Lok Sabha Question No. 3330 (UNSTARRED), answered on 2021-12-17
Subject: Stunting and Wasting among Children
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Sushil Kumar Singh

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

## LOK SABHA UNSTARRED QUESTION NO. 3330 TO BE ANSWERED ON 17 TH  DECEMBER, 2021

## STUNTING AND WASTING AMONG CHILDREN

## 3330. SHRI SUSHIL KUMAR SINGH:

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

- (a) the reasons for high prevalence of stunting and wasting among children in the country;
- (b)  the  steps  taken  by  the  Government  for  reducing  stunting  and  wasting  of  children  in  the country;
- (c) whether stunting is observed in children who do not suffer from wasting; and
- (d) if so, the reasons of prevalence of stunting without wasting?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) & (b): As per NFHS-5 (2019- 21) factsheets, the nutrition indicators for children under five years have improved as compared to NFHS-4 (2015-16) wherein, stunting has reduced from 38.4% to 35.5% and wasting has reduced from 21.0% to 19.3%.

As  per  inputs  received  from  the  Ministry  of  Women  and  Child  Development  (MWCD),  the Government has accorded high priority to the issue of malnutrition and is implementing several schemes/ programmes of different Ministries/Departments through States/UTs to address various aspects related to nutrition. Ministry of Women and Child is implementing POSHAN Abhiyaan, Pradhan Mantri Matru Vandana Yojana, Anganwadi Services and Scheme for Adolescent Girls under the  Umbrella  Integrated  Child  Development  Services  Scheme  (ICDS)  as  direct  targeted interventions to address the problem of malnutrition in the country.

States/UTs have been advised to promote use of AYUSH systems for prevention of malnutrition and  related  diseases.  A  programme  to  support  development  of  Poshan  Vatikas  at  Anganwadi Centres  to  meet  dietary  diversity  gap  leveraging  traditional  knowledge  in  nutritional  practices has also been taken up. Guidelines were issued for transparency and accountability in delivery of supplementary nutrition and to track nutritional outcomes on 13.01.2021.

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.

The Ministry of Health and Family Welfare has been implementing RMNCHA+N strategy under National  Health  Mission  (NHM),  with  programmes  and  strategies  to  improve  the  nutritional status of different age groups with focus on preventive aspects of undernutrition, which include,

-  Early initiation of breastfeeding within an hour of child birth, exclusive breastfeeding for first  six  months  and  appropriate  Infant  and  Young  Child  Feeding  (IYCF)  practices  are promoted under Mothers' Absolute Affection (MAA).
-  Home Based  Care  for  Young  Children  (HBYC)  has  been  initiated  as  an  extension  of Home  Based  Newborn  Care  (HBNC)  to  provide  community  based  care  by  ASHA workers with focus on improvement in child rearing practices, nutrition counselling and breastfeeding promotion till 15th months of life.
-  Biannual Vitamin A supplementation (VAS) for children of 9 to 59 months age.
-  'Anemia Mukt Bharat (AMB)' for prevention of anaemia through IFA supplementation and  treatment  of  anaemia  through  life  cycle  approach  i.e.  in  children,  adolescents, pregnant and lactating women, and women of reproductive age group.
-  National De-worming Day to administer Albendazole tablets to all the children in the age group  of  1-19  years  through  the  platform  of  AWCs  and  schools  for  good  nutritional outcomes and prevention of anaemia.
-  Prevention  of  childhood  illness  such  as  diarrheal  diseases  which  in  turn  prevents childhood malnutrition.
-  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.
-  Treatment of under-five year sick Severe Acute Malnutrition (SAM) children at special units called the Nutrition Rehabilitation Centres (NRCs), set up at public health facilities.

(c) & (d): As per National Family Health Survey India Report-4 (2015-16), Stunting, or low height-for-age,  is  a  sign  of  chronic  undernutrition  that  reflects  failure  to  receive  adequate nutrition  over  a  long  period.  Stunting  can  also  be  affected  by  recurrent  and  chronic  illness. Wasting, or low weight-for-height, is a measure of acute undernutrition and represents the failure to  receive  adequate nutrition in the period immediately before the survey. Wasting may result from inadequate food intake or from a recent episode of illness causing weight loss.

Wasting  and  stunting  can  co-exist  in  the  same  setting  and  occur  in  the  same  child.  Both manifestations  of  acute  and  chronic  undernutrition  share  common  risk  factors,  including infection, poor infant and young child feeding practices, inadequate diet and food insecurity, and poor maternal health and nutrition.