Lok Sabha Question No. 5718 (UNSTARRED), answered on 2025-04-04
Subject: Identification and Management of Malnutrition
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Prof. Sougata Ray

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 5718

TO BE ANSWERED ON 04.04.2025

## IDENTIFICATION AND MANAGEMENT OF MALNUTRITION

## 5718.  PROF. SOUGATA RAY:

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

- (a) whether the Government has any Protocol for Identification and Management of Malnutrition in children of the country;
- (b) if so, the details thereof?
- (c) whether over 32% of the children below  aged  five  years  in  the  country  are underweight;
- (d) if so, the details thereof, State wise; and
- (e) the details of the steps being taken to ensure the minimum weight and other parameters of children?

## ANSWER

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

(a) to (e) 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 for implementation of various activities lies with the States and UTs. This mission is a universal self-selecting umbrella scheme where there are no entry barriers for any beneficiary to register and receive services. This mission is being implemented across the country.

Under Mission Poshan 2.0, 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.

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.  The  community-based  approach  involves  timely  detection  and screening of children with severe acute malnutrition in the community, management for  those  without  medical  complications  with  wholesome,  local  nutritious  foods  at home and supportive medical care. The CMAM protocol includes an appetite test and screening process for children aged 6 months to 6 years who are severely acute malnourished (SAM) or severely underweight (SUW). Post-screening, such children are referred to Nutrition Rehabilitation Centers (NRC) or hospital facilities for further care. The steps involved under CMAM protocol are as follows:

Step-1: Growth monitoring of children

Step-2: Appetite Test for SAM Children

Step-3: Medical Assessment of SAM children

Step-4: Decide level of care of malnourished children

Step-5: Nutritional Management

Step-6: Medical Management

Step-7: Nutrition, Health Education and counseling including WASH practices

Step-8: Visit by Anganwadi worker and referral

Step-9: Duration of Monitoring

Step-10: Follow-up Care

Mission  Poshan  2.0  empowers  the  frontline  functionaries  by  providing  them  with smartphones. IT  systems  have  been  leveraged  to  strengthen  and  bring  about transparency  in  nutrition  delivery  support  systems  at  the  Anganwadi  centres.  The 'Poshan  Tracker'  application  was  rolled  out  on  1st  March  2021  as  an  important governance  tool.  The  Poshan  Tracker  facilitates  monitoring  and  tracking  of  all Anganwadi  centers,  Anganwadi  workers  and  beneficiaries  on  defined  indicators. Anganwadi workers are mandated to measure height and weight of all children (0-6 years) once a month. On the basis of height and weight data entered by Anganwadi workers, the Poshan Tracker is being leveraged for regular identification of stunting, wasting, under-weight prevalence among children as per WHO standards.

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 NFHS1 to NFHS-5 are given below:

| NFHS Survey              | Stunting%   |   Underweight %Wasting% |
|--------------------------|-------------|-------------------------|
| NFHS-1 (1992-93)*        | 52 53.4     |                    17.5 |
| NFHS-2 (1998-99)**       | 45.5 47     |                    15.5 |
| NFHS-3 (2005-6)***       | 48.0 42.5   |                    19.8 |
| NFHS-4 (2015-16)*** 38.4 | 35.8        |                    21   |
| NFHS-5 (2019-21)*** 35.5 | 32.1        |                    19.3 |

** 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 7.49 crores children up to 5 years were enrolled in Anganwadis and registered on Poshan Tracker of the Ministry of Women & Child Development as per the February 2025 Poshan Tracker data. 7.25 crores of these children were measured on growth parameters of height and weight. 39.09% of them have been found to be stunted, 16.60% have been found to be underweight and 5.35% wasted.

Further, the projected population of all children in India up to 6 years for the year 2021 is approximately 16.1 crores. As per the February 2025 data of Poshan Tracker, 8.80 crores children (0-6 years) were enrolled in Anganwadis out of whom 8.52 crores were measured on growth parameters of height and weight. 37.75% of these children (0-6 years) have been found to be stunted and 17.19% 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.

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