Lok Sabha Question No. 2850 (UNSTARRED), answered on 2021-03-12
Subject: Community Based Management of Malnutrition
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Aparajita Sarangi, Jual Oram

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA ADMITTED UNSTARRED QUESTION NO. 2850 TO BE ANSWERED ON 12.03.2021

## COMMUNITY BASED MANAGEMENT OF MALNUTRITION

2850.  SHRIMATI APARAJITA SARANGI: SHRI JUAL ORAM

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

- (a) the rate of prevalence of malnutrition among women and children during the last five years, State/UT-wise including Odisha;
- (b) the number of cases of underweight, wasting and stunting observed in children during the last 5 surveys conducted by the Government, State/UT-wise including Odisha;
- (c) whether malnutrition among women and children are more prevalent in rural areas than urban, if so, the reasons therefore and actions taken thereon;
- (d) whether the cases of malnutrition have increased since the lockdown, and if so, the action taken thereon;
- (e) whether the Government is considering to introduce a Community-based Management of Malnutrition (CMAM) to address severely acute malnutrition (SAM) among children; and
- (f) if so, the details thereof and if not, the reasons therefor?

## ANSWER

## MINISTER OF WOMEN AND CHILD DEVELOPMENT (SHRIMATI SMRITI ZUBIN IRANI)

(a to d) Data on nutrition indicators is captured under the various surveys commissioned by the Ministry of Health and Family Welfare. The prevalence of malnutrition among women as per NFHS-3 and 4 are at Annexure-I. The prevalence of underweight, wasting and stunting observed in children as reported under the last five surveys, State/UT-wise including Odisha, is at Annexure-II.

Prevalence  and  causes  of  malnutrition  vary  from  place  to  place  across  rural  and  urban areas.  During  Covid-19,  door-to-door  delivery  of  THR  to  beneficiaries  was  undertaken  by anganwadi workers.

Government has taken measures to strengthen nutritional content, delivery, outreach and outcomes with focus on developing practices that  nurture  health,  wellness  and  immunity  to disease  and  malnutrition.  Steps  have  also  been  taken  to  improve  nutritional  quality  and testing, strengthen delivery and leverage technology to improve governance. Government has advised  States/UTs  to  ensure  that  the  quality  of  supplementary  nutrition  conforms  to prescribed  standards  laid  down  under  the  Food  Safety  and  Standards  Act,  2006  and regulations made thereunder. States/UTs have also been advised to promote use of AYUSH systems  for prevention of malnutrition and  related diseases. A programme  to support development of Poshan Vatikas at Anganwadi centers to meet dietary diversity gap leveraging traditional knowledge in nutritional practices has also been taken up.

(e & f)  States/UTs have also been advised to launch a drive for identification of SAM children for referral to hospitals (if required) and AYUSH Centers in accordance with the detailed action plan approved by the District Nutrition Committee.

*******

Annexure-I Statement  referred  to  in  reply  of  Lok  Sabha  Un-Starred  Question  No.  2850  due  for answer on 12.03.2021, raised by Shrimati Aparajita Sarangi and Shri Jual Oram Prevalence  of  Underweight  and  Anaemia  among  Women  (age  15-49  Years)  as  per NFHS-3 and NFHS-4

|                      | Underweight (BMI <18.5)   | Underweight (BMI <18.5)   | Anaemia          | Anaemia          |
|----------------------|---------------------------|---------------------------|------------------|------------------|
| State                | NFHS-3 (2005-06)          | NFHS-4 (2015-16)          | NFHS-3 (2005-06) | NFHS-4 (2015-16) |
| Andaman & Nicobar    | -                         | 13.1                      | -                | 65.7             |
| Andhra Pradesh       | 33.5                      | 17.6                      | 62.9             | 60               |
| Arunachal Pradesh    | 16.4                      | 8.5                       | 50.5             | 43.2             |
| Assam                | 36.5                      | 25.7                      | 69.3             | 46               |
| Bihar                | 45                        | 30.4                      | 67.4             | 60.3             |
| Chandigarh           | -                         | 13.3                      | -                | 75.9             |
| Chhattisgarh         | 43.4                      | 26.7                      | 57.5             | 47               |
| Dadra & Nagar Haveli | -                         | 28.5                      | -                | 79.5             |
| Daman & Diu          | -                         | 12.9                      | -                | 58.9             |
| Delhi                | 14.8                      | 14.9                      | 44.3             | 54.3             |
| Goa                  | 27.9                      | 14.7                      | 38               | 31.3             |
| Gujarat              | 36.3                      | 27.2                      | 55.3             | 54.9             |
| Haryana              | 31.4                      | 15.8                      | 56.1             | 62.7             |
| Himachal Pradesh     | 29.9                      | 16.2                      | 43               | 53.5             |
| J&K                  | 24.6                      | 12.1                      | 52               | 49.4             |
| Jharkhand            | 42.9                      | 31.5                      | 69.5             | 65.2             |
| Karnataka            | 35.4                      | 20.7                      | 51.2             | 44.8             |
| Kerala               | 18                        | 9.7                       | 32.8             | 34.3             |
| Lakshadweep          | -                         | 13.5                      | -                | 46.4             |
| Madhya Pradesh       | 41.7                      | 28.4                      | 55.9             | 52.5             |
| Maharashtra          | 36.2                      | 23.5                      | 48.4             | 48               |
| Manipur              | 14.8                      | 8.8                       | 35.7             | 26.4             |
| Meghalaya            | 14.6                      | 12.1                      | 46.2             | 56.2             |
| Mizoram              | 14.4                      | 8.4                       | 38.1             | 22.5             |
| Nagaland             | 17.4                      | 12.3                      | -                | 27.9             |
| Odisha               | 41.4                      | 26.5                      | 61.1             | 51               |
| Puducherry           | -                         | 11.2                      | -                | 52.4             |
| Punjab               | 18.9                      | 11.7                      | 38               | 53.5             |
| Rajasthan            | 36.7                      | 27                        | 53.1             | 46.8             |
| Sikkim               | 11.2                      | 6.4                       | 59.5             | 34.9             |
| Tamil Nadu           | 28.4                      | 14.6                      | 53.2             | 55.0             |
| Telangana            | -                         | 22.9                      | -                | 56.6             |
| Tripura              | 36.9                      | 18.9                      | 65.1             | 54.5             |
| Uttar Pradesh        | 36                        | 25.3                      | 49.9             | 52.4             |
| Uttarakhand          | 30                        | 18.4                      | 54.7             | 45.2             |
| West Bengal          | 39.1                      | 21.3                      | 63.2             | 62.5             |
| India                | 35.5                      | 22.9                      | 55.3             | 53.1             |

Annexure-II Statement  referred  to  in  reply  of  Lok  Sabha  Un-Starred  Question  No.  2850  due  for answer on 12.03.2021, raised by Shrimati Aparajita Sarangi and Shri Jual Oram Prevalence  of  underweight,  wasting  and  stunting  observed  in  children  as  reported under the last five surveys, State/UT-wise

|       |                       | Underweight                     | Underweight                      | Underweight                       | Underweight                     | Underweight                    | Stunting                        | Stunting                         | Stunting                          | Stunting                        | Stunting                       | Wasting                         | Wasting                          | Wasting                           | Wasting                         | Wasting                        |
|-------|-----------------------|---------------------------------|----------------------------------|-----------------------------------|---------------------------------|--------------------------------|---------------------------------|----------------------------------|-----------------------------------|---------------------------------|--------------------------------|---------------------------------|----------------------------------|-----------------------------------|---------------------------------|--------------------------------|
| S.N o | State                 | NFH S-1 (199 2-93) unde r 4 yrs | NFHS- 2 (199 8-99) (under 3 yrs) | NFH S-3 (200 5-06) (und er 5 yrs) | NFH S-4 (201 5-16) unde r 5 yrs | CNN S (201 6- 18) und er 5 yrs | NFH S-1 (199 2-93) unde r 4 yrs | NFHS- 2 (199 8-99) (under 3 yrs) | NFH S-3 (200 5-06) (und er 5 yrs) | NFH S-4 (201 5-16) unde r 5 yrs | CNN S (201 6- 18) und er 5 yrs | NFH S-1 (199 2-93) unde r 4 yrs | NFHS- 2 (199 8-99) (under 3 yrs) | NFH S-3 (200 5-06) (und er 5 yrs) | NFH S-4 (201 5-16) unde r 5 yrs | CNN S (201 6- 18) und er 5 yrs |
| 1     | Andaman & Nicobar     | -                               | -                                | -                                 | 21.6                            | -                              | -                               | -                                | -                                 | 23.3                            | -                              | -                               | -                                | -                                 | 18.9                            | -                              |
| 2     | Andhra Prades h       | 49.1                            | 37.7                             | 32.5                              | 31.9                            | 33.5                           | -                               | 38.6                             | 42.7                              | 31.4                            | 31.5                           | -                               | 9.1                              | 12.2                              | 17.2                            | 17.1                           |
| 3     | Arunachal Pra desh    | 39.7                            | 24.3                             | 32.5                              | 19.5                            | 15.5                           | 53.9                            | 26.5                             | 43.3                              | 29.4                            | 28                             | 11.2                            | 7.9                              | 15.3                              | 17.3                            | 6.8                            |
| 4     | Assam                 | 50.4                            | 36                               | 36.4                              | 29.8                            | 29.4                           | 52.2                            | 50.2                             | 46.5                              | 36.4                            | 32.4                           | 10.8                            | 13.3                             | 13.7                              | 17                              | 19.4                           |
| 5     | Bihar                 | 62.6                            | 54.4                             | 55.9                              | 43.9                            | 38.7                           | 60.9                            | 53.7                             | 55.6                              | 48.3                            | 42                             | 21.8                            | 21.0                             | 27.1                              | 20.8                            | 14.5                           |
| 6     | Chandigarh            | -                               | -                                | -                                 | 24.5                            | -                              | -                               | -                                | -                                 | 28.7                            | -                              | -                               | -                                | -                                 | 10.9                            | -                              |
| 7     | Chhattisgarh          | -                               | -                                | 47.1                              | 37.7                            | 40                             | -                               | -                                | 52.9                              | 37.6                            | 35.4                           | -                               | -                                | 19.5                              | 23.1                            | 19.3                           |
| 8     | Dadra & Nagar Haveli  | -                               | -                                | -                                 | 27                              | 28.1                           | -                               | -                                | -                                 | 32.3                            | 28.8                           | -                               | -                                | -                                 | 17.1                            | 14.8                           |
| 9     | Daman & Diu           | -                               | -                                | -                                 | 38.9                            | -                              | -                               | -                                | -                                 | 41.7                            | -                              | -                               | -                                | -                                 | 27.6                            | -                              |
| 10    | Delhi                 | 41.6                            | 34.7                             | 26.1                              | 26.7                            | -                              | 43.2                            | 36.8                             | 42.2                              | 23.4                            | -                              | 11.9                            | 12.5                             | 15.4                              | 24.1                            | -                              |
| 11    | Goa                   | 35.0                            | 28.6                             | 25.0                              | 23.8                            | 20.3                           | 32.5                            | 18.1                             | 25.6                              | 20.1                            | 19.6                           | 15.3                            | 13.1                             | 14.1                              | 21.9                            | 15.8                           |
| 12    | Gujarat               | 50.1                            | 45.1                             | 44.6                              | 39.3                            | 34.2                           | 48.2                            | 43.6                             | 51.7                              | 38.5                            | 39.1                           | 18.9                            | 16.2                             | 18.7                              | 26.4                            | 17                             |
| 13    | Haryana               | 37.9                            | 34.6                             | 39.6                              | 29.4                            | 28.8                           | 46.7                            | 50.0                             | 45.7                              | 34                              | 34.9                           | 5.9                             | 5.3                              | 19.1                              | 21.2                            | 11.7                           |
| 14    | Himachal Prad esh     | 47.0                            | 43.6                             | 36.5                              | 21.2                            | 22.6                           | -                               | 41.3                             | 38.6                              | 26.3                            | 28.4                           | -                               | 16.9                             | 19.3                              | 13.7                            | 11                             |
| 15    | J&K                   | 44.5                            | 34.5                             | 25.6                              | 16.6                            | 13.1                           | 40.8                            | 38.8                             | 35.0                              | 27.4                            | 15.5                           | 14.8                            | 11.8                             | 14.8                              | 12.1                            | 14.9                           |
| 16    | Jharkhand             | -                               | -                                | 56.5                              | 47.8                            | 42.9                           | -                               | -                                | 49.8                              | 45.3                            | 36.2                           |                                 | -                                | 32.3                              | 29                              | 29.1                           |
| 17    | Karnataka             | 54.3                            | 43.9                             | 37.6                              | 35.2                            | 32.4                           | 47.6                            | 36.6                             | 43.7                              | 36.2                            | 32.5                           | 17.4                            | 20                               | 17.6                              | 26.1                            | 19.3                           |
| 18    | Kerala                | 28.5                            | 26.9                             | 22.9                              | 16.1                            | 18.7                           | 27.4                            | 21.9                             | 24.5                              | 19.7                            | 20.5                           | 11.6                            | 11.1                             | 15.9                              | 15.7                            | 12.6                           |
| 19    | Lakshadweep           | -                               | -                                | -                                 | 23.4                            | -                              | -                               | -                                | -                                 | 27                              | -                              | -                               | -                                | -                                 | 13.8                            | -                              |
| 20    | Madhya Prade sh       | 57.4                            | 55.1                             | 60.0                              | 42.8                            | 38.7                           | -                               | 51.0                             | 50                                | 42                              | 39.5                           | -                               | 19.8                             | 35.0                              | 25.8                            | 19.6                           |
| 21    | Maharashtra           | 54.2                            | 49.6                             | 37.0                              | 36                              | 30.9                           | 48.5                            | 39.9                             | 46.3                              | 34.4                            | 34.1                           | 20.2                            | 21.2                             | 16.5                              | 25.6                            | 16.9                           |
| 22    | Manipur               | 30.1                            | 27.5                             | 22.1                              | 13.8                            | 13                             | 33.6                            | 31.3                             | 35.6                              | 28.9                            | 28.9                           | 8.8                             | 8.2                              | 9.0                               | 6.8                             | 6                              |
| 23    | Meghalaya             | 45.5                            | 37.9                             | 48.8                              | 29                              | 29.6                           | 50.8                            | 44.9                             | 55.1                              | 43.8                            | 40.4                           | 18.9                            | 13.3                             | 30.7                              | 15.3                            | 14.7                           |
| 24    | Mizoram               | 28.1                            | 27.7                             | 19.9                              | 11.9                            | 11.3                           | 41.3                            | 34.6                             | 39.8                              | 28                              | 27.4                           | 2.2                             | 10.2                             | 9.0                               | 6.1                             | 5.8                            |
| 25    | Nagaland              | 28.7                            | 24.1                             | 25.2                              | 16.3 8                          | 16.3                           | 32.4                            | 33.0                             | 38.8                              | 28.6                            | 26.2                           | 12.7                            | 10.4                             | 13.3                              | 11.2                            | 12.9                           |
| 26    | Odisha                | 53.3                            | 54.4                             | 40.7                              | 34.4                            | 29.2                           | 48.2                            | 44.0                             | 45                                | 34.1                            | 29.1                           | 21.3                            | 24.3                             | 19.5                              | 20.4                            | 13.9                           |
| 27    | Puducherry            | -                               | -                                | -                                 | 21.6                            | 19.7                           | -                               | -                                | -                                 | 25.7                            | 24.3                           | -                               | -                                | -                                 | 15.6                            | 6.7                            |
| 28    | Punjab                | 45.9                            | 28.7                             | 24.9                              | 22.0                            | -                              | 40.0                            | 39.2                             | 36.7                              | 23.7                            | -                              | 19.9                            | 7.1                              | 9.2                               | 23.6                            | -                              |
| 29    | Rajasthan             | 41.6                            | 50.6                             | 39.9                              | 36.7                            | 31.5                           | 43.1                            | 52.0                             | 43.7                              | 39.1                            | 36.8                           | 19.5                            | 11.7                             | 20.4                              | 23                              | 14.3                           |
| 30    | Sikkim                | -                               | 20.6                             | 19.7                              | 14.2                            | 10.8                           | -                               | 31.7                             | 38.3                              | 29.6                            | 21.8                           | -                               | 4.8                              | 9.7                               | 14.2                            | 6.9                            |
| 31    | Tamil Nadu            | 48.2                            | 36.7                             | 29.8                              | 23.8                            | 23.5                           | -                               | 29.4                             | 30.9                              | 27.1                            | 19.7                           | -                               | 19.9                             | 22.2                              | 19.7                            | 20.7                           |
| 32 33 | Telangana             | -                               | -                                | -                                 | 28.5                            | 30.8                           | -                               | -                                | -                                 | 28.1                            | 29.3                           | -                               | -                                | - 24.6                            | 18                              | 17.9 12.8                      |
| 34    | Tripura Uttar Pradesh | 48.8                            | -                                | 39.6                              | 24.1                            | 23.8                           | 46.0                            | - 55.5                           | 35.7                              | 24.3                            | 31.9                           | 17.5 16.1                       | -                                | 14.8                              | 16.8 17.9                       | 18.5                           |
|       |                       | 59.0 -                          | 51.7                             | 42.4                              | 39.5                            | 36.8                           | 59.5                            | -                                | 56.8                              | 46.3                            | 38.8 29.9                      | -                               | 11.1 -                           | 18.8                              | 19.5                            | 5.9                            |
| 35    | Uttarakhand           |                                 | -                                | 38.0                              | 26.6                            | 18.7                           | -                               |                                  | 44.4                              | 33.5                            |                                |                                 |                                  |                                   |                                 | 20.1                           |
| 36    | West Bengal           | 56.8                            | 48.7                             | 38.7                              | 31.5                            | 30.9                           | -                               | 41.5                             | 44.6                              | 32.5                            | 25.3                           | -                               | 13.6                             | 16.9                              | 20.3                            | 17.3                           |
|       | INDIA                 | 53.4                            | 47.0                             | 42.5                              | 35.7                            | 33.4                           | 52.0                            | 45.5                             | 48.0                              | 38.4                            | 34.7                           | 17.5                            | 15.5                             | 19.8                              | 21                              |                                |