Lok Sabha Question No. 10 (STARRED), answered on 2019-06-21
Subject: Malnutrition among Children
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Deepak Baij

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

## LOK SABHA STARRED QUESTION NO. 10 TO BE ANSWERED ON THE 21 ST JU NE , 2019 MALNUTRITION AMONG C HILDREN

## †*10. SHRI DEEPAK BAIJ:

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

- (a) the number and status of malnourished children between the age group f zero to five in the country, State/UT - wise;
- (b) whether bone infection is increasing among the malnourishe d children due to which children are becoming vulnerable to disability; and
- (c) the funds spent during the last decade for the schemes being run by the M to eradicate malnutrition item and State/UT - wise and the outcome thereof?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. HARSH VARDHAN)

- (a) to (c ):  A statement is laid on the Table of the House

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 10* FOR 21 ST JUNE , 2019

As  per  National  Family  Health  Survey  (NFHS - 4)  35.7%  of  under - five children  are  underweight,  21%  wasted,  and  38.4%  stunted  across  the  count State/UT - wise detail is enclosed in A nnexure -I.

Although malnourished children are more vulnerable than normal children to any infection including bone infection due to lower immunity, there is no substantiate increase in bone infection among malnourished children due to w children are becoming vulnerable to disability.

Although  main  programme  for  ad dressing  the  issue  of  malnutrition  is Integrated  Child  Development  Scheme  (ICDS)  which  is  implemented  by  the Ministry  of  Women  and  Child  Development,  u nder National  Health  Mission (NHM),  the  Ministry  of  Health  and  Family  Welfare is  strengthening  the  health systems which includes various programs to reduce under - nutrition in vulnerable population across the life cycle , such as micronutrients supplementation program, management  of  sick  children  with  severe  acute  malnutrition  in  health  faci improvementof appropriate Infant and Young Child Feeding Practices ,Vitamin A supplementation, National Deworming Day etc. Prevention of Childhood illness such  as  Diarrhoeal  diseases  in  turn  prevents  childhood  malnutrition  indi Intensified  Diarrhoea  Control Fortnight  (IDCF)  is  being  implemented  for  this purpose. Janani Shishu Suraksha Karyakram (JSSK) which includes provision of free diet for the pregnant mothers and infants during their stay at health another strategy to provide nutritional rt.  suppo Other programmes like Immunization,  Home  Base  Young  Childcare  programme  (HBYC)  inter - alia address malnutrition and improve nutritional status.

The specific programs which have bearing on nutritional status of wom and children and their expenditure is enclosed at A nnexure- II.

As per National Family Health Surveys III and IV ,there has been r eduction in child malnutrition for stunting, under - weight and anaemia . The details may be seen as follows:

|   Sl No. | Child Malnutrition Indicators              | NFHS III (2005- 2006)   |   NFHS IV (2015- 2016) |
|----------|--------------------------------------------|-------------------------|------------------------|
|        1 | Children under 5 years who are stunted     | 48                      |                   38.4 |
|        2 | Children under 5 years who are wasted      | 19.8                    |                   21   |
|        3 | Children under 5 years who are severely    | wasted 6.4              |                    7.5 |
|        4 | Children under 5 years who are underweight | 42.5                    |                   32.7 |
|        5 | Children age -6 59 months who are anaemic  | 69.4                    |                   58.5 |

## State/UT- wise status of malnourished under - five children (NFHS - 4)

|   Sr. No | State/UTs         |   Underweight (%) |   Severely underweight(%) |   Wasted (%) |   Severely wasted (%) |   Stunted (%) |   Severely stunted(%) |
|----------|-------------------|-------------------|---------------------------|--------------|-----------------------|---------------|-----------------------|
|        1 | Bihar             |              43.9 |                      15.2 |         20.8 |                   7   |          48.3 |                  23.1 |
|        2 | Chhattisgarh      |              37.7 |                      11.2 |         23.1 |                   8.4 |          37.6 |                  15.7 |
|        3 | Himachal Pradesh  |              21.2 |                       4.3 |         13.7 |                   3.9 |          26.3 |                   7.8 |
|        4 | Jammu & Kashmir   |              16.6 |                       4.9 |         12.1 |                   5.6 |          27.4 |                  11.9 |
|        5 | Jharkhand         |              47.8 |                      17.4 |         29   |                  11.4 |          45.3 |                  20.2 |
|        6 | Madhya Pradesh    |              42.8 |                      14.3 |         25.8 |                   9.2 |          42   |                  18.6 |
|        7 | Odisha            |              34.4 |                       9.4 |         20.4 |                   6.4 |          34.1 |                  12.3 |
|        8 | Rajasthan         |              36.7 |                      12.2 |         23   |                   8.5 |          39.1 |                  17.3 |
|        9 | Uttar Pradesh     |              39.5 |                      12.2 |         17.9 |                   6   |          46.2 |                  21.2 |
|       10 | Uttarakhand       |              26.6 |                       7.5 |         19.5 |                   9   |          33.5 |                  14   |
|       11 | Arunachal Pradesh |              19.4 |                       5.7 |         17.3 |                   8   |          29.3 |                  11.9 |
|       12 | Assam             |              29.8 |                       8.1 |         17   |                   6.2 |          36.4 |                  14.3 |
|       13 | Manipur           |              13.8 |                       2.4 |          6.8 |                   2.2 |          28.9 |                   8.8 |
|       14 | Meghalaya         |              28.9 |                       6.8 |         15.3 |                   6.5 |          43.8 |                  18.9 |
|       15 | Mizoram           |              12   |                       2.8 |          6.1 |                   2.3 |          28.1 |                   8.8 |
|       16 | Nagaland          |              16.7 |                       4.3 |         11.3 |                   4.2 |          28.6 |                  10.3 |
|       17 | Sikkim            |              14.2 |                       3.7 |         14.2 |                   5.9 |          29.6 |                  12.5 |
|       18 | Tripura           |              24.1 |                       5.3 |         16.8 |                   6.3 |          24.3 |                   8.1 |
|       19 | Andhra Pradesh    |              31.9 |                       7.2 |         17.2 |                   4.5 |          31.4 |                  10.7 |
|       20 | Goa               |              23.8 |                       5.5 |         21.9 |                   9.5 |          20.1 |                   8.8 |
|       21 | Gujarat           |              39.3 |                      12.4 |         26.4 |                   9.5 |          38.5 |                  16.5 |
|       22 | Haryana           |              29.4 |                       8.1 |         21.2 |                   9   |          34   |                  14.8 |
|       23 | Karnataka         |              35.2 |                      11.6 |         26.1 |                  10.5 |          36.2 |                  16.6 |
|       24 | Kerala            |              16.1 |                       3.6 |         15.7 |                   6.5 |          19.7 |                   6.8 |
|       25 | Maharashtra       |              36   |                      10.5 |         25.6 |                   9.4 |          34.4 |                  12.9 |

| 26          | Punjab               |   21.6 |   5.8 |   15.6 |   5.6 |   25.7 |   8.3 |
|-------------|----------------------|--------|-------|--------|-------|--------|-------|
| 27          | Telangana            |   28.3 |   7.8 |   18   |   4.8 |   28   |   9.1 |
| 28          | Tamil Nadu           |   23.8 |   6.5 |   19.7 |   7.9 |   27.1 |  10.8 |
| 29          | West Bengal          |   31.5 |   8.8 |   20.3 |   6.5 |   32.5 |  10.3 |
| 30          | A & N Islands        |   21.5 |   4.4 |   18.9 |   7.5 |   23.3 |   6.9 |
| 31          | Chandigarh           |   24.5 |   5.8 |   10.9 |   3.9 |   28.7 |   7   |
| 32          | Dadra & Nagar Haveli |   38.8 |  11.3 |   27.6 |  11.4 |   41.7 |  19.7 |
| 33          | Daman & Diu          |   26.7 |   4.8 |   24.1 |  11.9 |   23.4 |   8   |
| 34          | Delhi                |   27   |   6.2 |   15.9 |   4.6 |   31.9 |  10.7 |
| 35          | Lakshadweep          |   23.6 |   5.6 |   13.7 |   2.9 |   26.8 |   6.2 |
| 36          | Puducherry           |   22   |   7   |   23.6 |   7.8 |   23.7 |  11   |
| India Total | India Total          |   35.7 |  11   |   21   |   7.4 |   38.4 |  16.3 |

## State/UT- wise Funds spent (In lakhs) in Micronutrient Supplementation Programmes, Infant and Young Child Feeding (IYCF) practices, Nutrition Rehabilitation Centres(NRCs) and Diarrhoea Control activities in the last decade (2009 - 10 to 2018 - 19)

| S.No.                     | Name of the State/UTs     | 2009- 10                  | 2010- 11                  | 2011- 12                  | 2012- 13                  | 2013- 14                  | 2014- 15                  | 2015- 16                  | 2016- 17                  | 2017- 18                  | 2018- 19                  |
|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|---------------------------|
| A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      | A. High Focus States      |
| 1                         | Bihar                     | 34.79                     | 41.45                     | 469.52                    | 1009.30                   | 2049.37                   | 675.15                    | 437.29                    | 540.98                    | 1007.20                   | 515.55                    |
| 2                         | Chhattisgarh              | 44.37                     | 159.74                    | 174.92                    | 217.87                    | 362.34                    | 298.99                    | 393.30                    | 451.02                    | 534.06                    | 544.97                    |
| 3                         | Himachal Pradesh          | 0.90                      | 0.00                      | 0.00                      | 25.00                     | 0.00                      | 0.07                      | 20.64                     | 34.83                     | 14.10                     | 7.81                      |
| 4                         | Jammu & Kashmir           | 0.26                      | 20.95                     | 55.53                     | 6.35                      | 29.21                     | 12.54                     | 27.32                     | 24.57                     | 71.98                     | 30.45                     |
| 5                         | Jharkhand                 | 28.18                     | 115.35                    | 201.68                    | 207.33                    | 399.34                    | 484.83                    | 565.24                    | 436.14                    | 419.70                    | 685.61                    |
| 6                         | Madhya Pradesh            | 1572.43                   | 1939.24                   | 1667.88                   | 1745.90                   | 2637.80                   | 1815.16                   | 1907.71                   | 2854.19                   | 2657.04                   | 2668.95                   |
| 7                         | Orissa                    | 354.54                    | 365.47                    | 107.49                    | 315.34                    | 124.28                    | 281.24                    | 194.58                    | 247.63                    | 306.46                    | 1040.53                   |
| 8                         | Rajasthan                 | 6.09                      | 168.08                    | 172.95                    | 256.89                    | 111.20                    | 205.92                    | 390.16                    | 437.15                    | 302.23                    | 460.25                    |
| 9                         | Uttar Pradesh             | 211.20                    | 154.58                    | 19.85                     | 76.15                     | 129.42                    | 189.39                    | 570.83                    | 1004.69                   | 980.34                    | 714.33                    |
| 10                        | Uttarakhand               | 0.00                      | 0.00                      | 0.00                      | 23.17                     | 0.00                      | 9.63                      | 19.39                     | 59.36                     | 30.55                     | 157.03                    |
|                           | Sub Total                 | 2252.76                   | 2964.86                   | 2869.82                   | 3883.30                   | 5842.96                   | 3972.92                   | 4526.46                   | 6090.55                   | 6323.66                   | 6825.50                   |
| B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             | B. NE State s             |
| 11                        | Arunachal Pradesh         | 0.00                      | 2.07                      | 0.12                      | 2.00                      | 13.03                     | 20.08                     | 29.42                     | 118.62                    | 49.08                     | 15.45                     |
| 12                        | Assam                     | 52.53                     | 35.20                     | 65.65                     | 50.59                     | 92.33                     | 75.49                     | 270.20                    | 246.69                    | 183.83                    | 209.25                    |
| 13                        | Manipur                   | 3.00                      | 9.03                      | 15.24                     | 1.18                      | 8.93                      | 110.72                    | 24.05                     | 163.63                    | 10.29                     | 99.77                     |
| 14                        | Meghalaya                 | 1.85                      | 3.17                      | 7.98                      | 8.62                      | 3.01                      | 20.44                     | 13.75                     | 68.76                     | 11.38                     | 85.13                     |
| 15                        | Mizoram                   | 0.13                      | 0.00                      | 0.91                      | 0.00                      | 47.25                     | 14.06                     | 112.42                    | 71.60                     | 4.20                      | 6.75                      |
| 16                        | Nagaland                  | 0.00                      | 0.00                      | 12.96                     | 19.76                     | 8.09                      | 4.32                      | 77.41                     | 110.79                    | 4.10                      | 87.86                     |
| 17                        | Sikkim                    | 0.54                      | 0.38                      | 0.00                      | 3.01                      | 0.00                      | 2.56                      | 8.34                      | 10.66                     | 1.83                      | 1.70                      |
| 18                        | Tripura                   | 47.67                     | 0.34                      | 18.40                     | 9.90                      | 50.52                     | 8.75                      | 52.59                     | 14.18                     | 21.31                     | 7.14                      |
|                           | Sub Total                 | 105.72                    | 50.19                     | 121.26                    | 95.05                     | 223.16                    | 256.43                    | 588.19                    | 804.92                    | 286.02                    | 513.05                    |
| C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States | C. Non- High Focus States |
| 19                        | Andhra Pradesh            | 0.00                      | 0.00                      | 0.00                      | 80.62                     | 21.58                     | 29.20                     | 316.43                    | 279.09                    | 122.57                    | 380.00                    |
| 20                        | Goa                       | 1.30                      | 2.46                      | 107.76                    | 8.01                      | 10.25                     | 8.47                      | 0.97                      | 15.12                     | 8.24                      | 1.11                      |
| 21                        | Gujarat                   | 41.38                     | 587.13                    | 565.30                    | 750.53                    | 655.75                    | 988.83                    | 1231.48                   | 1043.31                   | 913.46                    | 926.01                    |
| 22                        | Haryana                   | 45.94                     | 2.59                      | 7.46                      | 4.34                      | 103.88                    | 130.51                    | 9.51                      | 18.31                     | 37.41                     | 512.61                    |
| 23                        | Karnataka                 | 0.00                      | 117.04                    | 23.91                     | 281.98                    | 69.77                     | 48.93                     | 73.54                     | 72.50                     | 79.56                     | 106.47                    |
| 24                        | Kerala                    | 172.22                    | 102.70                    | 18.97                     | 58.99                     | 1.91                      | 10.72                     | 3.69                      | 38.65                     | 50.29                     | 118.09                    |
| 25                        | Maharashtra               | 328.53                    | 1105.73                   | 2539.46                   | 1799.34                   | 1521.83                   | 768.28                    | 162.55                    | 201.21                    | 225.05                    | 188.34                    |
| 26                        | Punjab                    | 0.00                      | 104.62                    | 4.03                      | 92.96                     | 11.44                     | 58.76                     | 18.76                     | 49.35                     | 72.03                     | 0.69                      |
| 27                        | Tamil Nadu                | 0.00                      | 0.00                      | 0.00                      | 2.45                      | 89.73                     | 353.57                    | 53.18                     | 199.53                    | 242.32                    | 194.97                    |
| 28                        | Telangana                 | --                        | --                        | --                        | --                        | --                        | 4.38                      | 45.61                     | 39.85                     | 123.97                    | 55.67                     |
| 29                        | West Bengal               | 49.19                     | 340.50                    | 148.66                    | 548.14                    | 389.70                    | 248.55                    | 1478.36                   | 893.42                    | 933.68                    | 1125.91                   |

|                     | Sub Total                 | 638.56              | 2362.77             | 3415.55             | 3627.36             | 2875.83             | 2650.21             | 3394.07             | 2850.33             | 2808.58             | 3609.87             |
|---------------------|---------------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|
| D. Small States/UTs | D. Small States/UTs       | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs | D. Small States/UTs |
| 30                  | Andaman & Nicobar Islands | 0.00                | 0.00                | 0.00                | 0.00                | 0.00                | 0.72                | 0.00                | 2.18                | 0.06                | 0.00                |
| 31                  | Chandigarh                | 9.98                | 0.00                | 0.00                | 0.01                | 0.05                | 0.21                | 0.00                | 0.00                | 0.88                | 0.21                |
| 32                  | Dadra & Nagar Haveli      | 0.00                | 0.00                | 0.00                | 2.66                | 1.74                | 1.33                | 59.20               | 0.93                | 0.26                | 0.11                |
| 33                  | Daman & Diu               | 1.24                | 0.60                | 0.00                | 0.33                | 0.00                | 0.00                | 0.00                | 0.08                | 0.00                | 1.13                |
| 34                  | Delhi                     | 11.19               | 9.69                | 3.05                | 24.40               | 2.81                | 3.51                | 4.91                | 3.78                | 4.78                | 16.42               |
| 35                  | Lakshadweep               | 0.00                | 0.00                | 0.00                | 0.00                | 0.00                | 0.00                | 0.66                | 0.97                | 1.24                | 0.00                |
| 36                  | Puducherry                | 1.38                | 1.00                | 9.29                | 3.50                | 0.80                | 0.00                | 15.00               | 24.98               | 1.40                | 13.63               |
|                     | Sub Total                 | 23.79               | 11.29               | 12.34               | 30.90               | 5.39                | 5.77                | 79.77               | 32.92               | 8.62                | 31.50               |
|                     | Grand Total               | 3020.83             | 5389.11             | 6418.98             | 7636.62             | 8947.35             | 6885.33             | 8588.49             | 9778.73             | 9426.88             | 10979.91            |

## Note:

- Expenditure includes expenditure against Central Release, State share & unspent balan the beginning of the year. It is updated upto 31 - 03- 2019, hence provisional.
- The Above Figures are as per FMR reported by State/UTs.