Lok Sabha Question No. 1884 (UNSTARRED), answered on 2024-12-06
Subject: Allocation of Funds under Poshan Programme
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Shri Tharaniventhan M S

## LOK SABHA UNSTARRED QUESTION NO. 1884 TO BE ANSWERED ON 6.12.2024

## ALLOCATION OF FUNDS UNDER POSHAN PROGRAMME

## 1884.    SHRI THARANIVENTHAN M S:

Will the Minister of Women and Child Development be pleased to state:

- (a) the key objectives of the Poshan 2.0 programme;
- (b) the amount of funds allocated and utilized under Poshan 2.0 Mission in Tamil Nadu till now;
- (c) the progress made under above said Mission to reduce malnutrition, especially stunting, wasting and underweight children and its impact on maternal health;
- (d) the role of Anganwadi centres and health workers in the implementation of the programme,  and  the  steps  being  taken  to  strengthen  their  capacity  and infrastructure;
- (e) the  efforts  being  made  to  address  the  nutritional  needs  of  adolescent  girls, pregnant  women and lactating mothers,  especially  in  rural  and  tribal  areas, State-wise; and
- (f) whether the Government plans to include new interventions under Poshan 2.0, if so, the details thereof?

## ANSWER

## MINISTER OF STATE IN THE MINISTRY OF WOMEN AND CHILD DEVELOPMENT (SHRIMATI SAVITRI THAKUR)

(a) to (f) Under the 15th Finance Commission, various components like Anganwadi services,  Poshan  Abhiyaan  and  Scheme  for  Adolescent  girls  (of  14-18  years  in Aspirational  Districts  and  North-Eastern  region)  have  been  subsumed  under  the umbrella  Mission  Saksham  Anganwadi  and  Poshan  2.0  (Mission  Poshan  2.0)  to address the challenge of malnutrition. It is a Centrally Sponsored mission, where the responsibility of implementation is with the States/UTs. The objectives of the Mission are as follows:

- To contribute to development of human capital in the country;
- Address challenge of malnutrition;
- Promote nutrition awareness and good eating habits for sustainable health and wellbeing

Under this Mission a new strategy has been made for reduction in malnutrition and for improved health, wellness and immunity through activities like community engagement, outreach, behavioral change, and advocacy. It focuses on Maternal Nutrition,  Infant  and  Young  Child  Feeding  Norms,  treatment  of  Severe  Acute Malnutrition  (SAM)/  Moderate  Acute  Malnutrition  (MAM)  and  wellness  through AYUSH practices to reduce prevalence of wasting, stunting, anaemia and being underweight.

Under this scheme, Supplementary Nutrition is provided to Children (6 months to 6 years), Pregnant Women, Lactating Mothers and Adolescent Girls to beat the intergenerational cycle of malnutrition  by  adopting  a  life  cycle  approach. Supplementary  nutrition  is  provided  in  accordance  with  the  nutrition  norms contained in Schedule-II of the National Food Security Act. These norms have been revised and upgraded last year. The old norms were largely calorie-specific; however, the revised norms are more comprehensive and balanced in terms of both quantity and quality of supplementary nutrition based on the principles of diet diversity that provides quality protein, healthy fats and micronutrients.

Fortified rice is being supplied to AWCs to meet the requirement of micro-nutrients and to control anaemia among women and children. Greater emphasis is being laid on the use of millets for preparation of Hot Cooked Meal at least once a week and Take Home ration at Anganwadi centers.

Ministries of Women & Child Development and Health & Family Welfare have jointly released the protocol for Community Management of Malnutrition (CMAM) to  prevent  and  treat  severely  acute  malnutrition  in  children  and  for  reducing associated morbidity and mortality.

Under Mission Poshan 2.0, one of the major activities undertaken is Community Mobilization and Awareness Advocacy leading to Jan Andolan to educate people on  nutritional  aspects.  State  and  UTs  are  conducting  and  reporting  regular sensitisation activities under community engagement programmes during Poshan Maahs  and  Poshan  Pakhwadas  celebrated  in  the  months  of  September  and March-April  respectively.  Community  Based  Events  (CBEs)  have  served  as  a significant strategy in changing nutritional practices and all Anganwadi workers are required to conduct two Community Based Events every month.

IT systems have been leveraged to strengthen and bring about transparency in nutrition  delivery  systems  at  the  Anganwadi  centres.  The  'Poshan  Tracker' application was rolled out on 1st March, 2021 as an important IT governance tool. It facilitates monitoring and tracking of all Anganwadi Centres (AWCs), Anganwadi Workers (AWWs) and beneficiaries on defined indicators. Poshan Tracker is being leveraged for dynamic identification of stunting, wasting, under-weight prevalence among children.

Various rounds of the National Family Health Survey (NFHS) conducted by Ministry of Health & Family Welfare since 1992-93 have shown improvement in malnutrition indicators in children across India. Details of these indicators for children since NFHS-1 to NFHS-5 are given below:

| NFHS Survey         |   Underweight% |   Wasting% |   Stunting% |
|---------------------|----------------|------------|-------------|
| NFHS-1 (1992-93)*   |           53.4 |       17.5 |        52   |
| NFHS-2 (1998-99)**  |           47   |       15.5 |        45.5 |
| NFHS-3 (2005-6)***  |           42.5 |       19.8 |        48   |
| NFHS-4 (2015-16)*** |           35.8 |       21   |        38.4 |
| NFHS-5 (2019-21)*** |           32.1 |       19.3 |        35.5 |

* Under 4 years
- ** Under 3 years
- *** Under 5 years

The above table gives a representative picture of malnutrition indicators among all children of 0-3 years, 0-4 years and 0-5 years age at the relevant time.

The projected population of all children up to 5 years in India for the year 2021 is 13.75 crores approximately (source: Population Projections for India and States 2011-2036,  National  Commission  on  Population,  Ministry  of  Health  &  Family Welfare).  However,  only  7.54  crores  children  up  to  5  years  are  enrolled  in Anganwadis and registered on Poshan Tracker of the Ministry of Women & Child Development as per the October 2024 data. 7.31 crores of these children were measured on growth parameters of height and weight. 38.9% of these children have been found to be stunted, 17% children have been found to be underweight and 5.2% wasted.

Further, the projected population of all children in India up to 6 years for the year 2021 is approximately 16.1 crores (source: Population Projections for India and States  2011-2036,  National  Commission  on  Population,  Ministry  of  Health  & Family Welfare). As per the October 2024 data of Poshan Tracker, 8.82 crores children (0-6 years) are enrolled in Anganwadis out of whom 8.55 crores were measured on growth parameters of height and weight. 37% of these children (06 years) have been found to be stunted and 17% children (0-6 years) have been found to be underweight.

The  analysis  of  the  above  NFHS  data  and  the  Poshan  Tracker  data  shows improvement in malnutrition indicators in children across India.

Details of funds released and utilized under Mission Poshan 2.0 in Tamil Nadu till now are at Annexure-I.

Details of role of Anganwadi centers and health workers in the implementation of the programme and the steps taken to strengthen their capacity and infrastructure are provided at Annexure - II.

State wise details of adolescent girls, pregnant women and lactating mothers as per Poshan Tracker are provided at Annexure - III.

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ANNEXURE REFERRED IN REPLY TO PART (b) OF LOK SABHA QUESTION NO. 1884 FOR 6.12.2024 REGARDING 'ALLOCATION OF FUNDS UNDER POSHAN PROGRAMME' ASKED BY SHRI THARANIVENTHAN M S

Details of funds released and utilized under Mission Poshan 2.0 in Tamil Nadu till now are as follows:

| Funds   | Released (in crore)   | Utilized (in crore)                 |
|---------|-----------------------|-------------------------------------|
| 2021-22 | 655.38                | 681.28                              |
| 2022-23 | 766.81                | 741.30                              |
| 2023-24 | 880.79                | Utilization Certificate not yet due |
| 2024-25 | 493.87*               | Still being utilized                |

## ANNEXURE REFERRED IN REPLY TO PART (d) OF LOK SABHA QUESTION NO. 1884 FOR 6.12.2024 REGARDING 'ALLOCATION OF FUNDS UNDER POSHAN PROGRAMME' ASKED BY SHRI THARANIVENTHAN M S

Role  of  Anganwadi  centers  and  health  workers  in  the  implementation  of  the programme and the steps taken to strengthen their capacity and infrastructure are as follows:

(a) Under Mission Poshan 2.0, Anganwadi workers (AWWs) have been technologically empowered with  the  provision  of  smartphones  for  efficient  monitoring  and  service delivery. The mobile application Poshan Tracker digitizes physical registers used by Anganwadi  workers.  This  improves  the  quality  of  their  work  while  simultaneously allowing them real-time monitoring of all activities going on simultaneously.

In addition to  AWWs,  Smartphones  are  provided  to  Supervisors and Block Coordinators. Similarly, data recharge support is provided to AWWs, Supervisors and Block Coordinators.

Regular monitoring of growth parameters is essential for identifying children who may be malnourished and for making timely interventions. Therefore, Anganwadi centres have been equipped with Growth Monitoring devices like infant meter, stadiometer, weighing scale-infant, weighing scale - Mother & Child.

National eGovernance Division (NeGD) regularly conducts field level trainings/workshops  directly  for  Anganwadi  Workers  regarding  use  of  the  Poshan Tracker Application. Multiple rounds of trainings have been held both virtually and physically, in various districts across the country.

Poshan Bhi Padhai Bhi (PBPB) launched by MWCD in 2023 is a path breaking Early Childhood Care and Education (ECCE) program to ensure that India has a high-quality pre-school network with well-trained Anganwadi workers which is in alignment with the National Education Policy (NEP) 2020.

PBPB  advocates  for  a  play-based,  joyful  low-cost  Teaching  Learning  Materials (TLMs), Do-It-Yourself (DIY) kit, activity-based learning pedagogy, targeted specifically at developmental milestones of 0-3-yearold children as well as 3-6-year old children. It also advocates using simple teaching-learning material and indigenous toys which are locally sourced and culturally acceptable.

A Two-Tier Training Implementation Model is being followed throughout the country for Training of functionaries. Tier 1 involves two days training of State Level Master Trainers (SLMTs). Tier 2 involves a 3 Days Training of Anganwadi Workers (AWWs). Up  to  2nd  December  2024,  21722  SLMTs  have  been  trained  under  PBPB programmes in 719 Districts of 35 states and 42,308 Anganwadi Workers have been trained in 182 Districts of 20 States. The Ministry has allocated funds to the tune of Rs. 476.06 Crores for FY 2023-24, 2024-25 and 2025-26 for training.

(b) In order to improve the infrastructure facility of Anganwadi Centres (AWCs), various steps  have been undertaken by the Ministry that,  inter  alia,  include  increasing  the funding for drinking water facilities and toilets at Anganwadi Centres from Rs.10,000/to Rs.17,000/- and Rs.12,000/- to Rs.36,000/- respectively.

Under  Mission  Poshan  2.0,  there  is  a  provision  of  construction  of  50,000  AWCs buildings over a period of five years @10,000 AWCs per year. The cost norms for construction of Anganwadi Centres in convergence with Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) have been revised from Rs.7 Lakh per AWC to Rs.12 Lakh per AWC wherein Rs.8.00 Lakh would be provided under MGNREGS, Rs.2.00 Lakh under 15 th  Finance Commission (FC) (or any other untied funds)  and  Rs.2.00  Lakh  by  MWCD  per  AWC  to  be  shared  between  Centre  and States/UTs in the prescribed cost sharing ratio. Further, States/UTs have also been advised  to  continue  to  tap  funds  for  construction  of  AWC  buildings  from  various schemes  such  as  Member  of Parliament Local  Area  Development  Scheme (MPLADS),  Rural  Infrastructure  Development  Fund  (RIDF),  Finance  Commission Grants  to  Panchayati  Raj  Institutions,  National  Rural  Employment  Guarantee  Act (NREGA), Multi- Sectoral Development Programme (MSDP) of Ministry of Minority Affairs, etc.

Directions have been issued to States/UTs to co-locate Anganwadi Centres, which are running on rent  without  sufficient  infrastructure,  at  nearby  Primary  Schools,  where space is available.

During  the  15 th   Finance  Commission  cycle,  2  lakh  Anganwadi  Centres  @  40,000 AWCs per year are to be upgraded as Saksham Anganwadis for improved nutrition delivery and for imparting early childhood care  and  development.  Saksham Anganwadis  are  to  be  provided  with  better  infrastructure  than  the  conventional Anganwadi Centres which includes internet/Wi-Fi connectivity, LED screens, water purifier/installation of RO Machine and smart learning equipments.

Further, the Government has also decided to upgrade all Mini AWCs with one worker to full-fledged Anganwadi Centres with one worker and one helper each.

(c)  Ministry  of  Health  and  Family  Welfare  is  implementing  Reproductive,  Maternal, Newborn, Child, and Adolescent Health and Nutrition (RMNCAH+N) strategy in a life cycle approach under National Health Mission (NHM), which includes interventions to address undernutrition all across the country. The activities undertaken by ASHA to address undernutrition are as follows:

- Anemia Mukt Bharat (AMB) strategy is implemented to reduce anemia among six  beneficiary  age  groups  -  children  (6-59  months),  children  (5-9  years), adolescents (10-19 years),  pregnant  and  lactating  women  and  in women  of reproductive age group (15-49 years) in life cycle approach through implementation of six interventions via robust institutional mechanism. Under AMB  Programme, Accredited Social Health Activist (ASHA) mobilizes beneficiaries for uptake of services and also conducts fortnightly home visits to children 6-59 months to equip the mothers with skills to provide biweekly IFA Syrup dose in households.
- Nutrition Rehabilitation Centers (NRCs) are set up at public health facilities to  provide  in-patient  medical  and  nutritional  care  to  children  under  5  years suffering from Severe Acute Malnourishment (SAM) with medical complications.  In  addition  to  curative  care,  special  focus  is  given  on  timely, adequate  and  appropriate  feeding  for  children;  on  improving  the  skills  of mothers  and  caregivers  on  complete  age-appropriate  caring  and  feeding practices. Under this programme, ASHA are provided incentive for referral of children under five years suffering from Severe Acute Malnutrition (SAM) with medical complications to NRC and follow up of these children after discharge from NRC.
- Mothers' Absolute Affection (MAA) Programme is implemented to improve breastfeeding  coverage  which  includes  early  initiation  of  breastfeeding  and exclusive  breastfeeding  for  first  six  months  followed  by  counselling  on  ageappropriate  complementary feeding  practices  through  ASHA  workers  during mother's meetings and health care provider at health facilities.
- Under National Deworming Day (NDD) albendazole tablets are administered in a single fixed day approach via schools and Anganwadi centres in two rounds (February and August) to reduce the soil transmitted helminth (STH) infestation among all children and adolescents (1-19 years). During NDD, ASHA mobilizes children  and  adolescents  to  school  and  Anganwadi  centre  for  albendazole administration.
- Lactation  Management  Centres :  Comprehensive  Lactation  Management Centres.  (CLMC)  are  facilities  established  to  ensure  availability  of  safe, pasteurized Donor Human Milk for feeding of sick, preterm and low birth weight babies admitted in Neonatal Intensive Care Units and Special Newborn Care Units. Lactation Management Unit (LMU) are established for providing lactation support  to  mothers  within  the  health  facility  for  collection,  storage  and dispensing of mother's own breastmilk for consumption by her baby.
- 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  including  nutrition  in  convergence  with  Ministry  of Women and Child Development. During VHSND, ASHA mobilizes beneficiaries and community to VHSND site for uptake of maternal and child health services.

## ANNEXURE REFERRED IN REPLY TO PART (e) OF LOK SABHA QUESTION NO. 1884 FOR 6.12.2024 REGARDING 'ALLOCATION OF FUNDS UNDER POSHAN PROGRAMME' ASKED BY SHRI THARANIVENTHAN M S

State wise number of adolescent girls, pregnant women and lactating mothers are as follows * :

| SN   | State Name                         | Pregnant Woman   | Lactating Mother   | Adolescent Girls**   |
|------|------------------------------------|------------------|--------------------|----------------------|
| 1    | Andaman & Nicobar Islands          | 681              | 613                |                      |
| 2    | Andhra Pradesh                     | 2,23,877         | 2,07,140           | 54,320               |
| 3    | Arunachal Pradesh                  | 2,293            | 1,719              | 15,932               |
| 4    | Assam                              | 1,55,137         | 81,154             | 3,81,190             |
| 5    | Bihar                              | 5,87,049         | 3,36,600           | 1,91,919             |
| 6    | Chhattisgarh                       | 1,72,092         | 1,10,436           | 1,10,948             |
| 7    | Dadra & Nagar Haveli - Daman & Diu | 3,286            | 2,042              |                      |
| 8    | Delhi                              | 62,358           | 57,447             |                      |
| 9    | Goa                                | 3,491            | 3,766              |                      |
| 10   | Gujarat                            | 2,09,939         | 1,75,508           | 66,550               |
| 11   | Haryana                            | 1,10,868         | 90,655             | 14,579               |
| 12   | Himachal Pradesh                   | 34,267           | 32,700             | 16,740               |
| 13   | J&K                                | 38,036           | 39,348             | 22,333               |
| 14   | Jharkhand                          | 1,55,922         | 90,619             | 2,64,371             |
| 15   | Karnataka                          | 3,10,877         | 2,21,252           | 65,041               |
| 16   | Kerala                             | 1,09,088         | 96,811             | 18,380               |
| 17   | Ladakh                             | 690              | 821                |                      |
| 18   | Lakshadweep                        | 376              | 424                |                      |
| 19   | Madhya Pradesh                     | 4,32,353         | 3,16,315           | 1,52,296             |
| 20   | Maharashtra                        | 2,86,249         | 2,53,865           | 1,09,307             |
| 21   | Manipur                            | 10,763           | 7,886              | 45,477               |
| 22   | Meghalaya                          | 7,803            | 6,544              | 43,241               |
| 23   | Mizoram                            | 5,544            | 3,490              | 19,250               |
| 24   | Nagaland                           | 1,134            | 1,224              | 25,529               |
| 25   | Odisha                             | 2,79,760         | 1,94,658           | 2,64,220             |
| 26   | Puducherry                         | 2,955            | 2,928              |                      |
| 27   | Punjab                             | 90,773           | 86,037             | 34,048               |
| 28   | Rajasthan                          | 3,09,196         | 2,34,130           | 41,786               |
| 29   | Sikkim                             | 1,298            | 1,197              | 8,098                |
| 30   | Tamil Nadu                         | 2,62,379         | 2,28,994           | 43,943               |
| 31   | Telangana                          | 98,402           | 61,646             | 26,335               |
| 32   | Tripura                            | 15,335           | 8,489              | 34,786               |
| 33   | UT-Chandigarh                      | 3,182            | 2,810              |                      |
| 34   | Uttar Pradesh                      | 15,52,687        | 10,35,505          | 2,04,097             |
| 35   | Uttarakhand                        | 61,387           | 49,761             | 72,836               |
| 36   | West Bengal                        | 5,26,502         | 3,74,306           |                      |
|      | Total                              | 61,28,029        | 44,18,840          | 23,47,552            |

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