Lok Sabha Question No. 5549 (UNSTARRED), answered on 2025-04-04
Subject: Micronutrient Deficiency among Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Shri P V Midhun Reddy, Shri Subbarayan K, Com. Selvaraj V

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 5549

TO BE ANSWERED ON 04.04.2025

## MICRONUTRIENT DEFICIENCY AMONG CHILDREN

5549.   SHRI SUBBARAYAN K: COM. SELVARAJ V: SHRI P V MIDHUN REDDY:

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

- (a) the percentage of children affected by micronutrient deficiency along with plans of the Government to address the said challenges;

(b)  whether  micronutrient  deficiency  in  school  children  can  affect  their  memory, cognition/ working memory, if so, the details thereof;

(c)  whether  the  Ministry  has  conducted  any  survey  about  micronutrient  deficiency among  children  in  the  country,  if  so,  the  details  thereof  and  if  not,  the  reason therefor; and

(d) the details of the incidence of child retardation in the country along with the steps taken to address this challenge?

## ANSWER

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

(a) to (d) 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.

The objectives of 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

Nutrition goes beyond mere eating of food; it requires proper digestion, absorption, and metabolism of nutrients. This process is influenced by factors like sanitation, education  and  access  to  safe  drinking  water.  As  malnutrition  requires  a  multisectoral  approach  involving  dimensions  of  food,  health,  water,  sanitation  and education,  it is crucial to effectively address  the  issue  of  malnutrition  in a convergent manner. It is being addressed under Mission Saksham Anganwadi and Poshan 2.0 by establishing cross cutting convergence amongst 18 Ministries/Departments.

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.

Under this mission, 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 in January 2023. 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 for 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 at least once a week for preparation of Hot Cooked Meal 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 this Mission, one of the major activities undertaken is Community Mobilization and Awareness Advocacy to educate people on nutritional aspects as adoption of good nutrition habit requires sustained efforts for behavioural change. State and UTs are  conducting  and  reporting  regular  sensitisation  activities  under  Jan  Andolans 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.

Ministry of Women & Child Development launched 'Anganwadi Protocol for Divyang Children' on 28 th  November, 2023 with inputs from Department of Empowerment of Persons  with Disabilities (DePwD)  and  Ministry  of Health & Family Welfare (MoH&FW).  The  protocol  embodies  a  Social  Model  for  Divyangjan  inclusive  care under the POSHAN Abhiyan, with a step-by-step approach comprising of

Step 1: Screening for early disability signs,

Step 2: Inclusion in community events and empowering families, and

Step  3:  Referral  support  via  ASHA/ANM  &  Rashtriya  Bal  Swasthya  Karyakram (RBSK) teams.

The  protocol  provides  guidance  to  district  administration  for  addressing  special needs of Divyang Children relating to education and nutrition. The protocol adopts a social model of disability, as against a purely medical model. It has been simplified for ease of communication, to be more effective on the ground for providing better quality care and service to Divyang 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         |   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   |                    42.5 | 19.8 |
| NFHS-4 (2015-16)*** |        38.4 |                    35.8 | 21   |
| NFHS-5 (2019-21)*** |        35.5 |                    32.1 | 19.3 |

* 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  7.49  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.

The  Ministry  of  Health  and  Family  Welfare  (MoHFW)  implements  Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N) strategy in a  life  cycle  approach  under  National  Health  Mission  (NHM).  The  strategy  includes interventions to address nutrition concerns including micronutrient deficiency among children across the country. The interventions are annexed.

Department  of  Empowerment  of  Persons  with  Disabilities  on  17.06.2021  has launched single window, Cross Disability Early Intervention Centres (CDEICs) in its various  National  Institutes  (NIs)  and  Composite  Regional  Centres  (CRCs)  to  give focused  attention  to  children  in  the  age  bracket  of  0-6  years.  The  CDEICs  are equipped to provide services for screening and identification facilities for identification  of  risk  cases  and  referring  for  appropriate  rehabilitative  services; Therapeutic  Services  viz.  Speech  Therapy,  Occupational  Therapy,  Physiotherapy and  Parental/Peer  Counseling.  At  present,  26  CDEICs  have  been  approved  in National Institutes  and  Composite Regional Centres in various States/UTs. As per Census 2011, there were 15.05 lakh mentally retarded persons in the Country.

*****

## Annexure

ANNEXURE REFERRED IN REPLY TO PART (a) OF LOK SABHA QUESTION NO. 5549 FOR 4.04.2025 REGARDING 'MICRONUTRIENT DEFICIENCY AMONG CHILDREN' ASKED BY SHRI SUBBARAYAN K, COM. SELVARAJ V AND SHRI P V MIDHUN REDDY

The interventions taken by MoHFW  to  address  nutrition concerns including micronutrient deficiency among children are as follows:

1. 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 to correction of micronutrient deficiencies through supplementation of potassium, magnesium, zinc, iron and vitamin supplements and on improving the skills for mother  and  caregivers  on  complete  age-appropriate  caring  and  feeding practices.
2. Anemia Mukt Bharat (AMB) Programme is implemented to reduce anemia 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.
3. Mothers' Absolute Affection (MAA) Programme is implemented to improve breastfeeding coverage in children which includes early initiation of breastfeeding  and  exclusive  breastfeeding  for  first  six  months  followed  by counseling on age-appropriate complementary feeding practices.
4.  Under Rashtriya Bal Swasthya Karyakaram (RBSK), Children from birth to six years of age are screened at Anganwadi centres and children from 6 years till  18  years  of  age  enrolled  in  Government  and  Government  aided  schools are screened for 4 DsDefects at birth, Diseases, Deficiencies and Development  delays,  spanning  32  common  health  conditions  for  early detection  and  free  treatment  and  management  for  these  identified  health conditions.
5. Lactation  Management  Centres :  Lactation  Management  Units  (LMU)  are facilities  established  to  provide  lactation  support  to  facilitate  expression  of mother's  own  milk  and  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.
6.  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).
7. 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.
8. *****