Lok Sabha Question No. 119 (STARRED), answered on 2024-02-09
Subject: Anaemia in Women and Malnutrition in Children
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Sanjay Seth

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA STARRED QUESTION NO. *119

TO BE ANSWERED ON 09.02.2024

## ANEMIA IN WOMEN AND MALNUTRITION IN CHILDREN

- *119 SHRI SANJAY SETH

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

- (a) the  number  of  women  suffering  from  anemia  and  children  suffering  from malnutrition in the country; State-wise
- (b) the details of steps taken by the Government to address the said issues;
- (c) the number of such women and children in Jharkhand, district-wise; and
- (d) details of resources provided to Jharkhand to address the above issue?

## ANSWER

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

(a) to (d) A Statement is laid on the table of the House

- *****

## Statement referred to in reply to Part (a) to (d) of Lok Sabha Starred Question no. 119 to be answered on 09.02.2024  regarding Anaemia in Women and Malnutrition in Children

(a) to (d) 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).  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.

Saksham  Anganwadi  and  Poshan  2.0  is  an  integrated  nutrition  support programme,  to  strengthen  nutritional  content,  delivery,  outreach  and  outcomes  with focus on developing practices that nurture health, wellness and immunity to disease and malnutrition. It 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.

The objectives of Poshan 2.0 are as follows:

- o To contribute to human capital development of the country;
- o Address challenges of malnutrition;
- o Promote nutrition awareness and good eating habits for sustainable health and well-being; and
- o Address nutrition related deficiencies through key strategies.

Further, to give high importance to issues around Anaemia, dedicated 'Anaemia related themes have been undertaken by Ministry of Women & Child Development under  Poshan  Abhiyaan  wherein  around  6  crore  activities  on  Anaemia  have  been reported so far. In the recently held Poshan Maah in September, 2023, more than 35 crore sensitisation activities have been reported, of which around 4 crore were focused around Anaemia. The Ministry took steps to encourage the adoption of millet across the country. So far, through Jan Andolans, more than 5 crore sensitisation activities have been conducted focusing on Millet promotion in last two years helping target beneficiaries to fight against anaemia through sensitisation and adoption of healthy, millet-based eating practices.

States/UTs  have  also  been  advised  to  promote  use  of  AYUSH  systems  for prevention  of  malnutrition  and  related  diseases.  First  ever National  protocol  for Community Management of Malnutrition in  children  was  launched  jointly  by  the Ministry  of  Women  and  Child  Development  and  the  Ministry  of  Health  and  Family Welfare  dated  10th  October  2023  providing  detailed  steps  for  identification  and management  of  malnourished  children  at  the  Anganwadi  level,  including  decisionmaking for referral, nutritional management and follow-up care. Further, area wise diet charts for pregnant women and malnourished pregnant women in the reproductive age group has also been prepared and disseminated to States/UTs.

The  key  interventions  of  MoHFW  to  improve  maternal  and  child  health including  anemia are:

- i. Anemia Mukt Bharat (AMB) strategy is implemented 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 steps taken to address the problem of anemia are:
2. o Prophylactic  Iron  and  Folic  Acid  Supplementation  in  all  six  target  age groups
3. o Intensified year-round Behaviour Change Communication (BCC) Campaign
4. o Testing using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents
5. o Addressing  non-nutritional  causes  of  anemia  in  endemic  pockets  with special focus on malaria, hemoglobinopathies and fluorosis
6. o Providing  incentives  to  the  ANM  for  identification  and  follow-up  of pregnant women with severe anemia in high priority districts (HPDs)
7. o Management of severe anemia in pregnant women by administration of IV Iron Sucrose/Blood transfusion
- ii. Monthly Village Health, Sanitation and Nutrition Day (VHSND) is an outreach activity at Anganwadi centers for provision of maternal and child care including nutrition in convergence with the ICDS.
- iii. MCP  Card  and  Safe  Motherhood  Booklet are  distributed  to  the  pregnant women for  educating  them  on  diet,  rest,  danger  signs  of  pregnancy,  benefit schemes and institutional deliveries.

The  data  on  anaemia  among  women  and  malnutrition  among  children  is released under National Family Health Survey (NFHS), which is conducted by Ministry of  Health  &  Family  Welfare.  The  report  of  NFHS-5  is  available  on  National  Family Health Survey portal (http://rchiips.org/nfhs/factsheet\_nfhs-5.shtml). 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 37% were found to be stunted and 17% were found to be underweight while among children under 5 years 6.29% were found to be wasted.

The levels of underweight and wasting reported on Poshan Tracker are much less than that projected by NFHS 5.

An amount of Rs. 1,17,289.19 Lakh has been released to the State of Jharkhand for the period from FY  2021-22  to FY  2023-24 (upto December  2023)  for implementation  of  various  activities  under  Mission  Poshan  2.0.  Moreover,  39,776 number  of  Smartphones  and  38,432  Growth  Monitoring  Devices  have  been  made available at the Anganwadi Centres of the State. Anganwadi Workers are also entering the data relating to the Mission along-with beneficiaries data on the Poshan Tracker application.  The  district  wise  number  of  Pregnant  Women,  Lactating  Mothers  and Children under 6 years registered on Poshan Tracker in the State of Jharkhand is at Annexure I.

As per the inputs received from MoHFW, the funds allocated under National Health  Mission  for  nutrition  programmes  implementation  (Anaemia  Mukt  Bharat, National Deworming  Day,  Mothers  Absolute  Affection,  Lactation  Management Centres, Nutrition Rehabilitation centres, Vitamin A Supplementation) to the State of Jharkhand for FY 2022-23 is Rs. 8578.42 Lakhs and for FY 2023-24 is Rs. 7943.52 Lakhs.

*****

Annexure I

## Annexure referred to reply to Part (c) of Lok Sabha Starred Question No. 119 to be  answered  on  09.02.2024  regarding  'Anemia  in  Women  and  Malnutrition  in Children'

| District            |   Lactating Mothers |   Pregnant Women |   Children 0- 6M |   Children 6M-3Y |   Children 3- 6Y |
|---------------------|---------------------|------------------|------------------|------------------|------------------|
| Bokaro              |                7828 |             9996 |             6183 |            66520 |            71121 |
| Chatra              |                5570 |             8031 |             4046 |            51910 |            51303 |
| Deoghar             |                6435 |             8866 |             5016 |            64809 |            71216 |
| Dhanbad             |                7992 |             9523 |             6852 |            66740 |            77169 |
| Dumka               |                5685 |             7986 |             5260 |            56725 |            82051 |
| East Singhbhum      |                7854 |            10257 |             6837 |            63453 |            54026 |
| Garhwa              |                6223 |             9329 |             3674 |            63878 |            56807 |
| Giridih             |               10158 |            13548 |             8709 |           110726 |           152211 |
| Godda               |                6994 |             8783 |             5749 |            68766 |            82412 |
| Gumla               |                4210 |             6014 |             4133 |            46828 |            49783 |
| Hazaribag           |                8150 |            12673 |             6372 |            76479 |            56513 |
| Jamtara             |                3613 |             5158 |             3310 |            34581 |            38516 |
| Khunti              |                2567 |             3485 |             2539 |            23597 |            21626 |
| Koderma             |                3945 |             5062 |             3254 |            30214 |            33636 |
| Latehar             |                3259 |             5259 |             2521 |            39669 |            42442 |
| Lohardaga           |                2414 |             3618 |             2106 |            24933 |            26525 |
| Pakur               |                4983 |             7363 |             5004 |            57775 |            64306 |
| Palamu              |               11344 |            14773 |             8550 |            97111 |            97893 |
| Ramgarh             |                3638 |             5135 |             3489 |            30982 |            28769 |
| Ranchi              |                8688 |            13140 |             8357 |            88837 |            86767 |
| Sahibganj           |                6489 |            11148 |             5023 |            75673 |            90997 |
| Seraikela-Kharsawan |                5101 |             6753 |             5073 |            41528 |            43166 |
| Simdega             |                1998 |             2822 |             1873 |            23038 |            27184 |
| West Singhbhum      |                6883 |             8742 |             6514 |            70655 |            76429 |
| Total               |              142021 |           197464 |           120444 |          1375427 |          1482868 |