Lok Sabha Question No. 1611 (UNSTARRED), answered on 2022-02-11
Subject: Death of Tribal Children due to Malnutrition
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sougata Ray

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

## LOK SABHA UNSTARRED QUESTION. No. 1611 TO BE ANSWERED ON 11 TH FEBRUARY 2022

## DEATH OF TRIBAL CHILDREN DUE TO MALNUTRITION

## 1611: PROF. SOUGATA RAY

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

- a) the cases of death of tribal children reported in the country due to malnutrition and lack of treatment facilities during the last three years, State/UT-wise;
- b) the  steps  taken  to  ensure  availability  of  food  and  medical  facilities  for  tribal community in the country;
- c) whether  any  State/UT  is  lagging  behind  in  arranging  such  facilities  to  the  tribal people; and
- d) if so, the details thereof and the corrective action taken thereon?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (d)

Malnutrition is not a direct cause of deaths in children; however, it can increase morbidity and mortality by reducing resistance to infections.  As per NFHS-5 (2019-21), the Under-5 Mortality Rate in India is 41.9 per 1000 live births. The Government is implementing several schemes and programmes of different Ministries to ensure availability of food for the tribal communities.

In  order  to  bring  down  child  mortality  all  across  the  country  including  in  tribal  areas,  the Government is supporting all States/UTs in implementation of Reproductive, Maternal, Newborn, Child, Adolescent health and Nutrition (RMNCAH+N) strategy as a life cycle approach under National Health Mission (NHM) based on the Annual Program Implementation Plan (APIP) submitted by States/UTs.

## Interventions for improving Child survival:

-  Facility Based New-born Care: Sick New-born Care Units (SNCUs) are established at District Hospital and  Medical College level, New-born  Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies.
-  Community Based care of New-born and Young Children: Under Home Based New-born Care (HBNC) and Home-Based Care of Young Children (HBYC) program, home  visits  are  performed  by  ASHAs  to  improve  child  rearing  practices  and  to identify sick new-born and young children including tribal children in the community.
-  Mothers' Absolute Affection  (MAA): Early  initiation  and  exclusive  breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted under Mothers' Absolute Affection (MAA).
-  Social  Awareness  and  Actions  to  Neutralize  Pneumonia  Successfully  (SAANS) initiative implemented since 2019 for reduction of Childhood morbidity and mortality due to Pneumonia.
-  Universal Immunization Programme (UIP) is implemented to provide vaccination to children including tribal children against life threatening diseases such as Tuberculosis,  Diphtheria,  Pertussis,  Polio,  Tetanus,  Hepatitis  B,  Measles,  Rubella, Pneumonia  and  Meningitis  caused  by  Haemophilus  Influenzae  B.  The  Rotavirus vaccination  has  also  been  rolled  out  in  the  country  for  prevention  of  Rota-viral diarrhoea.  Pneumococcal  Conjugate  Vaccine  (PCV)  has  been  introduced  in  all  the States and UTs.
-  Rashtriya Bal SwasthyaKaryakaram (RBSK): Children from 0 to 18 years of age are screened  for  30  health  conditions (i.e. Diseases,  Deficiencies,  Defects  and Developmental delay) under Rashtriya Bal SwasthyaKaryakaram (RBSK) to improve child  survival.  District  Early  Intervention  Centres  (DEICs)  at  district  health  facility level  are  established  for  confirmation  and  management  of  childrenincluding  tribal children screened under RBSK.
-  Nutrition  Rehabilitation  Centres  (NRCs) are  set  up  at  public  health  facilities  to treat and manage the children with Severe Acute Malnutrition (SAM) admitted with medical complications.
-  Intensified  Diarrhoea  Control  Fortnight  /  Defeat  Diarrhoea  (D2) initiative implemented for promoting ORS and Zinc use and for reducing diarrhoeal deaths.
-  Anaemia  Mukt  Bharat  (AMB)  strategy as  a  part  of  POSHAN  Abhiyan  aims  to strengthen  the  existing  mechanisms  and  foster  newer  strategies  to  tackle  anaemia which include testing & treatment of anaemia in school going adolescents & pregnant women, addressing non nutritional causes of anaemia and a comprehensive communication strategy.
-  Capacity Building: Several capacity building programs of health care providers are taken up for improving maternal and child survival and health outcomes.
-  Village Health Sanitation and Nutrition Days (VHSNDs) are observed for provision of  maternal  and child health services  and creating  awareness on maternal  and child care  in  convergence  with  Ministry  of  Women  and  Child  Development.  Health  and nutrition  education  through  mass  and  social  media  is  also  promoted  to  improve healthy practices and to generate demand for service uptake.
-  Mother and Child Protection Card is the joint initiative of the Ministry of Health & Family welfare and the Ministry of Woman and Child Development which addresses the  nutrition  concerns  in  children  including  tribal  children,  pregnant  women  and lactating mothers.

The other programmes/ schemes under different ministries are being implemented to improve the nutritional status are as under:

Ministry  of  Women  and  Child  Development  is  implementing  Anganwadi  Services,  a centrally  sponsored  flagship  programme  to  improve  the  nutritional  status  of  women  and children including  tribal children. The  scheme  provides  package  of  six  services  i.e. Supplementary Nutrition, Pre School Non-formal Education, Nutrition and Health Education, Immunization, Health Check-ups and Referral services.

Under the Ministry of Consumer Affairs,  Food and Public Distribution, the National  Food Security Act, (NFSA) legally entitles upto 75% of the rural population and 50% of the urban population  to  receive  subsidized  foodgrains  under  Targeted  Public  Distribution  System.

About  two  thirds  of  the  population  therefore  is  covered  under  the  Act  to  receive  highly subsidized foodgrains.

Also, in order to address anaemia and micro-nutrient deficiency in the country, Government of  India  approved  Centrally  Sponsored  Pilot  Scheme  on  "Fortification  of  Rice  &  its Distribution under Public Distribution System" for a period of 3 years beginning in 2019- 20. 15  State  Governments  namely  Andhra  Pradesh,  Kerala,  Karnataka,  Maharashtra,  Odisha, Gujarat,  Uttar  Pradesh,  Assam,  Tamil  Nadu,  Telangana,  Punjab,  Chhattisgarh,  Jharkhand, Uttarakhand& Madhya Pradesh consented and identified their respective Districts (1 District Per State) with total outlay of Rs 174.64 Cr. Ministry of Consumer Affairs, Food and Public Distribution in association with Ministry of Women & Child Development and Department of School Education & Literacy has planned to distribute fortified rice under ICDS/ Pradhan MantriPoshan  Shakti  Nirman  -  PM  POSHAN  (erstwhile  Mid-Day  Meal  Scheme{MDM}) across the country during this year in an effort to scale up the distribution of fortified rice in the country to help in fighting deficiency of micro-nutrients like Iron, Folic Acid & Vitamin B-12

Pradhan Mantri Poshan Shakti Nirman -PM  POSHAN  (erstwhile Mid-Day Meal Scheme{MDM})  under  Ministry  of  Education  provides  supplementary  feeding  to  school going children including tribal children.

The  Government  of  India  has  been  implementing  POSHAN  (Prime  Minister  Overarching Scheme  for  Holistic  Nourishment)  Abhiyaan,  to  address  malnutrition  in  India  through convergence, behaviour change, IEC advocacy, training and capacity building, innovations and demand generation.