Lok Sabha Question No. 4876 (UNSTARRED), answered on 2023-03-31
Subject: Malnutrition Deaths among Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Kani K. Navas, Mohammad Jawed, Y. S. Avinash Reddy

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 4876 TO BE ANSWERED ON 31.03.2023

## MALNUTRITION DEATHS AMONG CHILDREN

4876.  SHRI K. NAVASKANI: DR. MOHAMMAD JAWED: SHRI Y.S. AVINASH REDDY:

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

- (a) the details of women and children in the country who are still malnourished, State-wise;
- (b) whether the malnutrition deaths are on a rise among children in the country and if so, the details thereof;
- (c) whether the Government has made any enquiry about these deaths through National  Commission for Protection of  Child  Rights  (NCPCR) and  if  so,  the findings and recommendations made by NCPCR in this regard;
- (d) whether  the  Government  is  planning  to  expand  nutrition  programmes  to address malnutrition and if so, the details thereof;
- (e) the steps taken by the Government under POSHAN Abhiyan 2.0 to reduce the same; and
- (f) whether the Government is implementing Anganwadi Services Scheme, if so, the  progress made so far including further measures taken to ensure wider coverage of the programme?

## ANSWER

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

- (a)       As per NFHS-5, the prevalence of stunting, wasting and underweight among children  under  5  years  of  age  is  35.5%,  19.3%  and  32.1%  and  the  prevalence  of underweight among women is 18.7%. State-wise data of malnutrition as per NFHS-5 is at Annexure-1
- (b)  & (c)    Malnutrition is not a direct cause of death among children. However, it can increase morbidity and mortality by reducing resistance to infections. The overall under five  mortality  rate  has  reduced  from  49.7  (NFHS-4)  to  41.9  (NFHS-5)  deaths  per thousand live births.

No States have reported any direct deaths due to malnutririon. No such inquiry has been made by Government through NCPCR.

(d)  to (f)  The Government has accorded high priority to the issue of malnutrition and is  implementing  several  schemes  like  POSHAN  Abhiyaan,  Anganwadi  Services, Scheme for Adolescent Girls and Pradhan Mantri Matru Vandana Yojana (PMMVY) as direct targeted interventions to address the problem of malnutrition in the country. POSHAN Abhiyaan launched on 8th March 2018, aims to achieve improvement in nutritional  status  of  Adolescent  Girls,  Pregnant  Women  and  Lactating  Mothers  by adopting a synergised and result oriented approach. The Abhiyaan has been rolled out across 36 States/UTs.

Further, 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) 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.

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. Further, greater emphasis is being given on the use of millets for preparation of Hot Cooked Meal and Take Home rations (not raw ration) at Anganwadi centres for Pregnant Women, Lactating Mothers and Children below 6 years of age, as millets have high nutrient content which includes protein, essential fatty acid, dietary fibre, B-Vitamins, minerals such as calcium, iron, zinc, folic acid and other micro-nutrients thus helping to tackle anemia  and  other micro-nutrient deficiencies in women and children. Further, to address the challenge of malnutrition arising  due  to  micro-nutrient  deficiency,  only  fortified  rice  is  being  allocated  to States/UTs

The Anganwadi Services under Saksham Anganwadi and Poshan 2.0 is a universal self-selecting scheme available to all the beneficiaries who enrol at the AWCs across the country. There are 7074 sanctioned projects under Mission Poshan 2.0 with 13.9 lakh  Anganwadi  Centres  across  the  country.  9.94  crore  beneficiaries,  namely, pregnant  women,  lactating  mothers  and  children  under  the  age  of  6  years,  are registered for Anganwadi Services on the ICT application, Poshan Tracker, as on date, out of whom 91% are Aadhar-verified.

Under Saksham Anganwadi, 2 lakh selected Government- owned AWCs @ 40,000 AWCs  per  year  would  be  strengthened,  upgraded  and  rejuvenated  for  improved nutrition  delivery.  In  the  FY  2022-23,  close  to  40,000  Anganwadi  Centres  in Aspirational  Districts  have  been  identified  to  be  made  into  Saksham  Anganwadis, which will be enhanced with LED screens, Wi-fi, smart -visual teaching aids, Poshan Vatikas, Rainwater harvesting structures etc.

Further, an important focus of Poshan Abhiyan, one of the components of the Scheme, has been on 'Behaviour Change Communication' through Jan Andolan. At the national level, Rashtriya Poshan Maah is celebrated in the month of September across the country while Poshan Pakhwada is celebrated in March. Over the years, themes have included overall nutrition, hygiene, water and sanitation, anemia prevention, importance of breast-feeding, growth monitoring, role of Poshan Panchayats, AYUSH for Well-being, Yoga for Health, importance of PoshanVatikas for cultivation of local vegetables, medicinal plants/herbs and fruits at the community level etc. More than 60 crore Jan Andolan activities have been conducted across the country.

Further, Community Based Events or CBEs have served as a significant strategy in changing nutrition practices. Close to 3.70 crore CBEs have been conducted under the Abhiyaan, in the last four years.

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## Annexure

| Prevalence of Underweight, Stunting, Wasting & Severe wasting in children under 5 years as per NFHS-5   | Prevalence of Underweight, Stunting, Wasting & Severe wasting in children under 5 years as per NFHS-5   | Prevalence of Underweight, Stunting, Wasting & Severe wasting in children under 5 years as per NFHS-5   | Prevalence of Underweight, Stunting, Wasting & Severe wasting in children under 5 years as per NFHS-5   | Prevalence of Underweight, Stunting, Wasting & Severe wasting in children under 5 years as per NFHS-5   |
|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------|
| S. No.                                                                                                  | State                                                                                                   | Stunted                                                                                                 | Underweight                                                                                             | Wasting                                                                                                 |
| 1.                                                                                                      | Andaman & Nicobar                                                                                       | 22.5                                                                                                    | 23.7                                                                                                    | 16                                                                                                      |
| 2.                                                                                                      | Andhra Pradesh                                                                                          | 31.2                                                                                                    | 29.6                                                                                                    | 16.1                                                                                                    |
| 3.                                                                                                      | Arunachal Pradesh                                                                                       | 28                                                                                                      | 15.4                                                                                                    | 13.1                                                                                                    |
| 4.                                                                                                      | Assam                                                                                                   | 35.3                                                                                                    | 32.8                                                                                                    | 21.7                                                                                                    |
| 5.                                                                                                      | Bihar                                                                                                   | 42.9                                                                                                    | 41                                                                                                      | 22.9                                                                                                    |
| 6.                                                                                                      | Chandigarh                                                                                              | 25.3                                                                                                    | 20.6                                                                                                    | 8.4                                                                                                     |
| 7.                                                                                                      | Chhattisgarh                                                                                            | 34.6                                                                                                    | 31.3                                                                                                    | 18.9                                                                                                    |
| 8.                                                                                                      | Dadra Nagar Haveli and Daman & Diu                                                                      | 39.4                                                                                                    | 38.7                                                                                                    | 21.6                                                                                                    |
| 9.                                                                                                      | Delhi                                                                                                   | 30.9                                                                                                    | 21.8                                                                                                    | 11.2                                                                                                    |
| 10.                                                                                                     | Goa                                                                                                     | 25.8                                                                                                    | 24                                                                                                      | 19.1                                                                                                    |
| 11.                                                                                                     | Gujarat                                                                                                 | 39                                                                                                      | 39.7                                                                                                    | 25.1                                                                                                    |
| 12.                                                                                                     | Haryana                                                                                                 | 27.5                                                                                                    | 21.5                                                                                                    | 11.5                                                                                                    |
| 13.                                                                                                     | Himachal Pradesh                                                                                        | 30.8                                                                                                    | 25.5                                                                                                    | 17.4                                                                                                    |
| 14.                                                                                                     | Jammu & Kashmir                                                                                         | 26.9                                                                                                    | 21                                                                                                      | 19                                                                                                      |
| 15.                                                                                                     | Jharkhand                                                                                               | 39.6                                                                                                    | 39.4                                                                                                    | 22.4                                                                                                    |
| 16.                                                                                                     | Karnataka                                                                                               | 35.4                                                                                                    | 32.9                                                                                                    | 19.5                                                                                                    |
| 17.                                                                                                     | Kerala                                                                                                  | 23.4                                                                                                    | 19.7                                                                                                    | 15.8                                                                                                    |
| 18.                                                                                                     | Lakshadweep                                                                                             | 32.0                                                                                                    | 25.8                                                                                                    | 17.4                                                                                                    |
| 19                                                                                                      | Ladakh                                                                                                  | 30.5                                                                                                    | 20.4                                                                                                    | 17.5                                                                                                    |
| 20.                                                                                                     | Madhya Pradesh                                                                                          | 35.7                                                                                                    | 33.0                                                                                                    | 19.0                                                                                                    |
| 21.                                                                                                     | Maharashtra                                                                                             | 35.2                                                                                                    | 36.1                                                                                                    | 25.6                                                                                                    |
| 22.                                                                                                     | Manipur                                                                                                 | 23.4                                                                                                    | 13.3                                                                                                    | 9.9                                                                                                     |
| 23.                                                                                                     | Meghalaya                                                                                               | 46.5                                                                                                    | 26.6                                                                                                    | 12.1                                                                                                    |
| 24.                                                                                                     | Mizoram                                                                                                 | 28.9                                                                                                    | 12.7                                                                                                    | 9.8                                                                                                     |
| 25.                                                                                                     | Nagaland                                                                                                | 32.7                                                                                                    | 26.9                                                                                                    | 19.1                                                                                                    |
| 26.                                                                                                     | Odisha                                                                                                  | 31.0                                                                                                    | 29.7                                                                                                    | 18.1                                                                                                    |
| 28.                                                                                                     | Puducherry                                                                                              | 20.0                                                                                                    | 15.3                                                                                                    | 12.4                                                                                                    |
| 29.                                                                                                     | Punjab                                                                                                  | 24.5                                                                                                    | 16.9                                                                                                    | 10.6                                                                                                    |
| 30.                                                                                                     | Rajasthan                                                                                               | 31.8                                                                                                    | 27.6                                                                                                    | 16.8                                                                                                    |
| 30.                                                                                                     | Sikkim                                                                                                  | 22.3                                                                                                    | 13.1                                                                                                    | 13.7                                                                                                    |
| 31.                                                                                                     | Tamil Nadu                                                                                              | 25.0                                                                                                    | 22.0                                                                                                    | 14.6                                                                                                    |
| 32.                                                                                                     | Telangana                                                                                               | 33.1                                                                                                    | 31.8                                                                                                    | 21.7                                                                                                    |
| 33.                                                                                                     | Tripura                                                                                                 | 32.3                                                                                                    | 25.6                                                                                                    | 18.2                                                                                                    |
| 34.                                                                                                     | Uttar Pradesh                                                                                           | 39.7                                                                                                    | 32.1                                                                                                    | 17.3                                                                                                    |
| 35.                                                                                                     | Uttarakhand                                                                                             | 27.0                                                                                                    | 21.0                                                                                                    | 13.2                                                                                                    |
| 36.                                                                                                     | West Bengal                                                                                             | 33.8                                                                                                    | 32.2                                                                                                    | 20.3                                                                                                    |
|                                                                                                         | India                                                                                                   | 35.5                                                                                                    | 32.1                                                                                                    | 19.3                                                                                                    |

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