Lok Sabha Question No. 963 (UNSTARRED), answered on 2022-07-22
Subject: Death due to Malnutrition
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Dushyant Singh, Rahul Kaswan

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

## LOK SABHA UNSTARRED QUESTION. NO. 963 TO BE ANSWERED ON 22 ND  JULY 2022

## DEATH DUE TO MALNUTRITION

## 963. SHRI DUSHYANT SINGH: SHRI RAHUL KASWAN:

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

(a) whether the deaths of children due to malnutrition have been reported  from  various  parts of  the  country, particularly  in  the  tribal  areas  and  if  so,  the  details thereof, State/UTwise from 2016-2022;

(b)  whether the  Government  has  conducted  any inquiry  into  the  reported  deaths  of children  due  to malnutrition  in  the  country;

(c)  whether  the  Government  has  devised  any mechanism to minimize the malnutrition deaths especially in  tribal  areas  of  the  country;

(d) if so, the details thereof and the other measures being proposed  in  this  regard,  along with  the shortcomings  noticed  in  the  implementation  of  current policies/schemes;  and

(e)  the details  of  the  funds  spent  on  tackling malnutrition  in  tribal  areas  of  the  country from  2018-2022, State/UT-wise?

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY

## ANSWER WELFARE (DR. BHARATI PRAVIN PAWAR)

(a)  to  (e):  Malnutrition  is  not  a  direct  cause  of  death  in  children;  however,  it  can  increase morbidity and mortality by reducing resistance to infections.

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/schemes for improving Child survival has been place at Annexure 1.

The Ministry of Health and Family Welfare, Ministry of AYUSH and Ministry of Women & Child Development are the sectoral Ministries with regard to Health and Nutrition, including tribal  people.   These  Ministries  allocate  funds  under  Schedule  Tribe  Component  (STC). Ministry of Tribal Affairs also provides funds to the States based on their specific proposals as  gap  filling  to  address  the  issues  covering  health  &  nutrition  of  tribal  population.  The Ministry of Tribal Affairs have emphasized capacity building, IEC material (use of traditional food, minor millet in the food basket through intervention in schools, inclusion in curriculum personal hygiene, habit of clean toilets etc.) for dissemination by Tribal Research Institutes as well.  The funds allocated to the State/ UT governments for Health & Nutrition by Ministry of Tribal Affairs (MoTA) is given below:

| Health &Nutrition   | Health &Nutrition           |
|---------------------|-----------------------------|
| Years               | Fund Approved (Rs. In lakh) |
| 2018-19             | 11563.86                    |
| 2019-20             | 9945.12                     |
| 2022-21             | 10611.61                    |
| 2021-22             | 7692.02                     |

## Interventions for improving Child survival:

-  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 is 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) is introduced in all States/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  children including  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 is 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.

ANNEXURE 1

-  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.
-  The    Government    of    India    has    been    implementing POSHAN  (Prime  Minister Overarching Scheme  for  Holistic  Nourishment)  Abhiyan ,  to  address  malnutrition in    India    through  convergence,    behaviour    change,    IEC    advocacy,    training    and capacity  building,  innovations and demand generation. Ministry  of  Women  and  Child Development  is  implementing  Anganwadi  Services,  a centrally  sponsored  flagship programme  to  improve  the  nutritional  status  of 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 up to 75% of the rural population and 50% of the urban population  to  receive  subsidized  food grains  under  Targeted Public  Distribution  System. About  two  thirds  of  the  population  therefore  is  covered under  the  Act  to  receive  highly subsidized food grains.
-  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 Mantri Poshan  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.