Lok Sabha Question No. 1104 (UNSTARRED), answered on 2020-02-07
Subject: National Nutrition Survey
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Upendra Singh Rawat

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

## LOK SABHA UNSTARRED QUESTION NO. 1104 TO BE ANSWERED ON 7 th FEBRUARY, 2020

## NATIONAL NUTRITION S URVEY

## 1104. SHRI UPENDRA SINGH RAWAT:

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

- (a) whether it is a fact that the Comprehensive National Nutrition Survey has found a number ofdeficiencies in the health of the children in the country including Uttar Pradesh;
- (b) if so, the details thereof, State/UT - wis ;
- (c) whether any steps are being taken by the Governm nt to address the issues which have beenhighlighted in the said survey;
- (d) if so, the details thereof; and
- (e) if not, the reasons therefor?

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

## (SHRI ASHWINI KUMAR CHOUBEY)

- (a )& ( b): As per the Comprehensive National Nutrition Survey (CNNS) conducted by Ministry of Health and Family welfare (MoHFW) stunting is 34.7%, wasting is 1 7.3% and underweight is 33.4% in under five children. The Anemia prevalence as per the surve 40.5% and the deficiency of serum ferritin (Iron) is 31.9%.

Similarly, the deficiency of various other micronutrients at the National level five chi ldren is as under:

Vitamin A-17.6%

Vitamin - D -13.8%

Zinc-18.9%,

Vitamin B12-13.8%

Folate -23.3%

The level of median urinary iodine concentration was 213 at country level.

The State wise details including Uttar Pradesh is annexed.

- (c )to(e): Ministry  of  Health  and  Family  Welfare  (MoHFW)  has  constituted  five  sub groups for in - depth review/analysis of CNNS results to provide evidence based policy an programme implications. The five constituted sub groups are as under:
1. Vitamin A & Vitamin D deficiency
2. Anemia and Zinc deficiency
3. Iodine deficiency
4.  Non  Communicable  Disease  (NCD),  Overweight  and  Obesity  and  Chronic  Kidney diseases
5. Early Childhood Development, Anthropometry and hand grip strength and adolescent nutrition.

In  add ition  the  Government  of  India  has  launched  POSHAN  (Prime  Minister Overarching Scheme for Holistic Nourishment) Abhiyaan, to address malnutrition in In through  convergence,  behaviour  change,  IEC  advocacy,  training  and  capacity  buildi innovations and d emand generation. POSHAN Abhiyaan focuses on educating families on the  need  for  nutrition  and  motivating  them  on  adopting  these  into  their  behaviour promotion  of  locally  available  nutritious  food  through  various  community  based  ev (CBEs),  exhibiti ons,  rallies,  workshops  and  meetings  is  one  of  the  strategies  under POSHAN Abhiyaan.

The Ministry of Health and Family Welfare (MoHFW) is an important stakeholder of the  POSHAN  Abhiyaan.  Anaemia  Mukt  Bharat  (AMB)  strategy,  Defeat  Diarrhea  (D - 2) initi ative and Home Based Care of Young Children (HBYC) are the important components of the POSHAN Abhiyaan implemented by MoHFW.

Ministry  of  Health  and  family  Welfare  has  also  initiated  various  advocacy awareness campaigns including the 'Eat Right India' Campaign, which is built on the two broad pillars of 'Eat Healthy' and 'Eat Safe'. This aims to engage, excite and enable improve their health and wellbeing.

Village  Health  Sanitation  and  Nutrition  Day  (VHSND)  platform  is  being  used  fo crea ting  community  awareness  on  importance  of  balanced  and  healthy  diet,  and  bringi desired changes in the dietary practices through group counselling sessions.

The Government is also promoting use of fortified wheat flour, fortified rice, f oil an d double fortified salt in public funded supplementary nutrition programmes.

In  order  to  prevent  and  control  major  Non  Communicable  Diseases  (NCDs)  the National Programme for Prevention of Control of Cancer, Diabetes, Cardiovascular Disea and Stroke i s being implemented in all the States/UTs. Under NPCDCS, NCD cell have been established  at  National,  State  and  District  levels  for  programme  management,  and  N clinics are being set up at District and block levels, to provide services for early treatment and follow - up for common NCDs. Health promotion through behavior change with involvement of community, civil society, community based organization, schools and med etc is an important activity. The role of physical activities in health promoti on and prevention of NCDs is also being adopted as key strategy.

The MoHFW is implementing RMNCAH+N strategy under National Health Mission (NHM)  to  reduce  malnutrition  across  the  life  cycle.  The  various  intervention micronutrients  supplementation  program  including  Anemia  Mukt  Bharat  (AMB)  and biannual  Vitamin - A  supplementati on,  management  of  sick  children  with  severe  acute malnutrition in Nutrition Rehabilitation Centres (NRCs), improvement of appropriate I

and  Young  Child  Feeding  (IYCF)  Practices  under  Mothers  Absolute  Affection  (MAA) programme,  National Deworming Day, Universal Immunisation Programme (UIP) Janani Shishu Suraksha Karyakram (JSSK), Rastriya Bal Swasthya Karyakaram (RBSK) and Home Based Newborn Care.

All  these  programs  address  one  or  other  aspects  related  to  nutrition  and  hav potential to improve nu tritional outcomes in the country.

## State wise findings of CNNS in Children (1 -5 years)  as per CNNS

| S. No   | State/UT             | Stunting   | Under weight   | Wast ing   | Ane mia   | Serum ferritin (Iron deficie ncy)   | Vitami n-A deficie ncy   | Vitami n-D deficie ncy   | Zinc deficie ncy   | Vitami n B-12 deficie ncy   | Folate deficie ncy   | Median Urinary Iodine Concent ration   |
|---------|----------------------|------------|----------------|------------|-----------|-------------------------------------|--------------------------|--------------------------|--------------------|-----------------------------|----------------------|----------------------------------------|
| 1       | India                | 34.7       | 33.4           | 17.3       | 40.5      | 31.9                                | 17.6                     | 13.8                     | 18.9               | 13.8                        | 23.3                 | 213                                    |
| 2       | Delhi                | 28.8       | 28.1           | 14.8       | 47.0      | 38.3                                | 17.8                     | 32.5                     | 18.9               | 7.8                         | 1.3                  | 241                                    |
| 3       | Haryana              | 34.9       | 28.8           | 11.7       | 48.3      | 58.9                                | 26.1                     | 27.6                     | 6.2                | 11.6                        | 14.6                 | 252                                    |
| 4       | Himachal Pradesh     | 28.4       | 22.6           | 11.0       | 29.7      | 34.5                                | 5.9                      | 4.6                      | 41.1               | 6.9                         | 4.6                  | 101                                    |
| 5       | Jammu & Kashmir      | 15.5       | 13.1           | 14.9       | 27.1      | 44.7                                | 8.7                      | 22.9                     | 21.4               | 7.9                         | 5.9                  | 221                                    |
| 6       | Punjab               | 24.3       | 19.7           | 6.7        | 39.8      | 67.2                                | 17.2                     | 52.1                     | 21.0               | 17.1                        | 9.8                  | 188                                    |
| 7       | Rajasthan            | 36.8       | 31.5           | 14.3       | 32.4      | 44.3                                | 4.5                      | 25.2                     | 9.1                | 15.6                        | 34                   | 208                                    |
| 8       | Uttarakha nd         | 29.9       | 18.7           | 5.9        | 32.4      | 51.2                                | 14.3                     | 46.4                     | 22.4               | 19                          | 17.6                 | 167                                    |
| 9       | Chhattisga rh        | 35.4       | 40.0           | 19.3       | 40.8      | 38.5                                | 26.6                     | 10.5                     | 18.6               | 21.1                        | 43.7                 | 234                                    |
| 10      | Madhya Pradesh       | 39.5       | 38.7           | 19.6       | 53.5      | 45.9                                | 27.1                     | 7.7                      | 22.3               | 11.6                        | 57.6                 | 132                                    |
| 11      | Uttar Pradesh        | 38.8       | 36.8           | 18.5       | 43.0      | 23.9                                | 17.1                     | 13.2                     | 22.1               | 23.2                        | 6.1                  | 211                                    |
| 12      | Bihar                | 42.0       | 38.7           | 14.5       | 43.7      | 20.2                                | 23.5                     | 22.7                     | 19.7               | 13.8                        | 6.1                  | 259                                    |
| 13      | Jharkhand            | 36.2       | 42.9           | 29.1       | 43.7      | 13.8                                | 43.2                     | 19.2                     | 28.4               | 17.6                        | 5.3                  | 150                                    |
| 14      | Odisha               | 29.1       | 29.2           | 13.9       | 37.2      | 30.4                                | 19.8                     | 6.7                      | 18.7               | 7.2                         | 34.4                 | 197                                    |
| 15      | West Bengal          | 25.3       | 30.9           | 20.1       | 45.7      | 21.1                                | 5.0                      | 7.0                      | 15.2               | 1.9                         | 0.3                  | 239                                    |
| 16      | Arunachal Pradesh    | 28.0       | 15.5           | 6.8        | 28.3      | 14.9                                | 14.8                     | 7.3                      | 8.4                | 7                           | 38                   | 266                                    |
| 17      | Assam                | 32.4       | 29.4           | 19.4       | 33.7      | 8.5                                 | 21.4                     | 1.1                      | 27.1               | 2.8                         | 59.9                 | 132                                    |
| 18      | Manipur              | 28.9       | 13.0           | 6.0        | 10.0      | 17.4                                | 17.1                     | 41.2                     | 26.6               | 4.3                         | 6.4                  | 170                                    |
| 19      | Meghalaya            | 40.4       | 29.6           | 14.7       | 32.9      | 24.9                                | 6.3                      | 2.1                      | 14.3               | 8.5                         | 26.1                 | 264                                    |
| 20      | Mizoram              | 27.4       | 11.3           | 5.8        | 24.4      | 4.2                                 | 39.2                     | 5.5                      | 4.6                | 6.3                         | 17.9                 | 243                                    |
| 21      | Nagaland             | 26.2       | 16.3           | 12.9       | 8         | 0                                   | 23.6                     | 2.2                      | 0.9                | 12.4                        | 74.1                 | 100                                    |
| 22      | Sikkim               | 21.8       | 10.9           | 6.9        | 33        | 27.9                                | 2.7                      | 14.2                     | 22.4               | 6.5                         | 0.1                  | 273                                    |
| 23      | Tripura              | 31.9       | 23.8           | 12.8       | 33        | 16.0                                | 20.6                     | 15.2                     | 17.1               | 6                           | 1                    | 218                                    |
| 24      | Goa                  | 19.6       | 20.3           | 15.8       | 22.1      | 11.9                                | 2.4                      | 18.2                     | 25.6               | 3.2                         | 16.6                 | 142                                    |
| 25      | Gujarat              | 39.2       | 34.3           | 16.9       | 38.2      | 55.7                                | 14.6                     | 25.2                     | 19.8               | 29.2                        | 39.4                 | 187                                    |
| 26      | Maharasht ra         | 34.1       | 30.9           | 16.8       | 41.6      | 49.0                                | 9.4                      | 12.8                     | 12.3               | 11.8                        | 42.2                 | 136                                    |
| 27      | Andhra Pradesh       | 31.5       | 33.5           | 17.1       | 39.6      | 13.0                                | 20.8                     | 4.9                      | 10.0               | 11.1                        | 62.7                 | 150                                    |
| 28      | Karnataka            | 32.5       | 32.4           | 19.3       | 34.7      | 50.1                                | 9.6                      | 4.8                      | 20.1               | 15.4                        | 36                   | 282                                    |
| 29      | Kerala               | 20.5       | 18.7           | 12.6       | 12.5      | 35.2                                | 17.1                     | 11.8                     | 9.0                | 3.4                         | 18.4                 | 206                                    |
| 30 31   | Tamil Nadu Telangana | 19.7 29.3  | 23.5 30.8      | 20.7 17.9  | 27.3 37.8 | 41.7 33.4                           | 13.1 26.5                | 1.4 9.6                  | 20.1 10.1          | 6.6 12.4                    | 23.9 46.8            | 315 299                                |

Anemia* = The Anemia rates between NFHS and CNNS are not comparable due to different methods of estimations used in these surveys

## Annexure