Lok Sabha Question No. 207 (UNSTARRED), answered on 2024-02-02
Subject: Impact of POSHAN Abhiyaan Scheme
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Krupal Balaji Tumane

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA UNSTARRED QUESTION NO. 207

TO BE ANSWERED ON 02.02.2024

## IMPACT OF POSHAN ABHIYAAN SCHEME

## 207. SHRI KRUPAL BALAJI TUMANE:

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

- (a) Whether the Government has conducted a detailed review of the performance/impact of POSHAN Abhiyaan, if so, the details thereof, State-wise;
- (b) The details of the steps taken by the Government to achieve the goals under POSHAN Abhiyaan;
- (c) The number of cases of stunting under nutrition, anemia and low birth weight among infants, children, adolescent girls and women  reported  during the period of implementation of POSHAN Abhiyaan in Maharashtra, district-wise;
- (d) The  quantum  of  funds  released  and  utilized  by  the  Government  under  the  said schemes during the last five years; and
- (e) The  number  of  beneficiaries  of  the  said  scheme  in  the  country  States/UTs-wise including Maharashtra?

## ANSWER

## MINISTER OF WOMEN AND CHILD DEVELOPMENT (SHRIMATI SMRITI ZUBIN IRANI)

(a) to (c) Government reviews the performance/impact of scheme on regular basis. In addition, a third-party evaluation of all Centrally Sponsored Schemes in Women and Child Development Sector including Anganwadi services was conducted by NITI Aayog in 2020. The evaluation found the relevance of Anganwadi Services scheme satisfactory.

In  the  15th  FC,  components  of  nutritional  support  for  children  below  the  age  of  6  years, pregnant women and lactating mother, Adolescent Girls (14 - 18 years); Early Childhood Care and Education [3-6 years]; Anganwadi infrastructure including modern, upgraded Saksham Anganwadi, POSHAN Abhiyaan and Scheme for Adolescent Girls have been reorganised under Mission Saksham Anganwadi and Poshan 2.0 (Mission Poshan 2.0).

Under Mission Poshan 2.0, Supplementary nutrition is provided to beneficiaries 300 days in a year through the network of 13.97 lakh AWC located across the country for bridging the gap in  the  intake  as  compared  to  the  recommended  dietary  intake.  Only  fortified  rice  is  being supplied to AWCs to meet the requirement of micro nutrient and control anemia among women and children. Greater emphasis is being given on the use of millets for preparation of Hot Cooked Meal and Take Home rations (THR-not raw ration) at Anganwadi centres for Children below 6 years of age, Pregnant Women, Lactating Mothers.

The objectives of Poshan 2.0 are as follows:

- To contribute to human capital development of the country;
- Address challenges of malnutrition;
- Promote nutrition awareness and good eating habits for sustainable health and wellbeing; and
- Address nutrition related deficiencies through key strategies.

Steps have been taken to improve nutritional quality and testing in accredited labs, strengthen delivery and leverage technology under Poshan Tracker to improve governance. States/UTs have been advised to promote use of AYUSH systems for prevention of malnutrition and related  diseases.  A  programme  to  support  development  of  Poshan  Vatikas  at  Anganwadi Centres to meet dietary diversity gap leveraging traditional knowledge in nutritional practices has also been taken up.

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  AWCs,  AWWs  and  beneficiaries  on  defined  indicators. Technology under Poshan Tracker is being leveraged for dynamic identification of stunting, wasting, under-weight prevalence among children.

Further, under Poshan 2.0, for the first time, a digital revolution was ushered in when the Anganwadi  Centres  were  equipped  with  mobile  devices.  The  mobile  application  has  also facilitated  digitization  and  automation  of  physical  registers  used  by  AWWs  that  helps  in improving their quality of work. Poshan Tracker is available in 22 languages including Hindi and English. It has facilitated near real time data collection for Anganwadi Services such as, daily attendance, ECCE, Provision of Hot Cooked Meal (HCM)/Take Home Ration (THR-not raw  ration),  Growth  Measurement  etc.  The  App  also  offers  counselling  videos  on  key behaviours and services which help disseminate messages on birth preparedness, delivery, post-natal care, breastfeeding and complementary feeding. States/UTs can see their progress on  various  indicators  on  the  Poshan  Tracker  dashboard  on  monthly  basis  and  can  make course correction wherever required.

In addition, 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  severe  acute  malnutrition  children  thereby  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. Those malnourished children which have medical complications are referred for facility-based care.

The key interventions of MoHFW to improve maternal and child health including nutritional deficiencies and anemia, inter alia , are placed at Annexure I.

As per the recent report of NFHS-5 (2019-21), 35.2% children (under 5 years) were found to be stunted, 36.1% children (under 5 years) were found to be underweight and 25.6% children (under 5 years) were found to be wasted in Maharashtra. However, as per the data of Poshan Tracker for the month of December 2023, out of all children under 6 years that were measured in Maharashtra, 42% were found to be stunted, 16% were found to be underweight and 5% children  under  5  years  were  found  to  be  wasted.  The  levels  of  underweight  and  wasting obtained from Poshan Tracker are much less than that projected by NFHS 5.

The district-wise data on anemia and malnutrition among women and children of all States is released  under  National  Family  Health  Survey  (NHFS),  which  is  conducted  by  Ministry  of Health & Family Welfare. The report of NHFS-5 is available on National Family Health Survey portal (http://rchiips.org/nfhs/factsheet\_nfhs-5.shtml).

- d. The details of funds released and utilised under Mission Poshan 2.0 for the period from FY 2021-22 to FY 2023-24 is at Annexure-II.
- e. The State-wise number of beneficiaries of the scheme is at Annexure-III.

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## Annexure I

ANNEXURE REFERRED IN REPLY TO PART (b) of LOK SABHA UNSTARRED QUESTION NO. 207 FOR 2.02.2024 REGARDING 'IMPACT OF POSHAN ABHIYAAN SCHEME' ASKED BY SHRI KRUPAL BALAJI TUMANE, M.P.

## Interventions  of  Nutrition  Division  of  MoHFW  to  improve  maternal  and  child  health including nutritional deficiencies and anemia are:

1. Mothers'  Absolute  Affection  (MAA) to  improve  breastfeeding  coverage  which includes  early  initiation  of  breastfeeding  and  exclusive  breastfeeding  for  first  six months  followed  by  age-appropriate  complementary  feeding  practices  through capacity building of frontline health workers and comprehensive IEC campaigns.
2. Community Based care of New-born and Young Children :  Under  Home Based New-born Care (HBNC) and Home-Based Care of Young Children (HBYC) program, home visits are performed by ASHAs to improve child rearing practices and to identify sick new-born and young children in the community.
3. Nutrition  Rehabilitation  Centres  (NRCs) are  set  up  at  public  health  facilities  to provide in-patient medical and nutritional care to Severe Acute Malnourished (SAM) children under 5 years of age  with medical complications. Under  nutritional management of SAM children admitted in NRCs, therapeutic diet is provided during Stabilization phase and during rehabilitation phase. In addition to curative care, special focus is given on timely, adequate and appropriate feeding for children, correction of micronutrient deficiencies, improving the skills for mother and caregivers on complete age-appropriate caring and feeding practices and counselling support is provided to mothers for identifying nutrition and health problems in child.
4. Anemia Mukt Bharat (AMB) strategy aims 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.  The  interventions  are  Prophylactic  Iron  and  Folic  Acid Supplementation; Deworming; intensified year-round Behaviour Change Communication Campaign for improving Iron and Folic Acid Supplementation and age appropriate infant and young child feeding practices; testing of anaemia using digital methods and point of care treatment; provision of Iron and Folic Acid fortified foods with  focus  on  harnessing  locally  available  resources;  addressing  non-nutritional causes of anaemia in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis.
5. 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).

## Annexure II

ANNEXURE REFERRED IN REPLY TO PART (d) of LOK SABHA UNSTARRED QUESTION NO. 207 FOR 2.02.2024 REGARDING 'IMPACT OF POSHAN ABHIYAAN SCHEME' ASKED BY SHRI KRUPAL BALAJI TUMANE, M.P.

In the 15 th  FC, Saksham Anganwadi, POSHAN Abhiyaan and Scheme for Adolescent Girls have been reorganised under Mission Saksham Anganwadi and Poshan 2.0 (Mission Poshan 2.0). The The details of funds released and utilized under Mission Poshan 2.0 for the period from FY 2021-22 to FY 2023-24:

| Year    |   Funds released (in lakhs) | Funds Utilized* (in lakhs)   |
|---------|-----------------------------|------------------------------|
| 2021-22 |                 1.8368e+06  | 1835866.57                   |
| 2022-23 |                 1.91847e+06 | Utilization not due          |
| 2023-24 |                 1.48924e+06 | Utilization not due          |

* As per the Ucs shared by the States/Uts

## Annexure III

ANNEXURE REFERRED IN REPLY TO PART (e) of LOK SABHA UNSTARRED QUESTION NO. 207 FOR 2.02.2024 REGARDING 'IMPACT OF POSHAN ABHIYAAN SCHEME' ASKED BY SHRI KRUPAL BALAJI TUMANE, M.P.

The State-wise number of beneficiaries of the scheme*.

| State                              |   Pregnant women and Lactating mothers |   Children (0 - 5 years) |   Children (5 - 6 years) | Adolescent Girls in Aspirational districts and NER   |
|------------------------------------|----------------------------------------|--------------------------|--------------------------|------------------------------------------------------|
| Andhra Pradesh                     |                                 274208 |                  1922373 |                   247936 | 13726                                                |
| Arunachal Pradesh                  |                                   6878 |                    66132 |                    12932 | 15142                                                |
| Assam                              |                                 320934 |                  2474937 |                   506652 | 154220                                               |
| Bihar                              |                                 949526 |                  7690423 |                  1932384 | 237270                                               |
| Chhattisgarh                       |                                 398284 |                  2004529 |                   349072 | 124255                                               |
| Goa                                |                                  10973 |                    54018 |                     3619 |                                                      |
| Gujarat                            |                                 529521 |                  2878927 |                   416105 | 75073                                                |
| Haryana                            |                                 262826 |                  1428567 |                   309431 | 16669                                                |
| Himachal Pradesh                   |                                  85348 |                   423556 |                    68462 | 16855                                                |
| Jharkhand                          |                                 441913 |                  2595871 |                   404769 | 242839                                               |
| Karnataka                          |                                 568142 |                  3090597 |                   446338 | 1420                                                 |
| Kerala                             |                                 286997 |                  1680294 |                   340318 | 18699                                                |
| Madhya Pradesh                     |                                1063082 |                  5663948 |                  1108548 | 143230                                               |
| Maharashtra                        |                                 799675 |                  5260557 |                  1106808 | 114299                                               |
| Manipur                            |                                  19171 |                   214665 |                    52250 | 52343                                                |
| Meghalaya                          |                                  26149 |                   325636 |                    77956 | 56170                                                |
| Mizoram                            |                                  11132 |                    92519 |                    17894 | 23116                                                |
| Nagaland                           |                                   7581 |                    86525 |                    23596 | 27059                                                |
| Odisha                             |                                 579119 |                  2988533 |                   583216 | 297423                                               |
| Punjab                             |                                 228881 |                  1152164 |                   140610 | 29351                                                |
| Rajasthan                          |                                 678398 |                  3569770 |                   372520 | 43925                                                |
| Sikkim                             |                                   3837 |                    26139 |                     5308 | 9133                                                 |
| Tamil Nadu                         |                                 634440 |                  3180319 |                   323462 | 41639                                                |
| Telangana                          |                                 353411 |                  1757793 |                   164965 | 32146                                                |
| Tripura                            |                                  39719 |                   255825 |                    55794 | 35068                                                |
| Uttar Pradesh                      |                                3431899 |                 17101678 |                  2191331 | 240740                                               |
| Uttarakhand                        |                                 138558 |                   625421 |                    40869 | 73038                                                |
| West Bengal                        |                                1178777 |                  6525170 |                  1313129 |                                                      |
| Andaman & Nicobar Islands          |                                   1759 |                    10770 |                      353 |                                                      |
| Dadra & Nagar Haveli - Daman & Diu |                                   8820 |                    24227 |                     1942 |                                                      |
| Delhi                              |                                 144219 |                   557578 |                    18405 |                                                      |
| J&K                                |                                  99665 |                   620533 |                   104158 | 19935                                                |
| Ladakh                             |                                   2051 |                    14461 |                     2369 |                                                      |
| Lakshadweep                        |                                    938 |                     4163 |                       39 |                                                      |
| Puducherry                         |                                   8690 |                    29663 |                       34 |                                                      |
| UT-Chandigarh                      |                                   7018 |                    34329 |                     6514 |                                                      |
| Total                              |                               13602539 |                 76432610 |                 12750088 | 2154783                                              |

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