Lok Sabha Question No. 1462 (UNSTARRED), answered on 2023-02-10
Subject: Prevalence of Anaemia
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Umesh G. Jadhav, Prathap Simha

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 1462

TO BE ANSWERED ON 10.02.2023

## PREVALENCE OF ANAEMIA

1462. DR. UMESH G. JADHAV: SHRI PRATHAP SIMHA:

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

- (a) the details of targets set and achievements made under 'POSHAN Abhiyaan' during each of the last three years and the current year;
- (b) whether  as  per  the  National  Family  Health  Survey  (NFHS)-5,  cases  of prevalence of anaemia in children and adolescent girls and cases of stunting have also increased in the State of Karnataka and if so, the details thereof; and
- (c) the steps taken by the Government to bring down such prevalence of anaemia and stunting among women, children and adolescent girls in the country along with the funds allocated/utilized under POSHAN Abhiyaan during each of the last three years and the current year

## ANSWER

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

(a) 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  Abhiyaan  has  been  rolled-out  in  all  States  and  UTs.  POSHAN Abhiyaan was launched to achieve improvement in nutritional status of Children from 0-6 years, Adolescent Girls, Pregnant Women and Lactating Mothers, in a time bound manner with fixed targets as under:

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|   S.No | Objective                                                                                          | Target   |
|--------|----------------------------------------------------------------------------------------------------|----------|
|      1 | Prevent and reduce Stunting in children (0- 6 years)                                               | @2%p.a.  |
|      2 | Prevent and reduce under-nutrition (underweight prevalence) in children (0-6 years)                | @2%p.a.  |
|      3 | Reduce the prevalence of anaemia among young Children(6-59 months)                                 | @3%p.a.  |
|      4 | Reduce the prevalence of anaemia among Women and Adolescent Girls in the age group of 15-49 years. | @3%p.a.  |
|      5 | Reduce Low Birth Weight (LBW).                                                                     | @2%p.a.  |

The achievements under POSHAN Abhiyaan are as follows:

- i. POSHAN Abhiyaan  has  been  rolled  out  across  all  the  36  States/UTs.  The Abhiyaan covers around 735 Districts including 112 Aspirational Districts. The estimated number of underweight, malnourished and severely malnourished children under 5 years of age 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). Wasting has improved from  21%  (NFHS-4)  to  19.3  %  (NFHS-5),  Under-weight  has  improved  from 35.7% (NFHS-4) to 32.1% (NFHS-5) and stunting has improved from 38.4% (NFHS-4) to 35.5% (NFHS-5)
- ii. Under  POSHAN  Abhiyaan,  for  the  first  time,  the  Anganwadi  worker  was empowered with mobile devices. 11.22 lakh smart phones have been provided to Anganwadi workers. Besides, to promote regular growth monitoring, 12.65 lakh Growth Monitoring Devices such as Infantometer, Stadiometer, Weighing Scale for Mother and Infant and Weighing Scale for Child have been procured by States/UTs under the Abhiyaan.
- iii. IT systems have been leveraged to strengthen and bring about transparency in nutrition delivery support systems. The 'Poshan Tracker' application was rolled out on 1 st  March 2021 through National e-Governance Division (NeGD), as an important governance tool. Around 13.97 lakh AWCs have started using the ICT Application.
- iv. A Web and App based 'Grievance Redressal Cell' has been established for effective service delivery and beneficiary feedback. Besides, a national Poshan Helpline has been made available for beneficiaries and the public. Through the Helpline a beneficiary can raise a concern about the services offered under Mission Poshan 2.0
- v. Under the key component of Jan Andolan, total five (5) Poshan Maahs and four (4) Poshan Pakhwadas have been held across the country since 2018. Approx., 60+ crore Jan Andolan based activities have been conducted since the launch of the Abhiyaan. The Poshan Maah conducted during the month of September 2022 witnessed approximately 17 crore Jan Andolan based activities throughout the country. Around 3.70 crore Community Based Events (CBEs) have also been organized since the launch of the Abhiyaan in a convergent manner at Anganwadi Centres with field functionaries.
- vi. More than 4 lakh Poshan Vatikas have been developed and 1.10 lakh Medicinal Saplings have been planted across the country.
- vii. More  than  10  lakh  Frontline  Functionaries  have  been  trained  on  thematic modules.
- viii. 10.10 crore beneficiaries have been registered under Poshan Tracker (as on 31-12-2022). Details are as follows:
- ix. 88.15%  of  beneficiaries  registered  on  the  Poshan  Tracker  have  been successfully    Aadhar verified.
- x. For the first time, migration facility for pregnant women and lactating mothers from one AWC to another within and outside a State has been facilitated under the Poshan Tracker. Migration facility from one category to another category of beneficiary is also available.
- xi. Best  Practices  on  use  of  millets  and  improvement  in  nutritional  status  of severely acutely malnourished (SAM) children in districts were recognized and selected for the PM's Award for Excellence for promotion of Jan Bhagidari in Poshan Abhiyaan on 21st April 2022. These best practices, shared with all States/UTs included Mission Sampurna Poshan in Asifabad, Telangana, Mera Bachccha Abhiyaan Model in Datia, Madhya Pradesh and Project Sampoorna in Bongaigaon, Assam.
- xii. Area-wise diet charts for pregnant women were laid on the Table in Lok Sabha on 15 th  September 2020 and 23 rd  September 2020. Further, the diet charts have also been uploaded on Ministry's website in English and Hindi.
13. (b)       As per NFHS-5, the prevalence of anaemia among children and adolescent girls is 65.5% and 49.4% respectively in the State of Karnataka compared to 60.9% and 45.3% in NFHS-4. The prevalence of Stunting has reduced from 36.2% in NFHS4 to 35.4% in NFHS-5.

| Total Beneficiaries   | Lactating Mothers   | Pregnant Women   | Children (0-6M)   | Children (6m-3y)   | Children (3y-6y)                | Adolescent Girls (14-18 y)   |
|-----------------------|---------------------|------------------|-------------------|--------------------|---------------------------------|------------------------------|
| 10,10,50,463          | 52,41,440           | 80,40,215        | 45,95,834         |                    | 4,06,33,0404,25,39,93418,11,961 |                              |

(c) Government has accorded high priority to the issue of malnutrition and is making serious efforts to address this issue. The efforts under the Supplementary Nutrition Programme  under Anganwadi Services and POSHAN  Abhiyaan  have been rejuvenated  and  converged  as  '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  eco-system  to  develop  and promote practices that nurture health, wellness and immunity.

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, Governance, and Capacity-building. POSHAN Abhiyaan is the key pillar  for  Outreach  and  will  cover  innovations  related  to  nutritional  support,  ICT interventions, Media Advocacy and Research, Community Outreach and Jan Andolan. 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 provisioning of supplementary nutrition for prompt supervision and management of services.

Government released Streamlined Guidelines dated 13.1.2021 for greater transparency,  accountability  and  quality  in  the  nutrition  support  programme  and service delivery. These guidelines emphasize on ensuring the quality of supplementary  nutrition,  highlights  roles  and  responsibilities  of  duty  holders,  IT enabled  data  management  and  monitoring,  leveraging  of  traditional  knowledge through  AYUSH,  procurement  and  convergence  for  achieving  good  nutritional outcomes.

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. The Guidelines of Poshan 2.0 support development of  Poshan Vatikas at Anganwadi centers to meet dietary diversity gaps leveraging traditional knowledge in nutritional practices

Further, the 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.

Under POSHAN Abhiyaan, total Central funds amounting to Rs. 5402.95 crores have been released since 2017-18 and States/UTs have utilized Rs. 3572.77 crores (as on 31st March, 2022) to ensure eradication of malnutrition among the beneficiaries of the country. Details of funds released allocated under Poshan Abhiyan in each of the last three years is as under:

| Financial Year   |   Fund Allocated/ Released (Rs. in crores) |
|------------------|--------------------------------------------|
| FY 2019-20       |                                    1714.58 |
| FY 2020-21       |                                     208.44 |
| FY 2021-22       |                                     145.97 |

Funds have not been released to States/UTs, so far, in the year 2022-23.

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