Lok Sabha Question No. 3111 (UNSTARRED), answered on 2024-12-13
Subject: Malnutrition among Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Smt. Rachna Banerjee

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA UNSTARRED QUESTION NO. 3111 TO BE ANSWERED ON 13.12.2024

## MALNUTRITION AMONG CHILDREN

## 3111.  SMT. RACHNA BANERJEE:

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

- (a) whether the Government is aware that India has been ranked as 105 out of 127 countries, falling under the serious category according to the Global Nutrition Report, 2024;
- (b) if so, the details thereof;
- (c) whether the data is available with the Government regarding malnutrition in India;
- (d) if so, the details thereof, indicating the present percentage of underweight and stunted children in the country;
- (e) whether the Government  proposes  to declare malnutrition as medical emergency to save children dying of hunger and malnutrition in the country;
- (f) If so, the details of the action plan formulated and steps taken/proposed to save children from malnutrition?

## ANSWER

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

(a) to (f): 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.  Under  15th Finance  Commission,  Anganwadi  services,  Poshan  Abhiyaan  and  Scheme  for Adolescent girls (14-18 years in Aspirational Districts and North-East region) were subsumed under Mission Saksham Anganwadi and Poshan 2.0 (Mission Poshan 2.0). Mission Poshan 2.0 seeks to address the challenge of malnutrition through improved nutrition  content  and  delivery.  It  is  a  Centrally  Sponsored  Scheme,  where  the responsibility of implementation lies with the States/UTs.

Under Mission Poshan 2.0 a new strategy has been made for reduction in malnutrition and  for  improved  health,  wellness  and  immunity  through  community  engagement, outreach,  behavioral  change,  and  advocacy.  The  scheme  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.

Ministry  of  Women  & Child  Development  and  Ministry  of  Health  &  Family  Welfare 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 sensitization 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 nutrition practices and all Anganwadi workers are required to conduct two Community Based Events every month.

Nutritional support through Supplementary Nutrition Programme (SNP) is one of the integral components of Mission Poshan 2.0, under which supplementary nutrition is provided to children (06 months to 6 years), pregnant women and lactating mothers (PWLM) and Adolescent Girls (14 to 18 years) in order to bridge the gap in the Average Daily Intake of nutrients as compared to the Recommended Dietary Allowances which are suggested for Indian population by the National Institute of Nutrition. The nutrition norms for supplementary nutrition are contained in Schedule-II of the National Food Security Act. In order to address the challenge of malnutrition more effectively, these norms have been revised recently to make them 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 essential micronutrients.

Further, only fortified rice enriched with essential micronutrients such as iron, folic acid, and vitamin B12 is supplied under the supplementary nutrition to meet the requirement of micro-nutrients and control anemia among women and children. Greater emphasis is also given on the use of millets for preparation of Hot Cooked Meal at least once a week and Take Home ration at Anganwadi centers for beneficiaries.

Ministry of Health and Family Welfare implements the Reproductive, Maternal, Newborn,  Child,  Adolescent  Health  and  Nutrition  (RMNCAH+N)  strategy  in  a  life  cycle approach under National Health Mission (NHM). It includes interventions to address malnutrition among children across the country as mentioned below:

- Nutrition Rehabilitation Centres (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.
- Anaemia  Mukt  Bharat  (AMB)  strategy  is  implemented  to  reduce  anaemia among  six  beneficiaries  age  group  -  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.
- 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.
- 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.
- 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).
- 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.

The indicators for malnutrition like children being underweight, stunted or wasted have shown  a  steady  improvement  as  per  the  National  Family  Health  Survey  (NFHS) conducted by the Ministry of Health & Family Welfare. As per the report of NFHS-5 (2019-21),  the  nutrition  indicators  for  children  under  5  years  have  improved  as compared with NFHS-4 (2015-16). Stunting has reduced from 38.4% to 35.5%, while Wasting has reduced from 21.0% to 19.3% and Underweight prevalence has reduced from 35.8% to 32.1%.

As per the data of Poshan Tracker of the Ministry of Women & Child Development, for the month of October 2024, around 7.31 crores children up to 5 years were measured on growth parameters of height and weight. Out of whom, 38.9% were found to be stunted,  17%  were  found  to  be  underweight  and  5.2%  children  were  found  to  be wasted. The levels of underweight and wasting in children as obtained from Poshan Tracker data are much less than those projected by NFHS-5.

Further, the Government released Streamlined Guidelines dated 13.1.2021 for greater transparency,  accountability  and  quality  in  the  nutrition  support  programme  and service delivery. These guidelines emphasize on ensuring the quality of supplementary nutrition, highlight roles and responsibilities of duty holders, IT enabled data  management  and  monitoring,  leveraging  of  traditional  knowledge  through AYUSH, procurement and convergence for achieving good nutritional outcomes.

*****