Lok Sabha Question No. 1223 (UNSTARRED), answered on 2024-02-09
Subject: Malnutrition in Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Shrikant Eknath Shinde, Sujay Radhakrishna Vikhepatil, Unmesh Bhaiyyasaheb Patil, Krishna Pal Singh Yadav, Rita Bahuguna Joshi, Heena Vijaykumar Gavit

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA UNSTARRED QUESTION NO. 1223

TO BE ANSWERED ON 09.02.2024

## MALNUTRITION IN CHILDREN

1223.  DR. SHRIKANT EKNATH SHINDE:

DR. SUJAY RADHAKRISHNA VIKHE PATII:

SHRI UNMESH BHAIYYASAHEB PATIL:

DR. KRISHNA PAL SINGH YADAV:

PROF. RITA BAHUGUNA JOSHI:

DR. HEENA VIJAYKUMAR GAVIT:

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

- (a) the manner in which the Government has effectively addressed the issue of child malnutrition and ensured the nutritional well-being of children,
- (b) the  manner  in  which  the  Integrated  Child  Development  Services  (ICDS) scheme has contributed to the overall health and development the country; and
- (c) the  details  on  the  usage  of  technology  by  the  Government  to  enhance  the delivery of its services and improve outreach to beneficiaries?

## 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/programmes  of  different  Ministries/Departments 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  reorganized  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 anemia.

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 micronutrient and control anaemia 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 not raw ration) at Anganwadi centers 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  Centers  to  meet  dietary  diversity  gap  leveraging traditional knowledge in nutritional practices has also been taken up.

Under  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. IEC materials in the form of videos, pamphlets, flyers etc., in regional  languages  have  also  been  developed  around  critical  themes.  Social  & Behavioral  Changes  have  been  inculcated  through  conducting  Community  Based Events, Poshan Maah and Poshan Pakhwada in convergence with various Ministries/ Departments and other stakeholders. So far, more than 90 crore sensitization activities have  been  reported  by  States/  UTs  under  community  engagements  programmes through  11  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 nutrition practices. CBEs help to celebrate critical milestones in the life of pregnant women and children below two years of age and to disseminate critical information on inter alia, right time to ensure appropriate complementary  feeding  with  diet  diversity.  Close  to  3.70  crore  Community  Based Events have been held so far.

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.

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  indicators  for  malnutrition  like  underweight,  stunting  and  wasting  have shown a steady improvement in National Family Health Survey (NFHS) conducted by Ministry of Health & Family Welfare. As per the recent report of NFHS-5 (2019-21), the nutrition indicators for children under 5 years have improved as compared with NFHS-4 (2015-16). Stunting has reduced from 38.4% to 35.5%, while Wasting has reduced from 21.0% to 19.3% and Underweight prevalence has reduced from 35.8% to 32.1%.

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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