Lok Sabha Question No. 2126 (UNSTARRED), answered on 2023-12-15
Subject: Malnutrition among Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Rajeshbhai Naranbhai Chudasama

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA UNSTARRED QUESTION NO. 2126

TO BE ANSWERED ON 15.12.2023

## ' MALNUTRITION AMONG CHILDREN'

- 2126    SHRI RAJESHBHAI CHUDASAMA::

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

- (a) the number of children under the age of five die every day due to hunger and malnutrition in the country;
- (b) the details of such cases  registered during the last five years, Statewise;
- (c) the total number of malnourished children and rate of increase in undernourishment, child stunting, child mortality rate during the said period, yearwise; and
- (d) the steps taken by the Government to help these malnourished children?

## ANSWER

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

( a ) to (c) The data on death of children under the age of five years is maintained by Ministry  of  Health  and  Family  Welfare.  Malnutrition  is  not  a  direct  cause  of  deaths; however, it can increase morbidity and mortality by reducing resistance to infections.

The estimated number of underweight, malnourished and severely malnourished children under 5 years of age is obtained under National Family Health Survey (NFHS) conducted by the Ministry of Health & Family Welfare. As per the recent report of NFHS5  (2019-21),  the  nutrition  indicators  for  children  under  5  years  have  improved  as compared with NFHS-4 (2015-16). Wasting has improved from 21% (NFHS-4) to 19.3 % (NFHS-5), Under-weight has improved from 35.7% (NFHS-4) to 32.1% (NFHS-5) and stunting has improved from 38.4% (NFHS-4) to 35.5% (NFHS-5).

As per the data of Poshan Tracker for the month of November 2023, around 7.44 crore children under 6 years were measured, out of whom 37.51% were found to be stunted and 17.43% were found to be underweight and 6% children under 5 years were found to be wasted. The levels of underweight and wasting are much less than that projected by NFHS 5. The inputs received from the Ministry of Health & Family Welfare regarding statistics of Child Mortality as per the Sample Registration Survey (SRS) is at Annexure I.

(d) The Government has accorded high priority to the issue of malnutrition and is implementing several schemes/programmes of different Ministries/Departments through  States/UTs  to  address  various  aspects  related  to  nutrition.  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). Mission Poshan 2.0 focuses on Maternal Nutrition, Infant  and Young Child Feeding Norms,  Treatment  of  MAM/SAM  and  Wellness  through  Ayush  practices  to  reduce wasting and under-weight prevalence besides stunting and anaemia.

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) 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 well-being; 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.

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

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ANNEXURE I

ANNEXURE REFERRED IN REPLY TO PART (c) of LOK SABHA UNSTARRED QUESTION  NO.  2126  FOR  15.12.2023  REGARDING  'MALNUTRITION  AMONG CHILDREN' ASKED BY SHRI RAJESHBHAI CHUDASAMA, M.P.

As per the Sample Registration Survey (SRS), the Child Mortality rates are as below:

| Indicator                             | SRS (2018)   |   SRS (2019) |   SRS (2020) |
|---------------------------------------|--------------|--------------|--------------|
| Neonatal Mortality Rate (NMR)         | 23           |           22 |           20 |
| Infant Mortality Rate (IMR)           | 32           |           30 |           28 |
| Under 5 Child Mortality Rate (U5MR)36 |              |           35 |           32 |

## ANNEXURE II

ANNEXURE REFERRED IN REPLY TO PART (d) of LOK SABHA UNSTARRED QUESTION  NO.  2126  FOR  15.12.2023  REGARDING  'MALNUTRITION  AMONG CHILDREN' ASKED BY SHRI RAJESHBHAI CHUDASAMA, 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).