Lok Sabha Question No. 1638 (UNSTARRED), answered on 2022-12-16
Subject: Malnourished Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Lallu Singh, Amar Singh, Jadon Chandra Sen, Khagen Murmu

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 1638

TO BE ANSWERED ON 16.12.2022

## MALNOURISHED CHILDREN

## 1638.  SHRI LALLU SINGH:

DR. AMAR SINGH: DR. CHANDRA SEN JADON: SHRI KHAGEN MURMU:

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

- a.  whether  the  number  of  malnourished  children  is  steadily  increasing  in  the country, if so, the details in this regard, State-wise;
- b.  whether problems of wasting and stunting in children under five years of age are more in the districts of Uttar Pradesh, if so, the details thereof, district-wise;
- c. the  details  of  the  work  done  by  the  Government  in  this  regard  in  Firozabad district  of  Uttar  Pradesh  through  various  schemes/programmes  along  with  the outcome thereof;
- d.  whether  the  Government  has  drawn  any  action  plan  to  reduce  stunting  and wasting by 6 per cent by 2022 among children and anaemia by 9 per cent among children, teenage girls and pregnant women, if so, the details thereof and if not, the reasons therefor; and
- e.  the  other  measures  being  taken  by  the  Government  for  making  country malnutrition free?

## ANSWER

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

(a)  The  data  on  nutrition  indicators  is  obtained  under  National  Family  Health  Survey (NFHS) conducted by the Ministry of Health & Family Welfare. As per the recent report of NFHS-5 (2019-21), the nutrition indicators for children under 5 years have improved as compared with NFHS-4 (2015-16). Stunting has reduced from 38.4% to 35.5%, while wasting has reduced from 21.0% to 19.3%, underweight prevalence has reduced from 35.8% to 32.1%. The State/UT wise prevalence of malnutrition among children under five years of age is at Annexure-I .

(b)  As  per  the  recent  report  of  NFHS-5  (2019-21), the  nutrition  indicators for  children under 5 years have improved as compared with NFHS-4 (2015-16) in the State of Uttar Pradesh. Stunting has reduced from 46.3% to 39.7%, while wasting has reduced from 17.9% to 17.3%, underweight prevalence has reduced from 39.5% to 32.1%

District-wise prevalence of stunting, wasting and underweight among children under five years  of  age  as  per  National  Family  Health  Survey-5  (2019-21)  in  the  State  of  Uttar Pradesh is at Annexure-II.

(c ) Government has accorded high priority to the issue of malnutrition and is making serious  efforts  to  address  this  issue.  POSHAN  Abhiyaan,  a  flagship  scheme  of  the Government was launched in 2018 to address the malaise of malnutrition by adopting a synergised  and  result  oriented  approach.  To  ensure  a  holistic  approach,  all  districts (including Firozabad District of Uttar Pradesh) of States/UTs have been covered in the Abhiyaan.

Further  in  Firozabad  district,  State  Government  organizes  'Vajan  Diwas'  to  identify malnourished/  severely  malnourished  children  and  efforts  are  made  to  improve  the nutritional status of these children, which include health check-ups, treatment at NRCs, distribution  of  supplementary  nutrition,  and  ensuring  benefits  of  the  schemes  in convergence with line departments.

(d)  &  (e)  POSHAN Abhiyaan, a flagship scheme of the Government was launched in 2018  to  address  the  challenges  of  malnutrition  by  adopting  a  synergised  and  result oriented approach.  The programme  makes  interventions  by  use of technology, behavioural change through convergence and lays-down targets to be achieved across different parameters. The Abhiyaan has been rolled-out in all States and UTs.

The efforts under the Supplementary Nutrition Programme under Anganwadi Services and POSHAN Abhiyaan have been aligned under 'Saksham Anganwadi and POSHAN 2.0' (Mission Poshan 2.0). It seeks to address the challenges of malnutrition in children, adolescent  girls,  pregnant  women  and  lactating  mothers  through  a  strategic  shift  in nutrition content and delivery and by creation of a convergent ecosystem to develop and promote practices  that  nurture  health,  wellness  and  immunity.  The  Common  Core  of Poshan  2.0  focuses  on  Maternal  Nutrition,  Infant  and  Young  Child  Feeding  Norms, Treatment  of  MAM/SAM  and  Wellness  through  AYUSH.  It  rests  on  the  pillars  of Convergence, Capacity Building, Governance and Outreach. Under Poshan 2.0, focus is  on  diet  diversity,  food  fortification,  leveraging  traditional  systems  of  knowledge  and popularizing  use  of  millets.  Nutrition  awareness  strategies  under  Poshan  2.0  aim  to develop sustainable health and well-being through regional meal plans to bridge dietary gaps.

Steps  have  been  taken  to  improve  nutritional  quality  and  testing  in  accredited  labs, strengthen delivery and leverage technology under the 'Poshan Tracker', a robust ICT enabled platform to improve governance with regard to real-time monitoring of provision of supplementary nutrition for prompt supervision and management of services.

Under  Poshan  2.0,  focus  is  on  diet  diversity,  food  fortification,  leveraging  traditional systems of knowledge and popularizing use of millets. Nutrition awareness strategies under  Poshan  2.0  aim  to  develop  sustainable  health  and  well-being  through  regional meal plans to bridge dietary gaps. Saksham Anganwadi Guidelines support development of Poshan Vatikas at  Anganwadi centers to meet  dietary  diversity  gaps leveraging traditional knowledge in nutritional practices.

To address the challenges of malnutrition and anaemia in women and children arising due  to  deficiency  of  micro  nutrients  like  Iron,  Folic  Acid  and  Vitamin  B-12,  under Supplementary  Nutrition  Programme  (SNP)  of  Anganwadi  Services,  Ministry  has advised  all  the  States/UTs  to  ensure  use  of  relevant  fortified  food  articles  (wherever supplied),  including  Double  Fortified  Salt  in  the  administration  of  the  Supplementary Nutrition Programme. Under SNP, Fortified Rice was allocated to 21 States/UTs during the 2nd quarter of FY 2021-22 and from the 3 rd quarter  of  FY  2021-22 onwards only Fortified  Rice  is being  allocated to all  the State/UTs. So far, under SNP, this Ministry has allocated 731962 MTs of Fortified Rice in FY 2021-22 and 938207 MTs of Fortified rice up to third quarter of FY 2022-23 to all the States/UTs.

Further, more emphasis is being given on the supply of millets for preparation of Hot Cooked Meal and Take Home rations at Anganwadis for Pregnant Women, Lactating mothers  and  children  below  6  years  of  age,  as  millets  are  highly  nutritious  and  are known to have high nutrient content which includes protein, essential fatty acid, dietary fibre,  B-Vitamins,  minerals  such  as  calcium,  iron,  zinc,  folic  acid  and  other  micronutrients thus helping to tackle anaemia and other micro-nutrient deficiencies common among women and children. It may  also  be  noted  that  as  per  the  Mission  Saksham Anganwadi & Poshan 2.0 guidelines, millets need to be mandatorily supplied at least once a week and suitably integrated in THR and HCM in a palatable form.

Further,  Government of India has launched Anemia Mukt Bharat (AMB) strategy with the target to reduce anemia in women, children and adolescents in life cycle approach. The  6x6x6  strategy  under  AMB  implies  six  age  groups,  six  interventions  and  six institutional  mechanisms.  The  six  interventions  under  Anemia  Mukt  Bharat  strategy include, Prophylactic Iron Folic Acid Supplementation, Periodic de-worming, Intensified year-round  Behaviour  Change  Communication  Campaign,  Testing  and  treatment  of anemia, using digital methods  and  point of care treatment, Convergence  and coordination with other line departments and ministries for strengthening implementation  etc

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State/UT-wise prevalence of stunting, wasting and underweight among children under five years of age as per National Family Health Survey (NFHS):

| S. No.                      | Name of State/UT            | Stunting (%)     | Stunting (%)     | Wasting (%)      | Wasting (%)      | Underweight (%)   | Underweight (%)   |
|-----------------------------|-----------------------------|------------------|------------------|------------------|------------------|-------------------|-------------------|
| S. No.                      | Name of State/UT            | NHFS 4 (2015-16) | NHFS 5 (2019-21) | NHFS 4 (2015-16) | NHFS 5 (2019-21) | NHFS 4 (2015-16)  | NHFS 5 (2019-21)  |
| INDIA                       | INDIA                       | 38.4             | 35.5             | 21               | 19.3             | 35.8              | 32.1              |
| 1 Andaman & Nicobar Islands | 1 Andaman & Nicobar Islands | 23.3             | 22.5             | 18.9             | 16               | 21.6              | 23.7              |
| 2 Andhra Pradesh            | 2 Andhra Pradesh            | 31.4             | 31.2             | 17.2             | 16.1             | 31.9              | 29.6              |
| 3 Arunachal Pradesh         | 3 Arunachal Pradesh         | 29.4             | 28               | 17.3             | 13.1             | 19.4              | 15.4              |
| 4 Assam                     | 4 Assam                     | 36.4             | 35.3             | 17               | 21.7             | 29.8              | 32.8              |
| 5 Bihar                     | 5 Bihar                     | 48.3             | 42.9             | 20.8             | 22.9             | 43.9              | 41                |
| 6 Chandigarh                | 6 Chandigarh                | 28.7             | 25.3             | 10.9             | 8.4              | 24.5              | 20.6              |
| 7 Chhattisgarh              | 7 Chhattisgarh              | 37.6             | 34.6             | 23.1             | 18.9             | 37.7              | 31.3              |
| 8 Dadra & Nagar Haveli and  | 8 Dadra & Nagar Haveli and  | 37.2             | 39.4             | 26.7             | 21.6             | 35.8              | 38.7              |
| 9 Delhi                     | 9 Delhi                     | 31.9             | 30.9             | 15.9             | 11.2             | 27                | 21.8              |
| 10 Goa                      | 10 Goa                      | 20.1             | 25.8             | 21.9             | 19.1             | 23.8              | 24                |
| 11 Gujarat                  | 11 Gujarat                  | 38.5             | 39               | 26.4             | 25.1             | 39.3              | 39.7              |
| 12 Haryana                  | 12 Haryana                  | 34               | 27.5             | 21.2             | 11.5             | 29.4              | 21.5              |
| 13 Himachal Pradesh         | 13 Himachal Pradesh         | 26.3             | 30.8             | 13.7             | 17.4             | 21.2              | 25.5              |
| 14 Jammu & Kashmir          | 14 Jammu & Kashmir          | 27.4             | 26.9             | 12.1             | 19               | 16.6              | 21                |
| 15 Jharkhand                | 15 Jharkhand                | 45.3             | 39.6             | 29               | 22.4             | 47.8              | 39.4              |
| 16 Karnataka                | 16 Karnataka                | 36.2             | 35.4             | 26.1             | 19.5             | 35.2              | 32.9              |
| 17 Kerala                   | 17 Kerala                   | 19.7             | 23.4             | 15.7             | 15.8             | 16.1              | 19.7              |
| 18 Lakshadweep              | 18 Lakshadweep              | 26.8             | 32               | 13.7             | 17.4             | 23.6              | 25.8              |
| 19 Ladakh                   | 19 Ladakh                   | 30.9             | 30.5             | 9.3              | 17.5             | 18.7              | 20.4              |
| 20 Madhya Pradesh           | 20 Madhya Pradesh           | 42               | 35.7             | 25.8             | 19               | 42.8              | 33                |
| 21 Maharashtra              | 21 Maharashtra              | 34.4             | 35.2             | 25.6             | 25.6             | 36                | 36.1              |
| 22                          | Manipur                     | 28.9             | 23.4             | 6.8              | 9.9              | 13.8              | 13.3              |
| 23 Meghalaya                | 23 Meghalaya                | 43.8             | 46.5             | 15.3             | 12.1             | 28.9              | 26.6              |
| 24 Mizoram                  | 24 Mizoram                  | 28.1             | 28.9             | 6.1              | 9.8              | 12                | 12.7              |
| 25 Nagaland                 | 25 Nagaland                 | 28.6             | 32.7             | 11.3             | 19.1             | 16.7              | 26.9              |
| 26 Orissa                   | 26 Orissa                   | 34.1             | 31               | 20.4             | 18.1             | 34.4              | 29.7              |
| 27                          | Puducherry                  | 23.7             | 20               | 23.6             | 12.4             | 22                | 15.3              |

| 28            | Punjab      |   25.7 |   24.5 |   15.6 |   10.6 |   21.6 | 16.9       |
|---------------|-------------|--------|--------|--------|--------|--------|------------|
| 29            | 39.1        |   31.8 |   23   |   16.8 |   36.7 |   27.6 | Rajasthan  |
| 30 Sikkim     | 29.6        |   22.3 |   14.2 |   13.7 |   14.2 |   13.1 |            |
| 31            | 27.1        |   25   |   19.7 |   14.6 |   23.8 |   22   | Tamil Nadu |
| Telangana     | 28          |   33.1 |   18.1 |   21.7 |   28.4 |   31.8 | 32         |
| Tripura       | 24.3        |   32.3 |   16.8 |   18.2 |   24.1 |   25.6 | 33         |
| Uttar Pradesh | 46.3        |   39.7 |   17.9 |   17.3 |   39.5 |   32.1 | 34         |
| Uttarakhand   | 33.5        |   27   |   19.5 |   13.2 |   26.6 |   21   | 35         |
| 36 West       | Bengal 32.5 |   33.8 |   20.3 |   20.3 |   31.6 |   32.2 |            |

District-wise  prevalence  of  stunting,  wasting  and  underweight  among  children under five years of age as per National Family Health Survey-5 (2019-21) in State of Uttar Pradesh:

| S. No.   | Name of State/UT    | Stunting (%)     | Stunting (%)     | Wasting (%)      | Wasting (%)      | Underweight (%)   | Underweight (%)   |
|----------|---------------------|------------------|------------------|------------------|------------------|-------------------|-------------------|
| S. No.   | Name of State/UT    | NHFS 4 (2015-16) | NHFS 5 (2019-21) | NHFS 4 (2015-16) | NHFS 5 (2019-21) | NHFS 4 (2015-16)  | NHFS 5 (2019-21)  |
|          | Uttar Pradesh       | 46.3             | 39.7             | 17.9             | 17.3             | 39.5              | 32.1              |
| 1        | Agra                | 44.7             | 35.8             | 14.9             | 16.4             | 34.8              | 26.2              |
| 2        | Aligarh             | 49.1             | 35.0             | 14.6             | 10.9             | 38.2              | 26.3              |
| 3        | Allahabad           | 43.8             | 37.9             | 20.0             | 15.1             | 43.4              | 32.6              |
| 4        | Ambedkar Nagar      | 43.0             | 31.1             | 22.7             | 17.8             | 41.0              | 29.2              |
| 5        | Amethi              | -                | 35.8             | -                | 19.9             | -                 | 33.1              |
| 6        | Auraiya             | 43.6             | 39.7             | 26.5             | 19.4             | 46.4              | 32.6              |
| 7        | Azamgarh            | 40.0             | 33.4             | 16.9             | 14.4             | 33.0              | 28.0              |
| 8        | Baghpat             | 35.8             | 25.5             | 14.9             | 10.3             | 33.3              | 26.0              |
| 9        | Bahraich            | 65.1             | 52.1             | 13.7             | 14.3             | 44.0              | 38.0              |
| 10       | Ballia              | 39.6             | 43.8             | 14.1             | 21.9             | 31.1              | 42.5              |
| 11       | Balrampur           | 62.8             | 41.1             | 10.3             | 24.9             | 43.5              | 37.2              |
| 12       | Banda               | 46.7             | 51.0             | 18.0             | 25.7             | 41.5              | 49.8              |
| 13       | Bara Banki          | 51.5             | 41.9             | 12.2             | 18.1             | 40.2              | 31.9              |
| 14       | Bareilly            | 45.6             | 45.9             | 18.8             | 15.4             | 42.1              | 35.2              |
| 15       | Basti               | 48.9             | 35.9             | 14.1             | 24.1             | 33.3              | 39.2              |
| 16       | Bijnor              | 42.6             | 36.2             | 22.4             | 9.4              | 41.8              | 21.9              |
| 17       | Budaun              | 55.1             | 51.8             | 20.1             | 18.2             | 53.6              | 43.0              |
| 18       | Bulandshahr         | 43.2             | 37.6             | 16.0             | 13.8             | 33.8              | 26.5              |
| 19       | Chandauli           | 43.3             | 39.5             | 17.8             | 17.4             | 34.8              | 29.9              |
| 20       | Chitrakoot          | 50.9             | 47.4             | 33.3             | 24.8             | 52.5              | 41.8              |
| 21       | Deoria              | 41.2             | 36.8             | 14.1             | 26.5             | 31.6              | 39.4              |
| 22       | Etah                | 51.0             | 48.8             | 9.6              | 14.9             | 32.2              | 30.6              |
| 23       | Etawah              | 53.2             | 38.8             | 11.4             | 13.9             | 32.6              | 24.3              |
| 24       | Faizabad            | 49.9             | 30.6             | 19.3             | 12.3             | 44.9              | 27.5              |
| 25       | Farrukhabad         | 49.1             | 47.8             | 8.4              | 14.3             | 31.4              | 31.1              |
| 26       | Fatehpur            | 52.4             | 51.1             | 14.9             | 17.8             | 40.4              | 38.0              |
| 27       | Firozabad           | 44.0             | 46.9             | 11.7             | 9.5              | 27.9              | 25.6              |
| 28       | Gautam Buddha Nagar | 32.2             | 25.5             | 16.2             | 12.0             | 28.4              | 21.9              |
| 29       | Ghaziabad           | 34.7             | 28.1             | 13.9             | 17.1             | 29.6              | 23.3              |
| 30       | Ghazipur            | 41.4             | 39.3             | 17.7             | 25.7             | 31.7              | 38.3              |
| 31       | Gonda               | 56.9             | 45.9             | 9.8              | 12.1             | 38.6              | 28.0              |
| 32       | Gorakhpur           | 42.1             | 29.6             | 19.9             | 23.3             | 35.2              | 33.7              |
| 33       | Hamirpur            | 38.5             | 48.0             | 32.3             | 20.6             | 39.8              | 36.3              |
| 34       | Hapur               | -                | 30.2             | -                | 18.5             | -                 | 26.9              |

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|   35 | Hardoi                      | 50.5   |   44.5 | 14.7   |   22.3 | 39.9   |   32.9 |
|------|-----------------------------|--------|--------|--------|--------|--------|--------|
|   36 | Jalaun                      | 45.6   |   45.1 | 32.2   |   19.5 | 49.2   |   36.1 |
|   37 | Jaunpur                     | 48.0   |   40.5 | 27.3   |   14.8 | 52.7   |   30.3 |
|   38 | Jhansi                      | 36.1   |   40.9 | 27.2   |   25.2 | 39.5   |   39.3 |
|   39 | Jyotiba Phule Nagar         | 44.7   |   42.2 | 22.8   |   22.5 | 42.4   |   35.4 |
|   40 | Kannauj                     | 50.4   |   43   | 12.2   |   21.5 | 32.9   |   33.5 |
|   41 | Kanpur Dehat                | 45.9   |   44.1 | 15.4   |   12.5 | 36.1   |   32.8 |
|   42 | Kanpur Nagar                | 43.6   |   34.6 | 24.1   |   21.4 | 41.8   |   27.8 |
|   43 | Kanshiram Nagar             | 51.5   |   45.1 | 11.6   |   19.3 | 32.8   |   35.5 |
|   44 | Kaushambi                   | 50.1   |   40.2 | 29.9   |   18.3 | 52.8   |   36.8 |
|   45 | Kheri                       | 53.9   |   47.6 | 17.5   |   15.8 | 40.8   |   36.3 |
|   46 | Kushinagar                  | 45.0   |   32.2 | 14.6   |   24.3 | 35.1   |   36.6 |
|   47 | Lalitpur                    | 40.7   |   46.6 | 39.0   |   18.7 | 48.8   |   34.8 |
|   48 | Lucknow                     | 37.5   |   32.1 | 33.6   |   11.5 | 44.5   |   25.5 |
|   49 | Mahamaya Nagar              | 44.2   |   39.1 | 9.7    |   12   | 31.7   |   24.5 |
|   50 | Mahoba                      | 44.6   |   42.3 | 23.9   |   25   | 47.7   |   33.4 |
|   51 | Mahrajganj                  | 53.3   |   40.5 | 12.5   |   21.8 | 37.1   |   37.4 |
|   52 | Mainpuri                    | 46.5   |   44.3 | 11.5   |   14.6 | 32.5   |   33.6 |
|   53 | Mathura                     | 40.8   |   31.6 | 12.9   |   11   | 27.7   |   21.3 |
|   54 | Mau                         | 40.9   |   25.4 | 19.7   |   21.2 | 35.1   |   30.3 |
|   55 | Meerut                      | 35.3   |   32.1 | 18.8   |   10.2 | 35.2   |   23.6 |
|   56 | Mirzapur                    | 49.1   |   43.4 | 20.8   |   12.5 | 46.5   |   27.6 |
|   57 | Moradabad                   | 45.1   |   34.7 | 16.4   |   19.1 | 43.2   |   27   |
|   58 | Muzaffarnagar               | 40.8   |   29.8 | 18.8   |   20.7 | 36.9   |   29.9 |
|   59 | Pilibhit                    | 51.5   |   38.9 | 21.8   |   20.1 | 44.1   |   39.4 |
|   60 | Pratapgarh                  | 41.3   |   35.5 | 23.8   |   10   | 42.6   |   27.7 |
|   61 | Rae Bareli                  | 36.2   |   47   | 31.4   |   13   | 41.3   |   28.8 |
|   62 | Rampur                      | 46.0   |   40.4 | 20.8   |   17.5 | 44.4   |   32.1 |
|   63 | Saharanpur                  | 36.9   |   28.8 | 18.5   |   22   | 36.1   |   26.7 |
|   64 | Sambhal                     | -      |   51.6 | -      |   14.1 | -      |   29.8 |
|   65 | Sant Kabir Nagar            | 50.5   |   42.3 | 10.9   |   19   | 36.5   |   34.2 |
|   66 | Sant Ravidas Nagar(Bhadohi) | 51.4   |   42.7 | 21.5   |    9.1 | 49.1   |   26.5 |
|   67 | Shahjahanpur                | 49.3   |   44.5 | 23.6   |   17   | 54.3   |   34.7 |
|   68 | Shamli                      | -      |   28.6 | -      |   24.3 | -      |   27.5 |
|   69 | Shrawasti                   | 63.5   |   50.9 | 10.1   |   20.3 | 39.2   |   40.8 |
|   70 | Siddharthnagar              | 57.9   |   37.2 | 13.7   |   24.8 | 43.5   |   36.3 |
|   71 | Sitapur                     | 56.4   |   47.8 | 14.0   |   18.2 | 48.6   |   37.9 |
|   72 | Sonbhadra                   | 45.9   |   38.3 | 22.5   |   26.7 | 46.4   |   46.5 |
|   73 | Sultanpur                   | 45.9   |   33.4 | 19.1   |   10.7 | 39.8   |   28.3 |
|   74 | Unnao                       | 46.5   |   39.2 | 13.1   |   12.1 | 34.3   |   29.3 |
|   75 | Varanasi                    | 44.7   |   37.4 | 25.3   |   21   | 45.4   |   39   |

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