Lok Sabha Question No. 484 (UNSTARRED), answered on 2022-02-04
Subject: Anaemia Mukt Bharat
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Balashowry Vallabbhaneni, Sushil Kumar Singh, Gowdar Mallikarjunappa Siddeshwara

(a)

to (e).

In  2018,  the  Government  of  India  launched  the  Anaemia  Mukt  Bharat  (AMB)  strategy with the target to reduce anaemia in the vulnerable age groups such as women, children and  adolescents  in  life  cycle  approach  providing  preventive  and  curative  mechanisms through  a  6X6X6  strategy  including  six  target  beneficiaries,  six  interventions  and  six institutional  mechanisms  for  all  stakeholders  to  implement  the  strategy.  Under  AMB strategy, the interventions for tackling the problem of anaemia in all the States and UTs include:

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE

## DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION No. 484

## TO BE ANSWERED ON 4 th February 2022

## 'ANAEMIA MUKT BHARAT'

## 484: SHRI BALASHOWRY VALLABHANENI:

SHRI SUSHIL KUMAR SINGH:

SHRI G.M. SIDDESHWAR:

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

- a) whether  the  Government  has  started  the  implementation  of  Anaemia  Mukt  Bharat (AMB) programme in 2018, if so, the aims and objectives of AMB;
- b) whether a target of anaemia reduction by 3 percent per year has been achieved since implementation of AMB, if so, the details thereof along with prevalence of anaemia among six identified population group post implementation of AMB, State/UT/Group-wise;
- c) whether NFHS-5 has indicated an increase in anaemia across all age groups, if so, the details thereof and the reaction of the Government thereto;
- d) the reasons identified by the Government for increase in anemia among men, women including  pregnant  women  and  children  in  the  country  despite  implementation  of
5. AMB and other Government interventions to curb the menace; and
- e) whether the Government proposes to revisit the strategy of AMB, if so, the details thereof  along  with  other  corrective  measures  being  taken  to  make  AMB  more effective?

## ANSWER

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

## (DR. BHARATI PRAVIN PAWAR)

- i. Prophylactic Iron and Folic Acid Supplementation in all six target age groups
- ii. Intensified  year-round  Behaviour  Change  Communication  (BCC)  Campaign for:(a) improving compliance to Iron Folic Acid supplementation and deworming, (b) enhancing appropriate infant and young child feeding practices,  (c)  encouraging  increase  in  intake  of  iron-rich  food  through  diet diversity/quantity/frequency  and/or  fortified  foods  with  focus  on  harnessing locally  available  resources,  and  (d)  ensuring  delayed  cord  clamping  after delivery (by 3 minutes) in health facilities
- iii. Testing  and  treatment  of  anemia,  using  digital  methods  and  point  of  care treatment, with special focus on pregnant women and school-going adolescents
- iv. Addressing non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis
- v. Management of severe anaemia in pregnant women undertaken by administration of IV Iron Sucrose/Blood transfusion
- vi. Providing incentives to the ANM for identification and follow-up of pregnant women with severe anaemia in high priority districts (HPDs)
- vii. Training and orientation of Medical Officers and front line-workers on newer Maternal Health and Anaemia Mukt Bharat guidelines
- viii. Field  level  awareness  by  ASHAs through community mobilization activities and IEC and BCC activities

The  prevalence  of  anaemia  among  six  groups  as  per  the  National  Family  Health Survey 5 (2019-21), is 25.0 percent in men (15-49 years) and 57.0 percent in women (15-49 years). 31.1 percent in adolescent boys (15-19 yrs), 59.1 percent in adolescent girls,52.2 percent in pregnant women (15-49 years) and 67.1percent in children (6-59 months).

FewStates/UTs  have  shown  decline  in  anaemia  prevalence,  details  on  theState/UTwiseprevalenceof  anaemia  among  six  identified  population  groupsare  placed  at annexure.

The measures taken by the Government to make AMB programme more effective are:

- (i) working with other line departments and ministries for strengthening implementation

.

- (ii) engaging National Centre of Excellence and Advanced Research on Anemia Control  (NCEAR-A)  at  AIIMS,  Delhi  in  capacity  building  of  health  care providers
- (iii) strengthening supply chain and logistics
- (iv) development  of  AMB  Training  Toolkit  for  capacity  building  of  health  care providers in anaemia management and recent launch of Anemia Mukt Bharat e-Training Modules to facilitate training of the health care providers through virtual  platform  amid  COVID  19  pandemic  which  has  posed  a  challenge  in capacity building through physical trainings.

Health is a State subject and the primary responsibility for strengthening health care services  including  implementation  of  national  programs  lies  with  the  respective State/UT government. However, Government is taking steps to improve the condition of  anaemia  among  all  identified  groups  in  all  States/UTs.  Ministry  of  Health  and Family Welfare provides financial and technical support to States/UTs under NHM as proposed  during  annual  Programme  Implementation  Plan.  Covid-19  pandemic  has also  hampered AMB programme implementation contributing to anemia prevalence among all the age groups

## Annexure

|       | Anemia Prevalence (NFHS4 and NFHS-5 )   | Anemia Prevalence (NFHS4 and NFHS-5 )   | Anemia Prevalence (NFHS4 and NFHS-5 )                     | Anemia Prevalence (NFHS4 and NFHS-5 )                               | Anemia Prevalence (NFHS4 and NFHS-5 )                           | Anemia Prevalence (NFHS4 and NFHS-5 )         | Anemia Prevalence (NFHS4 and NFHS-5 )                 | Anemia Prevalence (NFHS4 and NFHS-5 )                           |
|-------|-----------------------------------------|-----------------------------------------|-----------------------------------------------------------|---------------------------------------------------------------------|-----------------------------------------------------------------|-----------------------------------------------|-------------------------------------------------------|-----------------------------------------------------------------|
| S no. | State/UT                                | NFHS                                    | Children age 6-59 months who are anaemic (<11.0 g/dl) (%) | Non-pregnant women age 15-49 years who are anaemic (<12.0 g/dl) (%) | Pregnant women age 15-49 years who are anaemic (<11.0 g/dl) (%) | All women age 15-49 years who are anaemic (%) | Adolescent girls age 15- 19 years who are anaemic (%) | Adolescent boysage 15-19 years who are anaemic (<13.0 g/dl) (%) |
|       |                                         | NFHS-5                                  | 67.1                                                      | 57.2                                                                | 52.2                                                            | 57                                            | 59.1                                                  | 31.1                                                            |
|       | India                                   | NFHS-4                                  | 58.6                                                      | 53.2                                                                | 50.4                                                            | 53.1                                          | 54.1                                                  | 29.2                                                            |
|       | Andaman &                               | NFHS-5                                  | 40                                                        | 57.6                                                                | 53.7                                                            | 57.5                                          | 44.9                                                  | 27.1                                                            |
| 1     | Nicobar Islands                         | NFHS-4                                  | 49                                                        | 65.8                                                                | 61.4                                                            | 65.7                                          | 68.1                                                  | 43                                                              |
|       |                                         | NFHS-5                                  | 63.2                                                      | 59                                                                  | 53.7                                                            | 58.8                                          | 60.1                                                  | 18.7                                                            |
| 2     | Andhra Pradesh                          | NFHS-4                                  | 58.6                                                      | 60.2                                                                | 52.9                                                            | 60                                            | 61.1                                                  | 29.3                                                            |
|       |                                         | NFHS-5                                  | 68.4                                                      | 66.4                                                                | 54.2                                                            | 65.9                                          | 67                                                    | 39.6                                                            |
| 3     | Assam                                   | NFHS-4                                  | 35.7                                                      | 46.1                                                                | 44.8                                                            | 46                                            | 42.7                                                  | 23.5                                                            |
|       |                                         | NFHS-5                                  | 69.4                                                      | 63.6                                                                | 63.1                                                            | 63.5                                          | 65.7                                                  | 34.8                                                            |
| 4     | Bihar                                   | NFHS-4                                  | 63.5                                                      | 60.4                                                                | 58.3                                                            | 60.3                                          | 61                                                    | 37.8                                                            |
|       | DNH& DD                                 | NFHS-5                                  | 75.8                                                      | 62.6                                                                | 60.7                                                            | 62.5                                          | 63.9                                                  | 37                                                              |
| 5     |                                         | NFHS-4                                  | 82                                                        | 73.4                                                                | 62.3                                                            | 72.9                                          | 75.9                                                  | 36.1                                                            |
|       |                                         | NFHS-5                                  | 53.2                                                      | 38.9                                                                | 41                                                              | 39                                            | 44.5                                                  | 15.8                                                            |
| 6     | Goa                                     | NFHS-4                                  | 48.3                                                      | 31.4                                                                | 26.7                                                            | 31.3                                          | 30.5                                                  | 6.6                                                             |
|       |                                         | NFHS-5                                  | 79.7                                                      | 65.1                                                                | 62.6                                                            | 65                                            | 69                                                    | 36                                                              |
| 7     | Gujarat                                 | NFHS-4                                  | 62.6                                                      | 55.1                                                                | 51.3                                                            | 54.9                                          | 56.5                                                  | 31.9                                                            |
|       |                                         | NFHS-5                                  | 55.4                                                      | 53.4                                                                | 42.2                                                            | 53                                            | 53.2                                                  | 22.1                                                            |
| 8     | Himachal Pradesh                        | NFHS-4                                  | 53.7                                                      | 53.6                                                                | 50.4                                                            | 53.5                                          | 52.7                                                  | 25                                                              |
|       | Jammu &                                 | NFHS-5                                  | 72.7                                                      | 67.3                                                                | 44.1                                                            | 65.9                                          | 76.2                                                  | 53.5                                                            |
| 9     | Kashmir                                 | NFHS-4                                  | 53.8                                                      | 49                                                                  | 46.9                                                            | 48.9                                          | 49.9                                                  | 29.5                                                            |
|       |                                         | NFHS-5                                  | 65.5                                                      | 47.8                                                                | 45.7                                                            | 47.8                                          | 49.4                                                  | 26.5                                                            |
| 10    | Karnataka                               | NFHS-4                                  | 60.9                                                      | 44.8                                                                | 45.4                                                            | 44.8                                          | 45.3                                                  | 24.5                                                            |
|       |                                         | NFHS-5                                  | 39.4                                                      | 36.5                                                                | 31.4                                                            | 36.3                                          | 32.5                                                  | 27.4                                                            |
| 11    | Kerala                                  | NFHS-4                                  |                                                           | 34.7                                                                | 22.6                                                            | 34.3                                          | 37.8                                                  | 14.3                                                            |
|       |                                         |                                         | 35.7                                                      | 26                                                                  | 20.9                                                            | 25.8                                          |                                                       |                                                                 |
| 12    | Lakshadweep                             | NFHS-5 NFHS-4                           | 43.1 53.6                                                 | 46.3                                                                | 39                                                              | 46                                            | 31.4 59                                               | * *                                                             |
|       |                                         | NFHS-5                                  | 92.5                                                      | 93.7                                                                | 78.1                                                            | 92.8                                          | 96.9                                                  | 93.1                                                            |
| 14    | Ladakh                                  | NFHS-4                                  | 91.4                                                      | 78.4                                                                | 79.3                                                            | 78.4                                          | 81.6                                                  | 57.6                                                            |
|       |                                         | NFHS-5                                  | 68.9                                                      | 54.5                                                                | 45.7                                                            | 54.2                                          | 57.2                                                  | 27.9                                                            |
| 15    | Maharashtra                             | NFHS-4                                  | 53.8                                                      | 47.9                                                                | 49.3                                                            | 48                                            | 49.7                                                  | 27.5                                                            |
|       | Meghalaya                               | NFHS-5                                  | 45.1                                                      | 54.4                                                                | 45                                                              | 53.8                                          | 52.5                                                  | 30.1                                                            |
| 16    |                                         | NFHS-4                                  | 48                                                        | 56.4                                                                | 53.3                                                            | 56.2                                          | 52.1                                                  | 25.2                                                            |
|       | Manipur                                 | NFHS-5                                  | 42.8                                                      | 29.3                                                                | 32.4                                                            | 29.4                                          | 27.9                                                  | 7.8                                                             |
| 17    |                                         | NFHS-4                                  | 23.9                                                      | 26.4                                                                | 26                                                              | 26.4                                          | 21.1                                                  | 9.2                                                             |
|       |                                         | NFHS-5                                  | 46.4                                                      | 34.8                                                                | 34                                                              | 34.8                                          | 34.9                                                  | 21.5                                                            |
| 18    | Mizoram                                 | NFHS-4                                  | 19.3                                                      | 24.7                                                                | 27                                                              | 24.8                                          | 21.3                                                  | 14.4                                                            |
|       | Nagaland                                | NFHS-4                                  | 42.7                                                      | 29.3                                                                |                                                                 | 28.9                                          | 33.9                                                  | 19.6                                                            |
| 19    |                                         | NFHS-5                                  |                                                           |                                                                     | 22.2                                                            |                                               |                                                       |                                                                 |
|       |                                         |                                         | 26.4                                                      | 27.7                                                                | 32.7                                                            | 27.9                                          | 26.3                                                  | 12.2                                                            |
|       | Sikkim                                  | NFHS-5                                  | 56.4                                                      | 42.1                                                                | 40.7                                                            | 42.1                                          | 46.7                                                  | 17.6                                                            |
| 20    |                                         | NFHS-4                                  | 55.1                                                      | 35.2                                                                | 23.6                                                            | 34.9                                          | 48.7                                                  | 16.7                                                            |
| 21    | Telangana                               | NFHS-5 NFHS-4                           | 70                                                        | 57.8                                                                | 53.2                                                            | 57.6                                          | 64.7 59.7                                             | 25.1 19.2                                                       |
|       |                                         | NFHS-5                                  | 60.7                                                      | 56.9                                                                | 48.2                                                            | 56.6                                          | 67.9                                                  | 27.2                                                            |
| 22    | Tripura                                 | NFHS-4                                  | 64.3 48.3                                                 | 67.4                                                                | 61.5                                                            | 67.2                                          | 52.2                                                  | 22                                                              |
|       |                                         | NFHS-5                                  | 69                                                        | 54.5 71.7                                                           | 54.4 62.3                                                       | 54.5 71.4                                     | 70.8                                                  | 38.7                                                            |
| 23    | West Bengal                             | NFHS-4                                  | 54.2                                                      | 62.8                                                                | 53.6                                                            | 62.5                                          | 62.2                                                  | 31.7                                                            |

| Arunachal      | NFHS-5   |   56.6 |   40.8 | 27.9   |   40.3 |   48.5 | 24.9   |
|----------------|----------|--------|--------|--------|--------|--------|--------|
| Pradesh        | NFHS-4   |   54.2 |   43.5 | 37.8   |   43.2 |   48.2 | 22.9   |
| Chandigarh     | NFHS-5   |   54.6 |   60.1 | *      |   60.3 |   57.7 | *      |
|                | NFHS-4   |   73.1 |   75.9 | *      |   75.9 |   74.7 | 22.4   |
| Chhattisgarh   | NFHS-5   |   67.2 |   61.2 | 51.8   |   60.8 |   61.4 | 31.5   |
|                | NFHS-4   |   41.6 |   47.3 | 41.5   |   47   |   45.5 | 27.4   |
| Nct Of Delhi   | NFHS-5   |   69.2 |   50.2 | 42.2   |   49.9 |   51.6 | 18.9   |
|                | NFHS-4   |   59.7 |   54.7 | 46.1   |   54.3 |   55.1 | 25.9   |
| Haryana        | NFHS-5   |   70.4 |   60.6 | 56.5   |   60.4 |   62.3 | 29.9   |
|                | NFHS-4   |   71.7 |   63.1 | 55     |   62.7 |   62.7 | 29.7   |
| Jharkhand      | NFHS-5   |   67.5 |   65.7 | 56.8   |   65.3 |   65.8 | 39.7   |
|                | NFHS-4   |   69.9 |   65.3 | 62.6   |   65.2 |   65   | 35.3   |
| Madhya Pradesh | NFHS-5   |   72.7 |   54.7 | 52.9   |   54.7 |   58.1 | 30.5   |
|                | NFHS-4   |   68.9 |   52.4 | 54.6   |   52.5 |   53.2 | 36.5   |
| Odisha         | NFHS-5   |   64.2 |   64.4 | 61.8   |   64.3 |   65.5 | 30     |
|                | NFHS-4   |   44.6 |   51.2 | 47.6   |   51   |   51   | 30.3   |
| Punjab         | NFHS-5   |   71.1 |   58.8 | 51.7   |   58.7 |   60.3 | 32.7   |
|                | NFHS-4   |   56.6 |   54   | 42     |   53.5 |   58   | 30.8   |
|                | NFHS-5   |   64   |   55.5 | 42.5   |   55.1 |   58.4 | 30.7   |
| Puducherry     | NFHS-4   |   44.9 |   53.4 | 26     |   52.4 |   55   | 40.6   |
| Rajasthan      | NFHS-5   |   71.5 |   54.7 | 46.3   |   54.4 |   59.4 | 34     |
|                | NFHS-4   |   60.3 |   46.8 | 46.6   |   46.8 |   49.1 | 22.1   |
| Tamil Nadu     | NFHS-5   |   57.4 |   53.6 | 48.3   |   53.4 |   52.9 | 24.6   |
|                | NFHS-4   |   50.7 |   55.4 | 44.4   |   55   |   54.2 | 26     |
| Uttar Pradesh  | NFHS-5   |   66.4 |   50.6 | 45.9   |   50.4 |   52.9 | 28.2   |
|                | NFHS-4   |   63.2 |   52.5 | 51     |   52.4 |   53.7 | 31.5   |
|                | NFHS-5   |   58.8 |   42.4 | 46.4   |   42.6 |   40.9 | 27.6   |
| Uttarakhand    | NFHS-4   |   59.8 |   45.1 | 46.5   |   45.2 |   46.4 | 22.2   |