Lok Sabha Question No. 1919 (UNSTARRED), answered on 2024-12-06
Subject: Integrated Nutrition Support Programme
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Smt. Bharti Pardhi, Shri Arvind Ganpat Sawant, Shri Shrirang Appa Chandu Barne, Shri Dharmendra Yadav

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 1919

TO BE ANSWERED ON 06.12.2024

## INTEGRATED NUTRITION SUPPORT PROGRAMME

## 1919.   SHRI ARVIND GANPAT SAWANT:

SHRI DHARMENDRA YADAV:

SMT. BHARTI PARDHI:

SHRI SHRIRANG APPA CHANDU BARNE:

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

- (a) whether States  are  facing  challenges  of  malnutrition  in  children,  adolescent girls, pregnant women and lactating mothers;
- (b) if so, the details thereof, State-wise, particularly in Maharashtra, Uttar Pradesh and Madhya Pradesh;
- (c) whether  the  Government  has  implemented  an  Integrated  Nutrition  Support Programme to address the said challenges;
- (d) if  so,  the  details  of  the  success  achieved  so  far  in  addressing  the  said challenges, State-wise particularly in Maharashtra, Uttar Pradesh and Madhya Pradesh;
- (e) whether  there  are  any  gaps  and  shortcomings  in  the  on-going  nutrition programme  which  create  hindrances  to improve implementation of an Integrated Nutrition Support Programme; and
- (f) if so, the details of the steps taken by the Government to overcome and address the shortcomings in the on-going nutrition programme along with the success achieved therein particularly in the said States?

## 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 Scheme, where the responsibility of implementation of the scheme is with the States/UTs.

Nutrition goes beyond mere eating of food; it requires proper digestion, absorption, and  metabolism  which  are  influenced  by  factors  like  sanitation,  education  and access to safe drinking water. As malnutrition requires a multi-sector approach involving dimensions of food, health, water, sanitation and education, it is crucial to  effectively  address  the  issue  of  malnutrition.  The  challenge  of malnutrition  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  multiple 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.

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  7.54  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.

The  State  wise  details  of  malnourished  children  including  Maharashtra,  Uttar Pradesh and Madhya Pradesh for the last three years are Annexed.

*****

Annexure

ANNEXURE  REFERRED  IN  REPLY  TO  PARTS  (b  and  d)  OF  LOK  SABHA QUESTION NO. 1919 FOR 6.12.2024  REGARDING  'INTEGRATED  NUTRITION SUPPORT PROGRAMME' ASKED BY SHRI ARVIND GANPAT SAWANT, SHRI DHARMENDRA YADAV, SMT.  BHARTI  PARDHI  AND  SHRI  SHRIRANG  APPA CHANDU BARNE

State wise details of malnourished children (0-5 years) in the country for October 2022, October 2023 and October 2024 from Poshan Tracker are as follows:

| State             | Oct, 2022     | Oct, 2022    | Oct, 2022        | Oct, 2023     | Oct, 2023    | Oct, 2023        | Oct, 2024     | Oct, 2024    | Oct, 2024        |
|-------------------|---------------|--------------|------------------|---------------|--------------|------------------|---------------|--------------|------------------|
| State             | Stun ted ( %) | Wast ed ( %) | Under weight (%) | Stun ted ( %) | Wast ed ( %) | Under weight (%) | Stunt ed (% ) | Wast ed (% ) | Under weight (%) |
| Andhra Pradesh    | 21.2          | 5.3          | 10.5             | 18.2          | 5.4          | 8.7              | 22.6          | 5.3          | 10.8             |
| Arunachal Pradesh | 33.3          | 5.3          | 14.6             | 27.2          | 4.6          | 9.1              | 32.7          | 4.1          | 9.6              |
| Assam             | 39.0          | 8.2          | 19.0             | 39.0          | 5.0          | 15.9             | 42.4          | 3.8          | 16.3             |
| Bihar             | 42.9          | 11.0         | 25.8             | 45.0          | 9.0          | 22.7             | 43.8          | 9.2          | 22.9             |
| Chhattisgarh      | 39.0          | 10.4         | 17.9             | 29.4          | 11.3         | 15.5             | 21.5          | 7.0          | 13.1             |
| Goa               | 37.2          | 9.0          | 16.2             | 18.8          | 2.3          | 5.8              | 4.1           | 0.6          | 1.7              |
| Gujarat           | 53.6          | 8.1          | 23.1             | 43.6          | 8.9          | 20.7             | 40.8          | 7.8          | 21.0             |
| Haryana           | 30.1          | 8.5          | 14.0             | 25.9          | 5.7          | 8.9              | 28.2          | 4.1          | 8.7              |
| Himachal Pradesh  | 26.1          | 4.6          | 10.8             | 21.7          | 2.4          | 7.2              | 18.4          | 1.7          | 6.3              |
| Jharkhand         | 43.2          | 12.1         | 25.9             | 38.8          | 8.8          | 18.8             | 43.8          | 6.2          | 19.3             |
| Karnataka         | 41.0          | 8.9          | 20.7             | 39.7          | 7.5          | 17.5             | 39.7          | 3.2          | 17.1             |
| Kerala            | 37.2          | 9.5          | 15.3             | 33.1          | 4.8          | 10.1             | 34.4          | 2.3          | 9.5              |
| Madhya Pradesh    | 52.4          | 9.7          | 33.0             | 40.5          | 8.2          | 23.6             | 46.5          | 6.9          | 26.5             |
| Maharashtra       | 49.5          | 7.1          | 21.8             | 48.1          | 5.6          | 17.5             | 47.7          | 4.1          | 16.5             |
| Manipur           | 17.8          | 2.8          | 7.6              | 16.3          | 1.2          | 7.7              | 7.7           | 0.3          | 2.6              |
| Meghalaya         | 27.4          | 3.1          | 8.7              | 24.7          | 1.8          | 6.6              | 18.2          | 0.4          | 4.5              |
| Mizoram           | 20.0          | 4.2          | 6.2              | 23.5          | 3.7          | 5.6              | 26.7          | 2.3          | 5.9              |
| Nagaland          | 27.8          | 6.9          | 9.8              | 22.9          | 4.6          | 7.0              | 28.0          | 5.3          | 6.6              |
| Odisha            | 30.6          | 5.9          | 14.7             | 34.3          | 4.0          | 14.8             | 29.1          | 2.9          | 12.8             |
| Punjab            | 32.9          | 9.2          | 12.9             | 18.0          | 5.4          | 7.9              | 18.4          | 3.0          | 5.9              |
| Rajasthan         | 37.0          | 11.6         | 20.0             | 35.7          | 7.5          | 16.7             | 36.6          | 5.5          | 17.7             |
| Sikkim            | 12.2          | 2.8          | 2.7              | 14.1          | 2.8          | 3.1              | 9.2           | 1.5          | 1.7              |
| Tamil Nadu        | 22.6          | 6.1          | 10.5             | 16.6          | 4.8          | 8.1              | 13.4          | 3.6          | 7.1              |
| Telangana         | 29.6          | 5.7          | 14.3             | 30.8          | 4.6          | 13.5             | 32.6          | 5.6          | 16.2             |
| Tripura           | 36.9          | 9.2          | 16.3             | 37.8          | 7.2          | 15.4             | 40.5          | 6.3          | 16.6             |
| Uttar Pradesh     | 45.2          | 9.5          | 21.7             | 45.7          | 5.7          | 19.4             | 48.0          | 3.9          | 19.4             |
| Uttarakhand       | 31.8          | 6.7          | 8.4              | 33.4          | 6.3          | 8.4              | 21.0          | 1.5          | 5.4              |
| West Bengal       | 41.1          | 10.1         | 16.2             | 38.1          | 8.6          | 12.5             | 38.0          | 7.5          | 13.0             |

| Andaman & Nicobar Islands          |   24.0 |   6.9 |   10.8 |   20.7 |   4.5 |   8.2 |   8.7 |   2.3 |   3.9 |
|------------------------------------|--------|-------|--------|--------|-------|-------|-------|-------|-------|
| Dadra & Nagar Haveli - Daman & Diu |   52.9 |  15.4 |   40.1 |   45.2 |  12.5 |  32.8 |  35.9 |   3.3 |  16.1 |
| Delhi                              |   32.8 |   4.5 |   16.5 |   33.6 |   4.8 |  19.1 |  41.9 |   3   |  20.6 |
| J&K                                |   14.5 |   2.5 |    5.6 |   18.1 |   2.5 |   5.1 |  12.1 |   0.7 |   3   |
| Ladakh                             |   27.9 |   5.3 |    8   |   15.9 |   1.8 |   3.5 |  11   |   0.2 |   2   |
| Lakshadweep                        |  100   |   0   |   75   |   39.9 |  11.8 |  19.4 |  46.5 |  11.9 |  25.1 |
| Puducherry                         |   26   |   9.3 |   12   |   29   |   7.9 |  11.6 |  40.2 |   6.8 |  13   |
| UT-Chandigarh                      |   36.6 |   4.5 |   18   |   34.1 |   0.7 |  12   |  26.3 |   1.8 |  11.8 |

*****