| 13      | Himachal Pradesh            |               53.3 |                    2.5 |                       28.1 |                         22.7 |
| 14      | Jammu And Kashmir           |               55.6 |                    2.6 |                       30.9 |                         22.1 |
| 15      | Jharkhand                   |               71.5 |                    1.1 |                       38.4 |                         32   |
| 16      | Karnataka                   |               63.4 |                    1   |                       30.3 |                         32.1 |
| 17      | Kerala                      |               35.9 |                    0.4 |                       12.9 |                         22.6 |
| 18      | Lakshadweep                 |               67.2 |                    0   |                       30   |                         37.2 |
| 19      | Madhya Pradesh              |               69.8 |                    1.9 |                       38.1 |                         29.8 |
| 20      | Maharashtra                 |               54   |                    0.8 |                       25.5 |                         27.7 |
| 21      | Manipur                     |               23.3 |                    0.2 |                        6.8 |                         16.3 |
| 22      | Meghalaya                   |               48.9 |                    0.6 |                       17.8 |                         30.5 |
| 23      | Mizoram                     |               24.5 |                    0.9 |                        8   |                         15.6 |
| 24      | Nagaland                    |               28   |                    0.4 |                       11.4 |                         16.2 |
| 25      | Delhi                       |               88.2 |                    8.7 |                       57.5 |                         22   |
| 26      | Odisha                      |               45.6 |                    0.9 |                       19.7 |                         25   |
| 27      | Puducherry                  |               48.5 |                    0.7 |                       16.3 |                         31.5 |
| 28      | Punjab                      |               57.1 |                    1.1 |                       28.1 |                         27.9 |
| 29      | Rajasthan                   |               61.6 |                    2   |                       32.5 |                         27.1 |
| 30      | Sikkim                      |               52.7 |                    0.5 |                       20.7 |                         31.5 |
| 31      | Tamil Nadu                  |               52.5 |                    1.3 |                       23.9 |                         27.3 |
| 32      | Tripura                     |               49.2 |                    0.3 |                       18.8 |                         30.1 |
| 33      | Uttar Pradesh               |               62.6 |                    2.1 |                       33.9 |                         26.6 |
| 34      | Uttarakhand                 |               59.2 |                    2.2 |                       30.6 |                         26.4 |
| 35      | West Bengal                 |               53.7 |                    0.6 |                       21.4 |                         31.7 |
| 36      | Telangana                   |               67.4 |                    3.4 |                       39.2 |                         24.8 |
|         | All India                   |               59.5 |                    1.5 |                       29.8 |                         28.2 |

## Annexure 2

## Details on funds released and spent on Anemia control for last three financial years (2016 - 17, 2017 - 18, 2018 - 19 and 2019 - 209 till Q - 2)

State-wise details of State Programme Implementation Plans Approvals and Expenditure for Anemia under NHM from the F.Y. 2016-17 to 2019-20

(Rs. in Lakhs)

| S.No.                | State             | 2016-17 (Rs in lakhs)   | 2016-17 (Rs in lakhs)   | 2017-18 (Rs in Lakhs)   | 2017-18 (Rs in Lakhs)   | 2018-19 (Rs in Lakhs)   | 2018-19 (Rs in Lakhs)   | 2019-20 till Q-2 (Rs in Lakhs)   | 2019-20 till Q-2 (Rs in Lakhs)   |
|----------------------|-------------------|-------------------------|-------------------------|-------------------------|-------------------------|-------------------------|-------------------------|----------------------------------|----------------------------------|
| A. High Focus States |                   | SPIP                    | EXP                     | SPIP                    | EXP                     | SPIP                    | EXP                     | SPIP                             | EXP                              |
| 1                    | Bihar             | 5856.69                 | 268.77                  | 4665.79                 | 1670.42                 | 13205.59                | 4029.99                 | 12827.90                         | 1096.17                          |
| 2                    | Chattisgarh       | 2784.50                 | 633.34                  | 4023.29                 | 862.81                  | 4041.01                 | 610.77                  | 3351.31                          | 1134.99                          |
| 3                    | Himachal Pradesh  | 60.77                   | 58.22                   | 109.50                  | 29.13                   | 1727.14                 | 1201.32                 | 1207.60                          | 340.85                           |
| 4                    | Jammu & Kashmir   | 736.98                  | 199.78                  | 911.30                  | 86.70                   | 3160.14                 | 2016.69                 | 2311.87                          | 682.90                           |
| 5                    | Jharkhand         | 2083.53                 | 535.25                  | 1417.08                 | 1064.94                 | 6524.48                 | 5190.68                 | 3791.72                          | 1245.76                          |
| 6                    | Madhya Pradesh    | 2212.28                 | 1551.86                 | 2075.22                 | 1077.63                 | 10219.90                | 5954.13                 | 10644.91                         | 2323.41                          |
| 7                    | Orissa            | 408.91                  | 115.33                  | 2535.50                 | 1186.22                 | 5498.59                 | 2794.04                 | 2462.95                          | 183.23                           |
| 8                    | Rajasthan         | 2273.28                 | 802.37                  | 1643.52                 | 973.49                  | 7828.55                 | 7630.83                 | 9040.06                          | 1074.75                          |
| 9                    | Uttar Pradesh     | 2765.30                 | 2352.07                 | 7189.98                 | 1950.75                 | 29094.66                | 21104.7 0               | 26713.02                         | 3597.80                          |
| 10                   | Uttarakhand       | 133.28                  | 192.28                  | 490.89                  | 339.49                  | 1289.98                 | 1498.70                 | 1114.02                          | 777.18                           |
|                      | Sub Total         | 19315.5 2               | 6709.26                 | 25062.0 7               | 9241.5 8                | 82590.0 4               | 52031. 85               | 73465.36                         | 12457.0 4                        |
| B. NE States         |                   |                         |                         |                         |                         |                         |                         |                                  |                                  |
| 11                   | Arunachal Pradesh | 61.11                   | 109.02                  | 692.11                  | 192.45                  | 457.03                  | 273.75                  | 651.03                           | 37.86                            |
| 12                   | Assam             | 2528.34                 | 875.24                  | 2359.00                 | 1122.00                 | 6422.18                 | 2442.58                 | 4519.78                          | 904.37                           |
| 13                   | Manipur           | 172.62                  | 155.34                  | 188.13                  | 60.27                   | 404.71                  | 278.77                  | 529.57                           | 57.14                            |
| 14                   | Meghalaya         | 470.40                  | 492.83                  | 1623.62                 | 791.87                  | 847.10                  | 2331.98                 | 839.31                           | 149.94                           |
| 15                   | Mizoram           | 228.13                  | 126.76                  | 436.91                  | 121.68                  | 305.12                  | 165.94                  | 336.68                           | 35.85                            |
| 16                   | Nagaland          | 160.49                  | 115.37                  | 312.61                  | 436.35                  | 413.91                  | 217.30                  | 488.86                           | 40.05                            |
| 17                   | Sikkim            | 59.00                   | 15.28                   | 65.87                   | 35.60                   | 137.23                  | 46.59                   | 92.91                            | 11.75                            |
| 18                   | Tripura           | 88.07                   | 177.72                  | 501.98                  | 189.33                  | 869.09                  | 543.74                  | 529.08                           | 109.61                           |
|                      | Sub Total         | 3768.16                 | 2067.56                 | 6180.23                 | 2949.5 6                | 9856.37                 | 6300.6 3                | 7987.22                          | 1346.56                          |
| C. Non- High         |                   |                         |                         |                         |                         |                         |                         |                                  |                                  |

| Focus States         |                            |           |           |           |           |           |           |           |           |
|----------------------|----------------------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| 19                   | Andhra Pradesh             | 1420.18   | 670.49    | 1847.01   | 1199.06   | 4661.23   | 3408.76   |   4671.53 | 1299.53   |
| 20                   | Goa                        | 57.66     | 43.00     | 96.86     | 62.59     | 194.96    | 103.43    |    131.94 | 42.29     |
| 21                   | Gujarat                    | 2092.35   | 1970.50   | 2006.09   | 1777.60   | 4672.28   | 3684.33   |   4630.87 | 1366.57   |
| 22                   | Haryana                    | 228.10    | 36.64     | 752.23    | 123.13    | 1696.82   | 767.90    |   1511.18 | 376.32    |
| 23                   | Karnataka                  | 1435.33   | 1343.73   | 4228.65   | 1435.29   | 6137.54   | 3016.99   |   6852.27 | 1255.81   |
| 24                   | Kerala                     | 590.92    | 615.72    | 606.76    | 436.60    | 2286.59   | 2031.74   |   2768.28 | 424.73    |
| 25                   | Maharashtra                | 5761.67   | 1785.26   | 7415.30   | 1090.56   | 6187.73   | 3940.79   |  17158.1  | 628.94    |
| 26                   | Punjab                     | 1280.14   | 1161.75   | 1372.64   | 329.04    | 3934.19   | 343.36    |   4255.4  | 586.93    |
| 27                   | Tamil Nadu                 | 1746.72   | 1961.67   | 907.48    | 1264.48   | 7193.91   | 5775.45   |   8824.07 | 2314.01   |
| 28                   | Telangana                  | 1582.83   | 417.75    | 852.06    | 1388.81   | 3045.94   | 1587.74   |   2049.41 | 857.34    |
| 29                   | West Bengal                | 3718.45   | 1979.34   | 4016.35   | 3394.70   | 9058.50   | 6348.74   |  12782.8  | 2274.88   |
|                      | Sub Total                  | 19914.3 6 | 11985.8 4 | 24101.4 3 | 12501. 85 | 49069.6 9 | 31009. 23 |  65635.8  | 11427.3 6 |
| D. Small States/ UTs | Andaman &                  | 47.37     | 10.66     | 74.65     | 7.95      | 32.37     | 20.50     |     23.99 | 11.17     |
| 30 31                | Nicobar Islands Chandigarh | 15.91     | 1.87      | 2.25      | 0.42      | 126.57    | 106.93    |      1.2  | 0.12      |
| 32                   | Dadra & Nagar Haveli       | 119.59    | 9.54      | 30.24     | 102.76    | 124.16    | 23.37     |     15.97 | 0.00      |
| 33                   | Daman & Diu                | 13.56     | 4.09      | 24.38     | 11.17     | 30.31     | 7.02      |     33.2  | 0.05      |
| 34                   | Delhi                      | 38.45     | 15.34     | 203.16    | 11.08     | 1523.28   | 154.58    |   1839.66 | 46.29     |
| 35                   | Lakshadweep                | 7.07      | 0.00      | 14.30     | 3.03      | 45.94     | 4.42      |      9.71 | 1.64      |
| 36                   | Puducherry                 | 130.83    | 132.19    | 124.74    | 86.68     | 320.16    | 186.59    |    356.8  | 13.68     |
|                      | Sub Total                  | 372.78    | 173.68    | 473.72    | 223.07    | 2202.79   | 503.41    |   2280.53 | 72.95     |
|                      | Grand Total                | 43370.82  | 20936.35  | 5         | 6         | 89        | 2         |      3    | 1         |
|                      |                            |           |           | 55817.4   | 24916.0   | 143718.   | 89845.1   | 149369    | 25303.9   |

## Note:

1. SPIP means State Programme Implementation Plan.
2. Expenditure includes expenditure against central Release, State release & unspent balan the beginning of  the year. Data is as updated up to 30.09.2019, hence provisional.
3. The above data is as per FMR submitted by States, hence provisional.