Lok Sabha Question No. 3720 (UNSTARRED), answered on 2023-08-11
Subject: Malnutrition and Anaemia among Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Hemant Tukaram Godse, Kalaben Mohanbhai Delkar, Gajanan Chandrakant Kirtikar

## GOVERNMENT OF INDIA MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA UNSTARRED QUESTION NO. 3720

TO BE ANSWERED ON 11.08.2023

## MALNUTRITION AND ANAEMIA AMONG CHILDREN

3720.  SHRI HEMANT TUKARAM GODSE: SHRIMATI DELKAR KALABEN MOHANBHAI: SHRI GAJANAN KIRTIKAR:

Will the Minister of WOMEN AND CHILD DEVELOPMENT be pleased to state:

- (a) the status of malnutrition and anaemia among children in the country vis-a-vis other countries;
- (b) the  details  of  malnutrition  and  anaemia  among  children  across  the  country, State-wise including Dadra & Nagar Haveli, Daman and Diu and Maharashtra;
- (c) the amount provided under the Integrated Child Development Scheme to end the  problem of malnutrition and anaemia among children in Dadra & Nagar Haveli, Daman and Diu and Maharashtra during the last three years;
- (d) whether the percentage of children suffering from malnutrition-anaemia is not declining; and
- (e) if so, the steps taken by the Government to reduce the said percentage, Statewise?

## ANSWER

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

(a to (c)  The data on nutrition indicators in the country is captured under the National Family Health Surveys conducted periodically by the Ministry of Health and Family Welfare. As per the latest round of NFHS conducted during 2019-21 (NFHS-5), the nutrition indicators for children under 5 years have improved as compared with NFHS4 (2015-16). The prevalence of stunting has reduced from 38.4% in NFHS-4 to 35.5% in  NFHS-5,  wasting  from  21.0%  to  19.3%  and  underweight  from  35.8%  to 32.1%. Further, as per data recorded in Poshan Tracker, ICT application for Mission Poshan 2.0, close to 7 crore children were measured in the country in the month of June 2023 as per which, 7% were wasted and 19% underweight, which is significantly lower than NFHS indicators.

The State/UT-wise data on the prevalence of malnutrition and anemia among children,  including  Dadra  &  Nagar  Haveli,  Daman  and  Diu  and  Maharashtra  is annexed.

During the last three years (FY 2020-21, 2021-22 and 2022-23), an amount of Rs. 1265.42 lakh has been released to Dadra & Nagar Haveli and Daman and Diu and Rs.  273746.5  lakh  has  been  released  to  Maharashtra  under  the  Supplementary Nutrition Programme of the Anganwadi Services.

(d) & (e)  POSHAN Abhiyaan under Saksham Anganwadi and Poshan 2.0 (or Mission Poshan  2.0),  is  a  programmatic  approach  to  address  the  life  cycle  issues  of malnutrition, including anemia through behaviour change, technology and convergence. Anemia awareness and prevention is one of the core focus areas under the Abhiyaan as part of Poshan ke Paanch sutra .

Mission Poshan 2.0 is designed to address the issue of malnutrition including anaemia  through  transparency,  accountability,  balanced  diets,  diet  diversity  and quality, greater grassroots involvement and last-mile delivery of services supported by key strategies, viz., corrective strategies to address nutrition related deficiencies like anaemia, nutrition awareness strategies to develop good eating habits for sustainable health and well-being, strategies for communication and development of green ecosystems such as Poshan Vatikas. Under Poshan 2.0, focus is on diet diversity, food fortification,  leveraging  traditional  systems  of  knowledge  and  popularizing  use  of millets. Nutrition awareness strategies under Poshan 2.0 aim to develop sustainable health and well-being through regional meal plans to bridge dietary gaps.

Further,  supplementary  nutrition  is  provided  to  pregnant  women,  lactating mothers and children up to the age of 6 years as per the nutritional norms. Recently, these nutrition norms have been revised to provide balanced nutrition including quality protein, healthy fats and 7 essential micro nutrients (calcium, zinc, iron, dietary folate, Vitamin-A, Vitamin B-6 and Vitamin B- 12.

Under Poshan 2.0, greater emphasis is being given on the use of millets for preparation of Hot Cooked Meal and Take Home rations (not raw ration) at Anganwadi centres for Pregnant Women, Lactating Mothers and Children below 6 years of age, in  view  of  their  high  nutrient  content  to  address  anaemia  and  micro-nutrient deficiencies in women and children. Under Supplementary Nutrition Programme, it is mandatory to provide millet based diet at least once a week. Further, under Mission Poshan 2.0, only fortified rice is allocated to States/UTs.

Ministry of Health and Family Welfare has launched Anemia Mukt Bharat (AMB) strategy with the target to reduce anemia in women, children and adolescents in life cycle  approach.  The  6x6x6  strategy  under  AMB  implies  six  age  groups,  six interventions and six institutional mechanisms. The six interventions  under Anemia Mukt Bharat strategy include, Prophylactic Iron Folic Acid Supplementation, Periodic de-worming,  intensified  year-round  Behaviour  Change  Communication  Campaign, Testing and treatment of anemia, using digital methods and point of care treatment, Convergence  and  coordination  with  other  line  departments  and  ministries  for strengthening implementation etc.

Further, under National Health Mission (NHM), several other programmes are implemented under Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition  (RMNCAH+N)  strategy  as  a  life  cycle  approach,  which  contribute  in addressing the problem of anemia in children. It includes Community Based care of New-born  and  Young  Children,  Mothers'  Absolute  Affection  (MAA),  Universal Immunization  Program,  Social  Awareness  and  Actions  to  Neutralize  Pneumonia Successfully  (SAANS);  Intensified  Diarrhoea  Control  Fortnight  (IDCF)  initiative, Nutrition Rehabilitation  Centres  (NRCs),  Rashtriya  Bal  Swasthya  Karyakaram (RBSK), Janani Shishu Suraksha Karyakram (JSSK) and Village Health Sanitation and Nutrition Day (VHSND).

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## Annexure

| State/UT wise prevalence of stunting, wasting, underweight and anaemia among children under five years of age as per NFHS 5 (2019-21)   | State/UT wise prevalence of stunting, wasting, underweight and anaemia among children under five years of age as per NFHS 5 (2019-21)   | State/UT wise prevalence of stunting, wasting, underweight and anaemia among children under five years of age as per NFHS 5 (2019-21)   | State/UT wise prevalence of stunting, wasting, underweight and anaemia among children under five years of age as per NFHS 5 (2019-21)   | State/UT wise prevalence of stunting, wasting, underweight and anaemia among children under five years of age as per NFHS 5 (2019-21)   |
|-----------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------|
| State/UT                                                                                                                                | Children under 5 years who are stunted (height-for- age) (%)                                                                            | Children under 5 years who are wasted (weight-for- height) (%)                                                                          | Children under 5 years who are underweight (weight-for- age) (%)                                                                        | Children age 6-59 months who are anaemic (<11.0 g/dl)(%)                                                                                |
| Andaman & Nicobar Islands                                                                                                               | 22.5                                                                                                                                    | 16                                                                                                                                      | 23.7                                                                                                                                    | 40                                                                                                                                      |
| Andhra Pradesh                                                                                                                          | 31.2                                                                                                                                    | 16.1                                                                                                                                    | 29.6                                                                                                                                    | 63.2                                                                                                                                    |
| Arunachal Pradesh                                                                                                                       | 28                                                                                                                                      | 13.1                                                                                                                                    | 15.4                                                                                                                                    | 56.6                                                                                                                                    |
| Assam                                                                                                                                   | 35.3                                                                                                                                    | 21.7                                                                                                                                    | 32.8                                                                                                                                    | 68.4                                                                                                                                    |
| Bihar                                                                                                                                   | 42.9                                                                                                                                    | 22.9                                                                                                                                    | 41                                                                                                                                      | 69.4                                                                                                                                    |
| Chandigarh                                                                                                                              | 25.3                                                                                                                                    | 8.4                                                                                                                                     | 20.6                                                                                                                                    | 54.6                                                                                                                                    |
| Chhattisgarh                                                                                                                            | 34.6                                                                                                                                    | 18.9                                                                                                                                    | 31.3                                                                                                                                    | 67.2                                                                                                                                    |
| Dadra & Nagar Haveli and Daman & Diu                                                                                                    | 39.4                                                                                                                                    | 21.6                                                                                                                                    | 38.7                                                                                                                                    | 75.8                                                                                                                                    |
| Delhi                                                                                                                                   | 30.9                                                                                                                                    | 11.2                                                                                                                                    | 21.8                                                                                                                                    | 69.2                                                                                                                                    |
| Goa                                                                                                                                     | 25.8                                                                                                                                    | 19.1                                                                                                                                    | 24                                                                                                                                      | 53.2                                                                                                                                    |
| Gujarat                                                                                                                                 | 39                                                                                                                                      | 25.1                                                                                                                                    | 39.7                                                                                                                                    | 79.7                                                                                                                                    |
| Haryana                                                                                                                                 | 27.5                                                                                                                                    | 11.5                                                                                                                                    | 21.5                                                                                                                                    | 70.4                                                                                                                                    |
| Himachal Pradesh                                                                                                                        | 30.8                                                                                                                                    | 17.4                                                                                                                                    | 25.5                                                                                                                                    | 55.4                                                                                                                                    |
| Jammu & Kashmir                                                                                                                         | 26.9                                                                                                                                    | 19                                                                                                                                      | 21                                                                                                                                      | 72.7                                                                                                                                    |
| Jharkhand                                                                                                                               | 39.6                                                                                                                                    | 22.4                                                                                                                                    | 39.4                                                                                                                                    | 67.5                                                                                                                                    |
| Karnataka                                                                                                                               | 35.4                                                                                                                                    | 19.5                                                                                                                                    | 32.9                                                                                                                                    | 65.5                                                                                                                                    |
| Kerala                                                                                                                                  | 23.4                                                                                                                                    | 15.8                                                                                                                                    | 19.7                                                                                                                                    | 39.4                                                                                                                                    |
| Ladakh                                                                                                                                  | 30.5                                                                                                                                    | 17.5                                                                                                                                    | 20.4                                                                                                                                    | 92.5                                                                                                                                    |
| Lakshadweep                                                                                                                             | 32                                                                                                                                      | 17.4                                                                                                                                    | 25.8                                                                                                                                    | 43.1                                                                                                                                    |
| Madhya Pradesh                                                                                                                          | 35.7                                                                                                                                    | 19                                                                                                                                      | 33                                                                                                                                      | 72.7                                                                                                                                    |
| Maharashtra                                                                                                                             | 35.2                                                                                                                                    | 25.6                                                                                                                                    | 36.1                                                                                                                                    | 68.9                                                                                                                                    |
| Manipur                                                                                                                                 | 23.4                                                                                                                                    | 9.9                                                                                                                                     | 13.3                                                                                                                                    | 42.8                                                                                                                                    |
| Meghalaya                                                                                                                               | 46.5                                                                                                                                    | 12.1                                                                                                                                    | 26.6                                                                                                                                    | 45.1                                                                                                                                    |
| Mizoram                                                                                                                                 | 28.9                                                                                                                                    | 9.8                                                                                                                                     | 12.7                                                                                                                                    | 46.4                                                                                                                                    |
| Nagaland                                                                                                                                | 32.7                                                                                                                                    | 19.1                                                                                                                                    | 26.9                                                                                                                                    | 42.7                                                                                                                                    |
| Odisha                                                                                                                                  | 31                                                                                                                                      | 18.1                                                                                                                                    | 29.7                                                                                                                                    | 64.2                                                                                                                                    |
| Puducherry                                                                                                                              | 20                                                                                                                                      | 12.4                                                                                                                                    | 15.3                                                                                                                                    | 64                                                                                                                                      |
| Punjab                                                                                                                                  | 24.5                                                                                                                                    | 10.6                                                                                                                                    | 16.9                                                                                                                                    | 71.1                                                                                                                                    |
| Rajasthan                                                                                                                               | 31.8                                                                                                                                    | 16.8                                                                                                                                    | 27.6                                                                                                                                    | 71.5                                                                                                                                    |
| Sikkim                                                                                                                                  | 22.3                                                                                                                                    | 13.7                                                                                                                                    | 13.1                                                                                                                                    | 56.4                                                                                                                                    |
| Tamil Nadu                                                                                                                              | 25                                                                                                                                      | 14.6                                                                                                                                    | 22                                                                                                                                      | 57.4                                                                                                                                    |
| Telangana                                                                                                                               | 33.1                                                                                                                                    | 21.7                                                                                                                                    | 31.8                                                                                                                                    | 70                                                                                                                                      |
| Tripura                                                                                                                                 | 32.3                                                                                                                                    | 18.2                                                                                                                                    | 25.6                                                                                                                                    | 64.3                                                                                                                                    |
| Uttar Pradesh                                                                                                                           | 39.7                                                                                                                                    | 17.3                                                                                                                                    | 32.1                                                                                                                                    | 66.4                                                                                                                                    |
| Uttarakhand                                                                                                                             | 27                                                                                                                                      | 13.2                                                                                                                                    | 21                                                                                                                                      | 58.8                                                                                                                                    |
| West Bengal                                                                                                                             | 33.8                                                                                                                                    | 20.3                                                                                                                                    | 32.2                                                                                                                                    | 69                                                                                                                                      |