Lok Sabha Question No. 2639 (UNSTARRED), answered on 2023-08-04
Subject: Malnutrition in Bihar
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Chandeshwar Prasad

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA UNSTARRED  QUESTION NO. 2639

TO BE ANSWERED ON 04.08.2023

## MALNUTRITION IN BIHAR

2639    SHRI CHANDESHWAR PRASAD:

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

- (a) whether there has been an increase in the number of malnourished women and children in the State of Bihar during the last three years and if so, the details thereof, along with the reasons therefor;
- (b) whether the cases of malnutrition are not detected due to faulty methods adopted for diagnosis of malnutrition and if so, the details thereof; and
- (c) the details of the efforts made by the Government to reduce malnutrition among women and children in the State?

## ANSWER

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

- (a) Malnutrition  is  a  complex  and  multi-dimensional  issue,  affected  mainly  by  a number of factors including inadequate food consumption, improper feeding and care practices, inequity and gender imbalances, poor sanitary and environmental conditions etc.

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 recently released report of the National Family Health Survey 5 (NFHS 5) the incidence of malnutrition among women in Bihar has improved from 30.4 % in NFHS 4 (2015-16) to 25.6 % in NFHS 5 (2019-20).

The prevalence of Stunting and Underweight among children under 5 years as per NFHS 5 (2019-20) when compared with NFHS 4 (2015-16) indicates an improvement of 5.4 (48.3% in NFHS-4 to 42.9% in NFHS-5) and 2.9 percentage points (43.9% in NFHS 4 to 41.0% in NFHS-5) respectively. However, prevalence of Wasting among children under 5 years has slightly increased in State of Bihar, as per NFHS-5, from 20.8% in NFHS-4 to 22.9% in NFHS-5.

Further,  as  per  data  recorded  in  Poshan  Tracker,  ICT  application  for  Mission Poshan 2.0, close to 71.79 lakh children were measured in the country in the month of June itself, of which, 9.79% were wasted and 24.14% underweight, which is significantly lower than NFHS indicators.

- (b) In order to accurately detect and monitor the cases of malnutrition, Government has launched the ICT application named as Poshan Tracker. Technology under Poshan Tracker is being leveraged for dynamic identification of stunting, wasting, under-weight prevalence among children through automatic calculation based on WHO growth charts. The application is helping in generating data, providing feedback to Program Managers and documenting the impact of scheme on nutrition indicators. The Ministry/ States/ Districts can thus make effective timely interventions, based on the data from tracker and  evaluate  the  progress  of  different  components. Further,  in  cases  of  severe malnutrition  or  underlying  health  conditions,  the  child  is  immediately  referred  to  the nearest  Nutrition  Rehabilitation  Centre/  Primary  Health  Centre  for  suitable  medical intervention
- (c) Saksham Anganwadi and Poshan 2.0 (Mission Poshan 2.0) announced in the budget 2021-22 is an Integrated Nutrition Support Programme. It seeks to address the challenges of malnutrition in children, adolescent girls, pregnant women and lactating mothers through a strategic shift in nutrition content and delivery and by creation of a convergent eco-system to develop and promote practices that nurture health, wellness and  immunity. Poshan  2.0  focusses  on  Maternal  Nutrition,  Infant  and  Young  Child Feeding  Norms,  Treatment  Protocols  for  SAM/MAM  and  Wellness  through  AYUSH practices to reduce wasting and under-weight prevalence besides stunting and anaemia, supported by the 'Poshan Tracker', a robust ICT centralised data system. Under Mission Poshan 2.0, malnutrition  through  focus  on  life  cycle  approach  is  addressed  through sustained behaviour  change,  convergence  and  use  of  technology  for  effective monitoring.

Moreover,  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 including Bihar have been advised to promote use of AYUSH systems for prevention of malnutrition and related diseases. Further, the mission raises communities' awareness on good nutrition behaviours for themselves and their children. It promotes access to nutritious, affordable and locally available diets through the  plantation  of  Poshan  Vatikas  or  nutri-gardens  at  Anganwadi  Centres  and  other interventions  such  as  the  promotion  of  kitchen  gardens  in  AWCs  and   homes.  To encourage diet-diversity and consumption of wholesome local produce, around 6.42 lakh Poshan Vatikas have been developed at AWC s. It  helps  meet  gaps between average diets  and  required  diets  by  providing  Supplementary  Nutrition  to  pregnant  women, lactating mothers and children from 6 months to 6 years of age.

Under the revised nutrition norms, in addition to energy and protein recommendations have also been given for 7 essential micronutrients (calcium, zinc, iron,  dietary  folate,  Vitamin A, Vitamin  B6 and Vitamin B12. Further, considering the nutritional quality of Millets, MWCD has advised all States/UTs to incorporate millets in the recipes to enhance the nutritional quality of the meal provided under Supplementary Nutrition programme of Anganwadi Services. Further, under Supplementary Nutrition Programme of Anganwadi Services Scheme, Fortified Rice is allocated to States. Under Guidelines  for  Mission  Poshan  2.0,  it  has  been  advised  to  mandatorily  incorporate millets in Supplementary Nutrition at least once a week.

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