Lok Sabha Question No. 5043 (UNSTARRED), answered on 2022-04-01
Subject: Methodology to Measure Malnutrition
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: K. Muraleedharan, Mohammad Jawed, Behanan Benny, Anto  Antony, T.N. Prathapan

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 5043

TO BE ANSWERED ON 01.04.2022

## METHODOLOGY TO MEASURE MALNUTRITION

5043.  SHRI K. MURALEEDHARAN: DR. MOHAMMAD JAWED: SHRI BENNY BEHANAN: SHRI ANTO ANTONY: SHRI T.N. PRATHAPAN:

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

- (a) whether the Government is on track to meet its promise of making India malnutrition free by 2022;
- (b) if so, the details thereof and if not, the reasons therefor;
- (c) the difference in the manner the Government calculates the level of malnutrition as compared to the Global Hunger Index and the rationale for this difference in methodology; and
- (d) the number of malnourished and severely acute malnourished children in the country from 2014 to till date, State-wise?

## ANSWER

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

- (a) & (b)    The Government has accorded high priority to the issue of malnutrition and is  making  serious  efforts  to  address  this  issue.  Government  implements  Anganwadi Services  Scheme,  POSHAN  Abhiyaan,  Pradhan  Mantri   Matru  Vandana  Yojana  and Scheme  for  Adolescent  Girls  under  the  Umbrella  Integrated  Child  Development Services Scheme (ICDS) as targeted interventions for Children under 6 years, Pregnant Women and Lactating Mothers and Adolescent Girls, throughout the country. POSHAN Abhiyaan  aims  to  reduce  malnutrition  in  a  phased  manner,  through  a  life  cycle approach,  by  adopting  a  synergised  and  result  oriented  approach.  Further,  Mission Poshan 2.0, an integrated nutrition support programme has been announced in budget 2021-2022  for  all  States/UTs.  It  seeks  to  strengthen  nutritional  content,  delivery, outreach and outcomes with focus on developing practices that nurture health, wellness and immunity to disease and malnutrition. All these schemes address in one or other aspects related to nutrition and have the potential to improve nutritional outcomes in the country.
- (c) Global Hunger Index (GHI) is published by 'Concern Worldwide & Welthungerhilfe.  The  GHI  scores  are  based  on  the  values  of  four  component indicators,  viz.,  Undernourishment  among  population,  Child  Wasting,  Child  Stunting

and Child Mortality. GHI is a tool for measuring and tracking hunger at global, regional, and country levels. Global Hunger Index (GHI) does not reflect India's true picture as it is  a  flawed measure of 'Hunger'. It should not be taken at face value as it is neither appropriate  nor  representative  of  hunger  prevalent  in  a  country.  Out  of  its  four indicators, only one indicator, i.e., undernourishment, is directly related to hunger. The indicator  "undernourishment  among  population"  in  GHI  is  obtained  through  a  gallup survey,  ,  which  has  completely  disregarded  Government's  economic  response  to Covid-19  of  providing  free  foodgrains  to  80  Crore  National  Food  Security  Act beneficiaries under Pradhan Mantri Garib Kalyan Anna Yojna.

The data on nutritional indicators in the country on the other hand, is captured under the  National  Family  Health  Surveys  conducted  periodically  by  the  Ministry  of  Health and  Family  Welfare.  Under  the  Survey,  the  level  of  malnutrition  among  children  is assessed  using  the  WHO  standards  and  for  adults  the  Body  Mass  Index  cut-offs recommended by WHO are used to assess the prevalence of under and over nutrition. Further, NFHS  also  provides  comprehensive  information  other  determinants of malnutrition,  viz.,  prevalence  of  micronutrient  deficiencies  like  anaemia,  food  intake and infant and young child feeding and care practices including data on immunization, maternal health  and nutrition,  etc.  The  data  provided  by  the  national  level  survey  is used to guide policies and programmes to address the nutritional challenges faced by the country.

(d)        The  prevalence  of  malnourished  and  severely  acute  malnourished  children  in the country as per the NFHS - 4 (2015-16) and NFHS - 5 (2019-21) data is annexed.

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| Annexure   | Annexure                            | Annexure                  | Annexure          | Annexure                                | Annexure          | Annexure                      | Annexure           | Annexure                                    | Annexure          |
|------------|-------------------------------------|---------------------------|-------------------|-----------------------------------------|-------------------|-------------------------------|--------------------|---------------------------------------------|-------------------|
| Prevalence | of State                            | Underweight, Stunting, rs | as                | Wasting per NFHS-4 & NFHS-5 Underweight | & Severe          | wasting Wasting (under 5 yrs) | in                 | children under Severe Wasting (under 5 yrs) | 5 yea             |
|            | of State                            | NFHS- 4 (2015-1 6)        | NFHS-5 ( 2019-21) | NFHS-4 (2015-16)                        | NFHS-5 ( 2019-21) | NFHS-4 (2015-1 6)             | NFHS- 5 (2019 -21) | NFHS-4 (2015-1 6)                           | NFHS-5 (2019-2 1) |
| 1.         | Andaman & Ni cobar                  | 23.3                      | 22.5              | 21.6                                    | 23.7              | 18.9                          | 16                 | 7.5                                         | 4.8               |
| 2.         | Andhra Prade sh                     | 31.4                      | 31.2              | 31.9                                    | 29.6              | 17.2                          | 16.1               | 4.5                                         | 6.0               |
| 3.         | Arunachal Pra desh                  | 29.4                      | 28                | 19.5                                    | 15.4              | 17.3                          | 13.1               | 8.0                                         | 6.5               |
| 4.         | Assam                               | 36.4                      | 35.3              | 29.8                                    | 32.8              | 17                            | 21.7               | 6.2                                         | 9.1               |
| 5.         | Bihar                               | 48.3                      | 42.9              | 43.9                                    | 41                | 20.8                          | 22.9               | 7.0                                         | 8.8               |
| 6.         | Chandigarh                          | 28.7                      | 25.3              | 24.5                                    | 20.6              | 10.9                          | 8.4                | 3.9                                         | 2.3               |
| 7.         | Chhattisgarh                        | 37.6                      | 34.6              | 37.7                                    | 31.3              | 23.1                          | 18.9               | 8.4                                         | 7.5               |
| 8.         | Dadra Nagar Haveli and D aman & Diu | 37.2                      | 39.4              | 35.8                                    | 38.7              | 26.7                          | 21.6               | 11.5                                        | 4.3               |
| 9.         | Delhi                               | 32.3                      | 30.9              | 27                                      | 21.8              | 17.1                          | 11.2               | 4.6                                         | 4.9               |
| 10.        | Goa                                 | 20.1                      | 25.8              | 23.8                                    | 24                | 21.9                          | 19.1               | 9.5                                         | 7.5               |
| 11.        | Gujarat                             | 38.5                      | 39                | 39.3                                    | 39.7              | 26.4                          | 25.1               | 9.5                                         | 10.6              |
| 12.        | Haryana                             | 34                        | 27.5              | 29.4                                    | 21.5              | 21.2                          | 11.5               | 9.0                                         | 4.4               |
| 13.        | Himachal Pra desh                   | 26.3                      | 30.8              | 21.2                                    | 25.5              | 13.7                          | 17.4               | 3.9                                         | 6.9               |
| 14.        | Jammu & Kas hmir                    | 27.4                      | 26.9              | 16.6                                    | 21                | 12.1                          | 19                 | 5.6                                         | 9.7               |
| 15.        | Jharkhand                           | 45.3                      | 39.6              | 47.8                                    | 39.4              | 29                            | 22.4               | 11.4                                        | 9.1               |
| 16.        | Karnataka                           | 36.2                      | 35.4              | 35.2                                    | 32.9              | 26.1                          | 19.5               | 10.5                                        | 8.4               |
| 17.        | Kerala                              | 19.7                      | 23.4              | 16.1                                    | 19.7              | 15.7                          | 15.8               | 6.5                                         | 5.8               |
| 18.        | Lakshadweep                         | 27.0                      | 32.0              | 23.4                                    | 25.8              | 13.8                          | 17.4               | 2.9                                         | 8.7               |
| 19         | Ladakh                              | 30.9                      | 30.5              | 18.7                                    | 20.4              | 9.3                           | 17.5               | 5.1                                         | 9.1               |
| 20.        | Madhya Prade sh                     | 42.0                      | 35.7              | 42.8                                    | 33.0              | 25.8                          | 19.0               | 9.2                                         | 6.5               |
| 21.        | Maharashtra                         | 34.4                      | 35.2              | 36.0                                    | 36.1              | 25.6                          | 25.6               | 9.4                                         | 10.9              |
| 22.        | Manipur                             | 28.9                      | 23.4              | 13.8                                    | 13.3              | 6.8                           | 9.9                | 2.2                                         | 3.4               |
| 23.        | Meghalaya                           | 43.8                      | 46.5              | 29.0                                    | 26.6              | 15.3                          | 12.1               | 6.5                                         | 4.7               |
| 24.        | Mizoram                             | 28                        | 28.9              | 11.9                                    | 12.7              | 6.1                           | 9.8                | 2.3                                         | 4.9               |
| 25.        | Nagaland                            | 28.6                      | 32.7              | 16.38                                   | 26.9              | 11.2                          | 19.1               | 4.2                                         | 7.9               |
| 26.        | Odisha                              | 34.1                      | 31.0              | 34.4                                    | 29.7              | 20.4                          | 18.1               | 6.4                                         | 6.1               |
| 28.        | Puducherry                          | 23.7                      | 20.0              | 22.0                                    | 15.3              | 23.6                          | 12.4               | 7.8                                         | 3.7               |
| 29.        | Punjab                              | 25.7                      | 24.5              | 21.6                                    | 16.9              | 15.6                          | 10.6               | 5.6                                         | 3.7               |

| 30.   | Rajasthan     |   39.1 |   31.8 |   36.7 |   27.6 |   23.0 |   16.8 |   8.6 |   7.6 |
|-------|---------------|--------|--------|--------|--------|--------|--------|-------|-------|
| 30.   | Sikkim        |   29.6 |   22.3 |   14.2 |   13.1 |   14.2 |   13.7 |   5.9 |   6.6 |
| 31.   | Tamil Nadu    |   27.1 |   25   |   23.8 |   22   |   19.7 |   14.6 |   7.9 |   5.5 |
| 32.   | Telangana     |   28.1 |   33.1 |   28.5 |   31.8 |   18   |   21.7 |   4.8 |   8.5 |
| 33.   | Tripura       |   24.3 |   32.3 |   24.1 |   25.6 |   16.8 |   18.2 |   6.3 |   7.3 |
| 34.   | Uttar Pradesh |   46.3 |   39.7 |   39.5 |   32.1 |   17.9 |   17.3 |   6   |   7.3 |
| 35.   | Uttarakhand   |   33.5 |   27   |   26.6 |   21   |   19.5 |   13.2 |   9   |   4.7 |
| 36.   | West Bengal   |   32.5 |   33.8 |   31.5 |   32.2 |   20.3 |   20.3 |   6.5 |   7.1 |
|       | India         |   38.4 |   35.5 |   35.8 |   32.1 |   21   |   19.3 |   7.5 |   7.7 |