Lok Sabha Question No. 227 (UNSTARRED), answered on 2022-07-18
Subject: Malnutrition in Tribal Communities
Ministry: TRIBAL AFFAIRS
Asked by: Shrikant Eknath Shinde, Rita Bahuguna Joshi, Sujay Radhakrishna Vikhepatil, Heena Vijaykumar Gavit

## GOVERNMENT OF INDIA MINISTRY OF TRIBAL AFFAIRS

## LOK SABHA UNSTARRED QUESTION NO- 227

TO BE ANSWERED ON- 18/07/2022

## MALNUTRITION IN TRIBAL COMMUNITIES

## 227.  DR. SHRIKANT EKNATH SHINDE:

PROF. RITA BAHUGUNA JOSHI:

DR. SUJAY RADHAKRISHNA VIKHE PATIL:

DR. HEENA GAVIT :

Will the Minister of TRIBAL AFFAIRS be pleased to state:

- (a) the details of the improvement in the average life expectancy of tribal people in the country since 2014, State/UT wise;
- (b)  the  details  of  the  decrease  in  number  of  recorded  cases  of  malnutrition  in  tribal communities, State-wise;
- (c)  the  number  of  Nutrition  Rehabilitation  Centers  functional  across  the  country  and details thereof, state-wise particularly in Uttar Pradesh, Madhya Pradesh and Maharashtra; and
- (d) the details of any plans, to build the capacity of these Centers or take any other steps to combat malnutrition and increase the average life expectancy of tribal population?

## ANSWER

## MINISTER OF STATE FOR TRIBAL AFFAIRS (SMT. RENUKA SINGH SARUTA)

- (a) : As informed by Office of Registrar General of India, it collects and maintains data on average life expectancy of all Indian citizens State and UT wise, which is not for specific  tribal  communities.As  per  the  Sample  Registration  System(SRS)   based abridged  life  table  2015-19  published  by  the  office  of  the  Registrar  General  and Census  Commissioner  Govt.  of  India,  the  average  life  expectancy  at  birth  has increased from 69.4 years in 2014-18 to 69.7 years in 2015-19. The State/UT wise average life  expectancy  of  the  country  may  also  be  accessed  from  the  report  SRS abridged life table available at the portal of Census of India (http://censusindia.gov.in/). The state wise details can be seen at Annexure I .
- (b) : Data on  Malnutrition  or  nutritional  indicators  is  collected  under  National  Health Family Survey conducted by the Ministry of Health & Family welfare (NHFS). The NFHS 5 data has been released. The survey report comprises data for key indicators in  respect  of  the  tribal  communities  providing  indication  with  respect  to  status  of malnutrition. The details of data regarding prevalence of under weight, stunting and wasting  in  children  under  5  year   andBody  Mass  Index(BMI)for  age  group  15-49 Years in STs as per NFHS (4) and NFHS (5) is submitted at Annexure II, providing a  comparison  of  status  between  2015-16  and  2019-21.  The  prevalence  of  severe malnutrition among children under 5 has reduced w.r.t stunting from 43.8 to 40.9; incase of wasting from 27.4 to 23.2; incase of under weight from 45.3 to 39.5from NHFS 4 (2015-16) to NHFS 5(2019-21) for STs.
- (c) : There  are  1089  functional  Nutrition  Rehabilitation  Centres  (NRCs)  across  the country  as  of  FY  2021-22.  Number  of  functional  NRCs  in  the  State  of  Madhya Pradesh, Uttar Pradesh and Maharashtra are 318, 79 & 39 respectively. Details of the State wise list has been attached at Annexure-III.
- (d) : Nutrition Rehabilitation Centres  (NRCs) are operational at public health facilities to exclusively cater  the  under-five  sick  Severe Acute Malnutrition(SAM) children who   are   admitted   for   clinical   management   of   their  medical   complications along   with   nutritional   management.  In  order  to  strengthen  the  capacity  and effective utilization of these centres, MoHFW provides support to the States/UTs for infrastructure cost, operational cost which includes wage compensation for mothers, HR, equipment, training of NRC staff, incentive to ASHA etc. In addition to curative care, efforts are made to build the capacity of mothers/caregivers through counselling and support on timely, adequate and age appropriate feeding & caring of children.

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 synergised and result oriented approach. Further, Mission Poshan 2.0, an integrated nutrition  support  programme  has  been  announced  in  budget  2021-22  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.

The measures taken/proposed by the Government of India for providing better health services to ensure healthy life and to further improve the average life expectancy of the people in the country also include:

- Mobilization of public health action at multiple levels

· The Pradhan Mantri Jan Arogya Yojna (PMJAY) Ayushman Bharat, with its two components  of  Health  and  Wellness  Centres  (HWCs)  and  Pradhan  Mantri  Jan Arogya Yojana (PMJAY), addresses disparity in access and reduces  out of pocket expenditure  for  secondary  and  tertiary  care  hospitalization  for  40%  of  India's population. The scheme provides hospital care for about 1,350 illnesses at secondary and tertiary level empanelled public and private hospitals. HWC encourages healthy choices  and  behaviours  including  Yoga  and  other  physical  activities.  ·  National Health  Mission  (NHM)  is  creating  a  network  of  1,50,000  HWCs  by  upgrading existing Sub  Centres (SCs) and Primary Health Centres (PHCs)  to provide Comprehensive  Primary  Health  Care  (CPHC),  which  is  universal  and  free  to  all those who access public health facilities. The CPHC basket of services cover 12 key service  areas,  which  go  beyond  the  Reproductive,  Maternal,  Neonatal,  Child  and Adolescent Health (RMNCH+A) services to include screening and care for NCDs (diabetes,  high  blood  pressure,  oral,  breast,  cervical  cancers  etc.),  elderly  care, palliative  and  rehabilitative  care,  Oral,  Eye  and  ENT  care,  mental  health  and  first level care for emergencies and trauma etc.

## Annexure-I

## Annexure-I referred to in part (a) of Lok Sabha Unstarred Question No.227 to be answered on 18.07.2022.

| Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   | Expectation of life at birth by sex and residence, India and bigger States, 2015-19   |
|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------|
| India &bigger States/UTs                                                              | Total                                                                                 | Total                                                                                 | Total                                                                                 | Rural                                                                                 | Rural                                                                                 | Rural                                                                                 | Urban                                                                                 | Urban                                                                                 | Urban                                                                                 |                                                                                       |                                                                                       |
|                                                                                       | Total                                                                                 | Male                                                                                  | Female                                                                                | Total                                                                                 | Male                                                                                  | Female                                                                                | Total                                                                                 | Male                                                                                  | Female                                                                                |                                                                                       |                                                                                       |
| India*                                                                                | 69.7                                                                                  | 68.4                                                                                  | 71.1                                                                                  | 68.3                                                                                  | 66.9                                                                                  | 69.7                                                                                  | 73.0                                                                                  | 71.8                                                                                  | 74.2                                                                                  |                                                                                       |                                                                                       |
| Andhra Pradesh                                                                        | 70.3                                                                                  | 68.9                                                                                  | 71.8                                                                                  | 69.4                                                                                  | 67.7                                                                                  | 71.2                                                                                  | 72.7                                                                                  | 71.8                                                                                  | 73.5                                                                                  |                                                                                       |                                                                                       |
| Assam                                                                                 | 67.5                                                                                  | 66.8                                                                                  | 68.3                                                                                  | 66.2                                                                                  | 65.6                                                                                  | 67.0                                                                                  | 74.1                                                                                  | 73.3                                                                                  | 74.9                                                                                  |                                                                                       |                                                                                       |
| Bihar                                                                                 | 69.2                                                                                  | 69.6                                                                                  | 68.8                                                                                  | 68.8                                                                                  | 69.2                                                                                  | 68.4                                                                                  | 72.0                                                                                  | 72.5                                                                                  | 71.4                                                                                  |                                                                                       |                                                                                       |
| Chhattisgarh                                                                          | 65.3                                                                                  | 63.7                                                                                  | 66.9                                                                                  | 64.4                                                                                  | 62.8                                                                                  | 66.0                                                                                  | 68.3                                                                                  | 67.0                                                                                  | 69.8                                                                                  |                                                                                       |                                                                                       |
| Delhi                                                                                 | 75.9                                                                                  | 74.3                                                                                  | 77.5                                                                                  | 73.6                                                                                  | 71.3                                                                                  | 75.6                                                                                  | 75.9                                                                                  | 74.4                                                                                  | 77.6                                                                                  |                                                                                       |                                                                                       |
| Gujarat                                                                               | 70.2                                                                                  | 67.9                                                                                  | 72.8                                                                                  | 68.9                                                                                  | 65.7                                                                                  | 72.5                                                                                  | 72.0                                                                                  | 70.8                                                                                  | 73.2                                                                                  |                                                                                       |                                                                                       |
| Haryana                                                                               | 69.9                                                                                  | 67.7                                                                                  | 72.6                                                                                  | 68.6                                                                                  | 66.3                                                                                  | 71.4                                                                                  | 72.4                                                                                  | 70.1                                                                                  | 75.0                                                                                  |                                                                                       |                                                                                       |
| Himachal Pradesh                                                                      | 73.1                                                                                  | 69.9                                                                                  | 77.1                                                                                  | 72.8                                                                                  | 69.4                                                                                  | 76.8                                                                                  | 77.8                                                                                  | 74.9                                                                                  | 82.3                                                                                  |                                                                                       |                                                                                       |
| Jammu &Kashmir                                                                        | 74.2                                                                                  | 72.6                                                                                  | 76.1                                                                                  | 72.8                                                                                  | 71.2                                                                                  | 74.6                                                                                  | 77.6                                                                                  | 75.7                                                                                  | 79.6                                                                                  |                                                                                       |                                                                                       |
| Jharkhand                                                                             | 69.4                                                                                  | 70.2                                                                                  | 68.8                                                                                  | 68.6                                                                                  | 69.6                                                                                  | 67.7                                                                                  | 72.2                                                                                  | 71.8                                                                                  | 72.6                                                                                  |                                                                                       |                                                                                       |
| Karnataka                                                                             | 69.5                                                                                  | 67.9                                                                                  | 71.3                                                                                  | 67.9                                                                                  | 66.0                                                                                  | 70.0                                                                                  | 72.8                                                                                  | 71.7                                                                                  | 73.9                                                                                  |                                                                                       |                                                                                       |
| Kerala                                                                                | 75.2                                                                                  | 72.3                                                                                  | 78.0                                                                                  | 75.2                                                                                  | 72.4                                                                                  | 78.1                                                                                  | 75.1                                                                                  | 72.1                                                                                  | 78.0                                                                                  |                                                                                       |                                                                                       |
| Madhya Pradesh                                                                        | 67.0                                                                                  | 65.2                                                                                  | 69.1                                                                                  | 65.9                                                                                  | 63.8                                                                                  | 68.1                                                                                  | 70.7                                                                                  | 69.4                                                                                  | 72.2                                                                                  |                                                                                       |                                                                                       |
| Maharashtra                                                                           | 72.7                                                                                  | 71.6                                                                                  | 74.0                                                                                  | 71.4                                                                                  | 70.2                                                                                  | 72.5                                                                                  | 74.5                                                                                  | 73.2                                                                                  | 76.0                                                                                  |                                                                                       |                                                                                       |
| Odisha                                                                                | 69.8                                                                                  | 68.5                                                                                  | 71.1                                                                                  | 69.3                                                                                  | 68.0                                                                                  | 70.7                                                                                  | 72.2                                                                                  | 71.3                                                                                  | 73.1                                                                                  |                                                                                       |                                                                                       |
| Punjab                                                                                | 72.8                                                                                  | 71.1                                                                                  | 74.7                                                                                  | 71.3                                                                                  | 69.7                                                                                  | 73.3                                                                                  | 75.4                                                                                  | 73.0                                                                                  | 78.6                                                                                  |                                                                                       |                                                                                       |
| Rajasthan                                                                             | 69.0                                                                                  | 66.8                                                                                  | 71.3                                                                                  | 67.9                                                                                  | 65.4                                                                                  | 70.6                                                                                  | 72.6                                                                                  | 71.8                                                                                  | 73.3                                                                                  |                                                                                       |                                                                                       |
| Tamil Nadu                                                                            | 72.6                                                                                  | 70.6                                                                                  | 74.9                                                                                  | 70.4                                                                                  | 68.3                                                                                  | 72.7                                                                                  | 74.9                                                                                  | 73.0                                                                                  | 77.1                                                                                  |                                                                                       |                                                                                       |
| Telangana                                                                             | 69.8                                                                                  | 68.6                                                                                  | 71.1                                                                                  | 68.3                                                                                  | 66.6                                                                                  | 70.1                                                                                  | 71.9                                                                                  | 71.7                                                                                  | 72.1                                                                                  |                                                                                       |                                                                                       |
| Uttar Pradesh                                                                         | 65.6                                                                                  | 65.0                                                                                  | 66.2                                                                                  | 64.6                                                                                  | 63.8                                                                                  | 65.3                                                                                  | 68.9                                                                                  | 68.8                                                                                  | 69.0                                                                                  |                                                                                       |                                                                                       |
| Uttarakhand                                                                           | 70.6                                                                                  | 67.6                                                                                  | 73.9                                                                                  | 70.4                                                                                  | 67.1                                                                                  | 73.9                                                                                  | 71.0                                                                                  | 68.7                                                                                  | 73.7                                                                                  |                                                                                       |                                                                                       |
| West Bengal                                                                           | 72.1                                                                                  | 71.0                                                                                  | 73.2                                                                                  | 70.9                                                                                  | 69.5                                                                                  | 72.2                                                                                  | 74.3                                                                                  | 73.6                                                                                  | 75.1                                                                                  |                                                                                       |                                                                                       |

Annexure-II referred  to  in  part  (b)  of  Lok  Sabha  Unstarred  Question  No.227  to  be answered on 18.07.2022.

Table : Malnutrition among ST across states of India, 2015-16 (NFHS-4) &2019-21 (NFHS-5)

|             |                   | Stunting(Height- for-Age)   | Stunting(Height- for-Age)   | Wasting(Weight- for-Height)   | Wasting(Weight- for-Height)   | Underweight(Weight- for-Age)   | Underweight(Weight- for-Age)   | BMI<18 (Males)   | BMI<18 (Males)   | BMI<18 (Females)   | BMI<18 (Females)     |
|-------------|-------------------|-----------------------------|-----------------------------|-------------------------------|-------------------------------|--------------------------------|--------------------------------|------------------|------------------|--------------------|----------------------|
| S.No.States | S.No.States       | Age < 5 years               | Age < 5 years               | Age < 5 years                 | Age < 5 years                 | Age < 5 years                  | Age < 5 years                  | Aged 15-49       | Aged 15-49       | yrs Aged 15-49yrs  | yrs Aged 15-49yrs    |
|             |                   | NFHS 4                      | NFHS5                       | NFHS4 (%)                     | NFHS5                         | NFHS4                          | NFHS5                          |                  |                  |                    | NFHS4NFHS5NFHS4NFHS5 |
|             |                   | (%)                         | (%)                         |                               | (%)                           | (%)                            | (%)                            | (%)              | (%)              | (%)                | (%)                  |
| 1           | Andhra Pradesh    | 31.7                        | 41                          | 26.6                          | 20.3                          | 47.4                           | 46.3                           | 28.3             | 28.1             | 28.8               | 21.1                 |
| 2           | Arunachal Pradesh | 30.5                        | 27.9                        | 16.4                          | 13.4                          | 18.1                           | 13.7                           | 6.5              | 3.2              | 6.4                | 4.2                  |
| 3           | Assam             | 28.2                        | 30.7                        | 10.5                          | 19.2                          | 18.5                           | 25.7                           | 7.3              | 7.4              | 14.4               | 11.8                 |
| 4           | Bihar             | 48.2                        | 42.4                        | 23.8                          | 25.4                          | 46.8                           | 45.4                           | 27.7             | 23.5             | 29.2               | 29.6                 |
| 5           | Chhattisgarh      | 42.2                        | 38.4                        | 26                            | 20.8                          | 43.8                           | 36.3                           | 23.7             | 20.5             | 34                 | 29.3                 |
| 6           | Goa               | 25.7                        | 33.6                        | 21.9                          | 19                            | 24.4                           | 17.4                           | 11.6             | 9.7              | 26.7               | 17.1                 |
| 7           | Gujarat           | 47.5                        | 45.4                        | 32                            | 29.5                          | 51.6                           | 48.7                           | 38.4             | 25.1             | 40.6               | 35.1                 |
| 8           | Haryana           | 32.5                        | 39.5                        | 27.7                          | 11.2                          | 28.9                           | 39.7*                          |                  | 22.5             | 24.4               | 20.5                 |
| 9           | Himachal Pradesh  | 22.3                        | 32.9                        | 15                            | 16.8                          | 20.3                           | 21.1                           | 24.6             | 5.9              | 15.6               | 13.7                 |
| 10          | Jharkhand         | 48.8                        | 44.9                        | 34.4                          | 25.2                          | 55.1                           | 46.4                           | 24.6             | 17.9             | 34.9               | 28                   |
| 11          | Karnataka         | 39.3                        | 39.5                        | 25.4                          | 21.5                          | 40.3                           | 35.8                           | 21.4             | 20.1             | 23.6               | 21.4                 |
| 12          | Kerala            | 23.9                        | 36.9                        | 18.8                          | 10.3                          | 21.6                           | 19.4                           | 16.9             | 13.6             | 20.1               | 18.9                 |
| 13          | Madhya Pradesh    | 48.2                        | 40                          | 30.2                          | 21.4                          | 51.5                           | 39.8                           | 30.3             | 19.6             | 34.4               | 27.4                 |
| 14          | Maharashtra       | 45.4                        | 41.4                        | 32.9                          | 32                            | 49.4                           | 46.5                           | 24.5             | 23               | 38.3               | 30.2                 |
| 15          | Manipur           | 34.3                        | 26.8                        | 7.1                           | 10                            | 12.6                           | 12.6                           | 5.7              | 3.8              | 7.1                | 6.2                  |
| 16          | Meghalaya         | 44.3                        | 46.6                        | 14.9                          | 11.8                          | 28.6                           | 26                             | 10.5             | 9.4              | 11                 | 10.9                 |
| 17          | Mizoram           | 27.2                        | 28.5                        | 6                             | 9.5                           | 11.6                           | 12.7                           | 7.3              | 5.2              | 8.3                | 5.4                  |
| 18          | Nagaland          | 28.9                        | 32.6                        | 11                            | 17.9                          | 16.3                           | 26.2                           | 10.9             | 7.2              | 11.6               | 10.9                 |
| 19          | Odisha            | 45.5                        | 42.1                        | 27.8                          | 22.8                          | 48.5                           | 42.1                           | 23.7             | 18.2             | 36.5               | 30.6                 |
| 20          | Punjab            | NA                          | NA                          | NA                            | NANA                          |                                | NA                             |                  |                  | 10.7               | 15.8                 |
| 21          | Rajasthan         | 49.3                        | 35.9                        | 31.3                          | 18.6                          | 52.1                           | 32                             | 32.6             | 16.7             | 37.5               | 24.8                 |
| 22          | Sikkim            | 29.6                        | 19.7                        | 16.6                          | 11.2                          | 14.2                           | 14.5                           | 1.4              | 2.8              | 4                  | 4.1                  |

| 23   | Tamil Nadu    | 25.7   | 31.2   | 26.1   | 20.6   | 33   | 31.1   | 13.5   | 13.3   | 18.2   | 19.6   |
|------|---------------|--------|--------|--------|--------|------|--------|--------|--------|--------|--------|
| 24   | Telangana     | 34.7   | 33.4   | 20.2   | 24.6   | 35.4 | 31.7   | 23.7   | 19.7   | 29.2   | 21.5   |
| 25   | Tripura       | 24.9   | 34.2   | 18.5   | 20.1   | 20.9 | 30.5   | 6.8    | 10.7   | 14.2   | 12.4   |
| 26   | Uttar Pradesh | 50.9   | 49.2   | 22.3   | 24.4   | 46   | 45.9   | 29NA   | 29NA   | 29.8NA | 29.8NA |
| 27   | Uttarakhand   | 34.9   | 23.7   | 19     | 6.2    | 29.9 | 12.4   | 19.2   | 3.4    | 21.5   | 15.1   |
| 28   | West Bengal   | 37.3   | 36.7   | 27.8   | 24.6   | 42   | 44.4   | 20     | 24.2   | 33.2   | 22.7   |
| 29   |               |        |        |        |        |      |        |        |        | 31.7   | 25.5   |
|      | India         | 43.8   | 40.9   | 27.4   | 23.2   | 45.3 | 39.5   |        |        |        |        |

## Annexure-III

## Annexure-III referred  to  in  part  (c)  of  Lok  Sabha  Unstarred  Question  No.227  to  be answered on 18.07.2022

| Status of functional NRC 2021-22   | Status of functional NRC 2021-22   |
|------------------------------------|------------------------------------|
| States/UTs                         | No. of functional NRCs             |
| Arunachal Pradesh                  | 1                                  |
| Andhra Pradesh                     | 21                                 |
| Assam                              | 27                                 |
| Bihar                              | 41                                 |
| Chandigarh                         | 1                                  |
| Chhattisgarh                       | 80                                 |
| Dadra&NH                           | 1                                  |
| Delhi                              | 2                                  |
| Gujarat                            | 136                                |
| Haryana                            | 11                                 |
| Himachal Pradesh                   | 4                                  |
| Jammu &Kashmir                     | 6                                  |
| Ladakh                             | 2                                  |
| Jharkhand                          | 96                                 |
| Karnataka                          | 32                                 |
| Kerala                             | 4                                  |
| Madhya Pradesh                     | 318                                |
| Maharashtra                        | 39                                 |
| Manipur                            | 1                                  |
| Meghalaya                          | 7                                  |
| Nagaland                           | 1                                  |
| Odisha                             | 67                                 |
| Rajasthan                          | 40                                 |
| Tamil Nadu                         | 6                                  |
| Telengana                          | 12                                 |
| Tripura                            | 1                                  |
| Uttarakhand                        | 2                                  |
| West Bengal                        | 51                                 |
| INDIA                              | 1089                               |