Lok Sabha Question No. 959 (UNSTARRED), answered on 2019-11-22
Subject: Malnutrition Deaths
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sanjay(Kaka) Ramchandra Patil, D.K. Suresh, Balubhau (Alias Suresh Narayan) Dhanorkar

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

## LOK SABHA UNSTARRED QUESTION NO. 959 TO BE ANSWERED ON 22 ND NOVEMBER, 2019

## MALNUTRITION DEATHS

## 959. SHRI SANJAY KAKA PATIL: SHRI D.K. SURESH:

## SHRI BALUBHAU ALIAS SURESH NARAYAN DHANORKAR:

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

- (a) the number of child deaths due to malnutrition across India during 2014 -2019;
- (b) whether the Government has taken any steps to cur b impact of child malnutrition in the State of  Maharashtra,  particularly  in  Nandurbar,  Melghat  and  rest  of  tribal  areas  where malnutrition death are on the rise, if so, the details thereof;
- (c)  whether  the  Government  has  conducted  any  nutrition  sur veys  to  ascertain  the  number  of malnutrition  affected  children  and  conducted  any  research  to  identify  the  gaps  and recommendations  to  achieve  the  target  of  malnutrition  free  society,  if  so,  the  details outcome thereof;
- (d)  the details  of  children  suffering  from  malnutrition,  stunted  growth  and  underwei State/UT - wise; and
- (e) the details of various central schemes being implemented to curb malnutrition, stunted and underweight among children and the quantum of funds allocated under each of them during the financial year 2019 - 0?

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

- (a): Malnutrition is not a direct cause of child deaths; however, it can increase morb dity and mortality by reducing resistance to infections. The data regarding the number of child de to malnutrition is not maintained by GoI at central level.
- (b): Government  of  India  is  implementing  various  activities  to  curb  impact  of  ch malnutrition in all the states and districts including the State of Maharashtra.

POSHAN  (Prime  Minister  Overarching  Scheme  for  Holistic  Nourishment)  Abhiyaan, holistically addr esses malnutrition with the goal to achieve improvement in nutritional stat children  0 - 6  years,  pregnant  women  and  lactating  mothers  through  convergence,  behaviour change,  IEC  advocacy,  training  and  capacity  building,  use  of  technology  i.e.  Comm App lication Software (CAS), innovations and demand generation.

As per the information received from the State of Maharashtra under the Integrated Development Scheme (ICDS) the following action are being taken:

- Children under the age of 6 months to 3 years, pregnant and breastfeeding mothers are given Take Home Ration (THR) and hot cooked meal for children under the age of 3 - 6 years.
- Under  the  Dr.  A  P  J  Abdul  Kalam  Amrut  Aahar  Yojana,  a  onetime  square  diet  is provided to pregnant and lactating mothe rs in the tribal project. Children under the age o 6 months to 6 years are also provided bananas and eggs (for vegetarian children pe per beneficiary 2 bananas and non vegetarian children 4 eggs weekly).
- Village Child Development Centres (VCDC) have been started for SAM children in the state. Three time additional food and energy dense nutritious food is provided to children from the VCDC.

In  addition  to  these  initiatives,  the  S tate  of  Maharashtra  has  Child  Treatment  Centers (CTC)  at  the  tri bal  blocks  for  management  of  sick  SAM  children  and i ntensified  HBNC programme for timely referral of sick infants. The other initiatives taken by State of Maharashtra areposting Pediatrician on rotation basis, establishment of Melghat cell, incentive to B humka Padiyal for referral and appointment of bilingual Counselors.

Apart  from  these  initiatives  under  NHM  Micronutrients  supplementation  program including Anemia Mukt Bharat (AMB), Vitamin A supplementation, sick SAM care in Nutrition Rehabilit ation Centres (NRCs), improvement of appropriate Infant and Young Child Feeding practices  and  Mothers  Absolute  Affection  (MAA)  programme,  National  Deworming  Day, Intensified Diarrhoea Control Fortnight (IDCF) and Home Base Young Childcare programme (HBYC) are also implemented.

The bike ambulance and SNCU at Dharni (Melghat) is operaionalised in Melghat district . The boat ambulance and special RCH camps are started in Nandurbar district to provide R services in difficult areas.

(c): The Ministry of Health and Family Welfare (MoHFW), Government of India with support from UNICEF has conducted the first ever Comprehensive National Nutrition Survey (CNNS), during  2016  to  18  in  30  States.  The  CNNS  results  highlight  improvements  by  reduction stunting (height  for  age),  wasting  (weight  for  height)  and  underweight  (weight  for  age children below five years of age from 38.4% to 34.7%, 21.0% to 17.3% and 35.7% to 33.4 respectively in comparison to NFHS - 4.

(d): The detail of children suffering from ma lnutrition, stunted growth and underweight as per National Family Health Survey (NFHS - 4), 2015 -16 is in annexure.

(e): The Government of India has launched POSHAN (Prime Minister Overarching Scheme for Holistic  Nourishment)  Abhiyaan,  to  address  malnutriti on  challenges  in  India.  The  goals  of POSHAN Abhiyaan are to prevent and reduce stunting, underweight and low birth weight by 2 per annum and the reduction of anaemia by 3% per annum. The funds allocation for the year 2019- 20 for POSHAN Abhiyaan is Rs. 340 0 crore.

The Government of India is implementing Anganwadi Services, a centrally sponsore flagship programme of the Government to improve the nutritional and health status of child the  age -group  0 - 6  years  and  to  reduce  the  incidence  of  malnutrition .  The  scheme  provides  a package  of  six  services  i.e.  Supplementary  Nutrition,  Pre  School  Non - formal  Education,

Nutrition and Health Education, Immunisation, Health checkups and referral services.  The allocated for the year 2019 - 20 under Anganwadi se rvices scheme is Rs. 19927.67 crore out of which  Rs.  9368.12  crore  has  been  allotted  to  State/UTs  under  Supplementary  Nutrit programme (SNP)

The Ministry of Health and Family Welfare is also implementing RMNCHA+N strategy under National Health Mission (NHM) to reduce under - nutrition in vulnerable population across the life cycle. The various intervention are micronutrients supplementation pro management of sick children with severe acute malnutrition in health facilities, improve appropriat e Infant and Young Child Feeding Practices and Mothers Absolute Affection (MAA) programme,  National Deworming Day, Defeat Diarrhoea, Janani Shishu Suraksha Karyakram (JSSK),  Immunization,  and  Home  Base  Young  Childcare  programme  (HBYC).  The  funds allocated under RCH flexible pool for the year 2019 - 20 covering these activities is Rs. 5703.52 crore.

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

## Annexure

| 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          | ArunachalPradesh     |              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 |