Lok Sabha Question No. 3124 (UNSTARRED), answered on 2024-08-09
Subject: Malnutrition among Women and  Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Shri Bidyut Baran Mahato

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 3124 TO BE ANSWERED ON 09.08.2024

## MALNUTRITION AMONG WOMEN AND CHILDREN

## 3124.   SHRI BIDYUT BARAN MAHATO:

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

- (a) The  details  of  the  schemes  presently  run  by  the  Government  to  eradicate malnutrition among women and children;
- (b) Whether any complaints have been received regarding the said schemes;
- (c) If so, the details thereof along with the action taken by the Government against the concerned persons, so far;
- (d) Whether the Government is considering to monitor the said schemes, if so, the details thereof; and
- (e) The names and details of the schemes related to child and maternal health in remote rural areas and villages far away from the district headquarters?

## ANSWER

## MINISTER OF WOMEN AND CHILD DEVELOPMENT (SHRIMATI ANNPURNA DEVI)

(a) to (e) 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) during the 15th Finance  Commission.  Mission  Poshan  2.0  seeks  to  address  the  challenge  of malnutrition through improved nutrition content and delivery. This is a universal selfselecting (no entry barriers) scheme available to all the beneficiaries who enroll at the Anganwadi Centers (AWCs) and is being implemented in all States/UTs across the country.

Under  Mission  Poshan  2.0  a  strategic  shift  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 wasting, underweight prevalence, stunting and anaemia.

Under this scheme, Supplementary Nutrition is provided to Children (6 months to 6 years), Pregnant Women, Lactating Mothers and Adolescent Girls to address the intergenerational  cycle  of  malnutrition  by  adopting  a  life  cycle  approach.  The Supplementary  nutrition  is  provided  in  accordance  with  the  nutrition  norms contained  in  Schedule-II  of  the  National  Food  Security  Act.  To  address  the challenge of malnutrition more effectively, these norms have been revised. 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 control anaemia among women and children. Greater emphasis is being given on the use of millets for preparation of Hot Cooked Meal at least once a week and Take Home ration (THR - not raw ration) at Anganwadi centers for beneficiaries.

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 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 the 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 MarchApril  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.

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.  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 24 languages including Hindi and English. It has facilitated near real time data collection and monitoring of Anganwadi Services, at all levels, which include daily attendance, Early Childhood Care and Education (ECCE),  Provision  of  Hot  Cooked  Meal  (HCM)/Take  Home  Ration  (THR-not  raw ration), Growth Measurement etc.

Mission Poshan 2.0 is a Centrally Sponsored scheme, where the responsibility of implementation  of  the  scheme  falls  under  the  ambit  of  State  Government/UT administration. Various matters pertaining to implementation of scheme are reviewed with  States  at  various  levels  through  sustained  engagements/meetings/video conferences on regular basis.

In addition, Ministry of Women & Child Development is also implementing Pradhan Mantri Matru Vandana Yojana (PMMVY) which is a centrally sponsored scheme. It aims  to  provide  cash  incentive  through  Direct  Benefit  Transfer  (DBT)  mode  to Pregnant Women & Lactating Mothers (PW&LM) for partial compensation for wage loss so that she can take adequate rest before and after delivery and to improve her health seeking behaviour. Benefit of ₹5,000/- in two instalments are provided for first child. Further, as per the new guideline for 'Mission Shakti', applicable with effect from 01.04.2022, the scheme seeks to promote positive behavioural change towards girl child by providing additional cash incentive of ₹6,000/- for the second child, if that is a girl child.

As informed by Ministry of Health and Family Welfare (MoHFW), the Ministry has implemented various interventions for addressing nutrition concerns among women and children across the country, including in rural areas:

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 of age suffering from Severe Acute Malnutrition (SAM) with medical complications. 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.
2.  Anaemia Mukt Bharat (AMB): The Government of India implements Anemia Mukt  Bharat  (AMB) programme to  reduce prevalence  of  anemia among  six beneficiary groups - Children 6-59 months, Children 5-9 years, Adolescents 1019 years, Pregnant women, lactating mother and Women of Reproductive Age (20-49 years). The  interventions are Prophylactic Iron and Folic Acid Supplementation, deworming among children 1-19 years and pregnant women, Intensified Behaviour Change Communication (BCC) Campaign, Provision of IFA  fortified  food  in  government  funded  public  health  programme  and addressing non-nutritional causes of anaemia in endemic pockets with special focus on malaria, haemoglobinopathies and fluorosis, implemented via robust institutional mechanism.
3.  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).
4.  Mothers' Absolute Affection (MAA) Programme is implemented to emphasize on improving breastfeeding coverage  which  includes early initiation of breastfeeding and exclusive breastfeeding for first six months followed by ageappropriate  complementary  feeding  practices  through  capacity  building  of frontline health workers and comprehensive IEC campaigns.
5.  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 breast milk for consumption by her baby.
6.  Mother and Child Protection Card is the joint initiative of the Ministry of Health & Family welfare and the Ministry of Woman and Child Development which addresses the nutrition concerns in children.

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