Lok Sabha Question No. 1362 (UNSTARRED), answered on 2024-02-09
Subject: Anaemic Women in Reproductive Age Group
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Dileshwar Kamait, Thalikkottai Rajuthevar Baalu

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 1362

TO BE ANSWERED ON 9.2.2024

## ANAEMIC WOMEN IN REPRODUCTIVE AGE GROUP

- 1362   SHRI DILESHWAR KAMAIT: SHRI T.R. BAALU:

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

- (a) Whether India accounts for almost a quarter of the stunted children worldwide and the country's share of anaemic women in the reproductive age group is a substantial one-third of the global numbers;
- (b) If so, the reaction of the Government thereto; and
- (c) The measures taken/being taken by the Government keeping in view the fact that India's food policies have not succeeded in responding adequately to the growing nutrition needs of the people and meet the challenges of the changing times?

## ANSWER

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

(a) to (c) The Government has accorded high priority to the issue of malnutrition and is  implementing  several  schemes/  programs  in  different  Ministries/  Department through States/ UTs to address various aspects related to nutrition. In the 15th Finance Commission, 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 (THRnot 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 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.

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.

Streamlining Guidelines have been issued by MWCD on 13 th  January 2021 on Quality  Assurance,  Roles  and  Responsibilities  of  Duty  Holders,  procedure  for procurement,  integrating  AYUSH  concepts  and  Data  Management  and  Monitoring through Poshan Tracker for transparency, efficiency and accountability in delivery of Supplementary Nutrition. Nutritional Status and Quality Standards of food items under Supplementary  Nutrition,  and  Transparency  is  being  monitored  in  Supply  Chain Management at State, District and Village Level.

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 who 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. The data relating to stunted children and anaemic women in the reproductive age group is maintained by Ministry of Health and Family Welfare (MoHFW). The report of NFHS-5 is available on National Family Health Survey portal (http://rchiips.org/nfhs/factsheet\_nfhs-5.shtml). As per the National Family Health Survey 5 (2019-21) conducted by the Ministry of Health & family Welfare, India has shown improvement in the prevalence of stunting among children. The prevalence of stunted children under five years in the country has reduced from 38.4% to 35.5%. Further, the prevalence of anaemia among all women of reproductive  age  group  15-49  years  in  the  country  as  per  the  National

Family Health Survey 5 (2019-21) is 57%.

As per the data of Poshan Tracker for the month of December 2023, around 7.44 crore children under 6 years were measured, out of whom 36% were found to be stunted and 17% were found to be underweight and 6% 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.

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ANNEXURE REFERRED IN REPLY TO PART (c) of LOK SABHA UNSTARRED QUESTION  NO.  1362  FOR  9.02.2024  REGARDING  'ANAEMIC  WOMEN  IN REPRODUCTIVE  AGE  GROUP'  ASKED  BY  SHRI  DILESHWAR  KAMAIT  AND SHRI T.R. BAALU, M.P.

Interventions of  Nutrition  Division  of  MoHFW  to  improve maternal and child health including nutritional deficiencies and anaemia 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).

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