Lok Sabha Question No. 2668 (UNSTARRED), answered on 2023-08-04
Subject: Measures to Reduce Malnutrition
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Annasaheb Shankar Jolle

## GOVERNMENT OF INDIA

## MINISTRY OF WOMEN & CHILD DEVELOPMENT

## LOK SABHA

## UNSTARRED QUESTION NO. 2668 TO BE ANSWERED ON 04.08.2023

## MEASURES TO REDUCE MALNUTRITION

## 2668.  SHRI ANNASAHEB SHANKAR JOLLE:

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

- (a) the details of malnourished women and children in the country, State-wise including Karnataka;
- (b) the steps taken by Government under POSHAN Abhiyaan 2.0 to reduce malnutrition in the country;
- (c) whether  Government is  implementing  Anganwadi  Services  Scheme and  if  so,  the progress made therein so far; and
- (d) the  details  of  measures  taken  by  Government  to  ensure  wider  coverage  of  the programme?

## ANSWER

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

(a) The  estimated  number  of  underweight,  malnourished  and  severely  malnourished children under 5 years of age and women is obtained under National Family Health Survey (NFHS)  conducted  by  the  Ministry  of  Health  &  Family  Welfare.  As  per  NFHS-5,  the prevalence of stunting, wasting and underweight among children under 5 years of age is 35.5%, 19.3% and 32.1% and the prevalence of underweight among women is 18.7%.  Statewise data including Karnataka as per NFHS-5 is annexed.

Further, as per data recorded in Poshan Tracker, ICT application for Mission Poshan 2.0, close to 7 crore children were measured in the country in the month of June 2023 as per which,  7%  were  wasted  and  19%  underweight,  which  is  significantly  lower  than  NFHS indicators.  In  the  State  of  Karnataka,  28.75  lakh  children  under  the  age  of  5  years  were measured  in  the  month  of  June  2023,  out  of  which  8%  were  wasted  and  21%  were underweight which is significantly lower than NFHS-5 indicators for the State, which is 19.5% wasting and 32.9% underweight.

(b) The  Government  has  accorded  high  priority  to  the  issue  of  malnutrition  and  is implementing several schemes as direct targeted interventions to address the problem of malnutrition in the country. POSHAN Abhiyaan launched on 8th March 2018, aims to achieve improvement  in  nutritional  status  of  Adolescent  Girls,  Pregnant  Women  and  Lactating Mothers in a time bound manner by adopting a synergised and result oriented approach. The Abhiyaan  has  been  rolled  out  across  36  States/UTs.  Further,  the  efforts  under  the Supplementary Nutrition  Programme  under  Anganwadi  Services  and  POSHAN  Abhiyaan have been realigned and converged as 'Saksham Anganwadi and POSHAN 2.0' (Mission Poshan 2.0) 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 focuses on Maternal Nutrition, Infant and Young Child Feeding Norms, Treatment  of  MAM/SAM  and  Wellness  through  AYUSH.  It  rests  on  the  pillars of Convergence, Governance, and Capacity-building. POSHAN Abhiyaan is the key pillar for Outreach and will cover innovations related to nutritional support, ICT interventions, Media Advocacy and Research, Community Outreach and Jan Andolan. Steps have been taken to improve nutritional quality and testing in accredited labs, strengthen delivery and leverage technology under the 'Poshan Tracker', a robust ICT enabled platform to improve governance with  regard  to  real  time  monitoring  of  provisioning  of  supplementary  nutrition  for  prompt supervision and management of services.

Under Poshan 2.0, focus is on diet diversity, food fortification, leveraging traditional systems of knowledge and popularizing use of millets. Nutrition awareness strategies under Poshan 2.0 aim to develop sustainable health and well-being through regional meal plans to bridge  dietary  gaps.  Further,  greater  emphasis  is  being  given  on  the  use  of  millets  for preparation  of  Hot  Cooked  Meal  and  Take  Home  rations  (not  raw  ration)  at  Anganwadi centres for Pregnant Women, Lactating Mothers and Children below 6 years of age, as millets have  high  nutrient  content  which  includes  protein,  essential  fatty  acid,  dietary  fibre,  BVitamins,  minerals  such  as  calcium,  iron,  zinc,  folic  acid  and  other  micro-nutrients  thus helping  to  tackle  anemia  and  other  micro-nutrient  deficiencies  in  women  and  children. Further, to address the challenge of malnutrition arising due to micro-nutrient deficiency, only fortified rice is being allocated to States/UTs.

(c)        The Anganwadi Services under Saksham Anganwadi and Poshan 2.0 is a universal self-selecting scheme available to all the beneficiaries who enrol at the AWCs across the country.  There  are  7074  sanctioned  projects  under  Mission  Poshan  2.0  with  13.9  lakh Anganwadi Centres across the country. 10.3 crore beneficiaries, namely, pregnant women, lactating mothers, children under the age of 6 years and adolescent girls (14-18 years of age in North East and Aspirational districts), are registered for Anganwadi Services on the ICT application, Poshan Tracker, as on date, out of whom close to 94% are Aadhar-verified.

Under Saksham Anganwadi, 2 lakh selected Govt. owned AWCs @ 40,000 AWCs per year would be strengthened and upgraded for improved nutrition delivery. In the FY 202223, close to 41,192 Anganwadi Centres in Aspirational Districts have been identified to be made into Saksham Anganwadis, which will be enhanced with LED screens, smart -visual teaching  aids,  Poshan  Vatikas,  Rainwater  harvesting  structures  etc.  WiFi  shall  be  made available through BharatNet wherever possible.

(d)       Poshan Abhiyan scheme under Mission Poshan 2.0 makes interventions with the use of technology and behavioural change through convergence. An important focus has been on 'Behaviour Change Communication' or BCC to address inadequate and inappropriate infant  and  young  child  feeding  practices,  nutrition  and  care  during  pregnancy  and adolescence.  POSHAN  Abhiyaan  aims  to  foster  behavioural  change  among  individuals, especially parents and communities thus paving the way for a mass movement to promote transformative change, also referred to as ' Jan Andolan'

Community Based Events or 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. The gatherings serve as a platform for disseminating essential  messages  and  to  counsel  pregnant  and  lactating  women,  and  their  influencers (husbands/mothers-in-law) on appropriate nutrition and health behaviour. Close to 3.70 crore CBEs have been conducted under the Abhiyaan, in the last four years. Further, at the national level, Rashtriya Poshan Maah is celebrated in the month of September across the country while Poshan  Pakhwada is  celebrated  in  March.  Over  the  years,  themes  have  included overall  nutrition,  hygiene,  water  and  sanitation,  anemia  prevention,  importance  of  breastfeeding,  growth  monitoring,  role  of  Poshan  Panchayats,  AYUSH  for Well-being,  'Back  to Basics - Yoga for Health', importance of PoshanVatikas for cultivation of local vegetables, medicinal plants/herbs and fruits at the community level, Poshan ke Paanch Sutra etc. More than 60 crore Jan Andolan activities have been conducted, so far, across the country.

## Prevalence of under-nutrition among women and children as per NFHS-5 (2019-

21)

| S. No   | State                              |   Stunted (under 5 yrs) |   Underweight (under 5 yrs) |   Wasting (under 5 yrs) |   Women (age 15-49 years) |
|---------|------------------------------------|-------------------------|-----------------------------|-------------------------|---------------------------|
| 1       | Andaman & Nicobar Islands          |                    22.5 |                        23.7 |                    16   |                       9.4 |
| 2       | Andhra Pradesh                     |                    31.2 |                        29.6 |                    16.1 |                      14.8 |
| 3       | Arunachal Pradesh                  |                    28   |                        15.4 |                    13.1 |                       5.7 |
| 4       | Assam                              |                    35.3 |                        32.8 |                    21.7 |                      17.7 |
| 5       | Bihar                              |                    42.9 |                        41   |                    22.9 |                      25.6 |
| 6       | Chandigarh                         |                    25.3 |                        20.6 |                     8.4 |                      13   |
| 7       | Chhattisgarh                       |                    34.6 |                        31.3 |                    18.9 |                      23.1 |
| 8       | Dadra Nagar Haveli and Daman & Diu |                    39.4 |                        38.7 |                    21.6 |                      25.1 |
| 9       | Delhi                              |                    30.9 |                        21.8 |                    11.2 |                      10   |
| 10      | Goa                                |                    25.8 |                        24   |                    19.1 |                      13.8 |
| 11      | Gujarat                            |                    39   |                        39.7 |                    25.1 |                      25.2 |
| 12      | Haryana                            |                    27.5 |                        21.5 |                    11.5 |                      15.1 |
| 13      | Himachal Pradesh                   |                    30.8 |                        25.5 |                    17.4 |                      13.9 |
| 14      | Jammu & Kashmir                    |                    26.9 |                        21   |                    19   |                       5.2 |
| 15      | Jharkhand                          |                    39.6 |                        39.4 |                    22.4 |                      26.2 |
| 16      | Karnataka                          |                    35.4 |                        32.9 |                    19.5 |                      17.2 |
| 17      | Kerala                             |                    23.4 |                        19.7 |                    15.8 |                      10.1 |
| 18      | Lakshadweep                        |                    32   |                        25.8 |                    17.4 |                       8   |
| 19      | Ladakh                             |                    30.5 |                        20.4 |                    17.5 |                       4.4 |
| 20      | Madhya Pradesh                     |                    35.7 |                        33   |                    19   |                      23   |
| 21      | Maharashtra                        |                    35.2 |                        36.1 |                    25.6 |                      20.8 |
| 22      | Manipur                            |                    23.4 |                        13.3 |                     9.9 |                       7.2 |
| 23      | Meghalaya                          |                    46.5 |                        26.6 |                    12.1 |                      10.8 |
| 24      | Mizoram                            |                    28.9 |                        12.7 |                     9.8 |                       5.3 |
| 25      | Nagaland                           |                    32.7 |                        26.9 |                    19.1 |                      11.1 |
| 26      | Odisha                             |                    31   |                        29.7 |                    18.1 |                      20.8 |
| 28      | Puducherry                         |                    20   |                        15.3 |                    12.4 |                       9   |
| 29      | Punjab                             |                    24.5 |                        16.9 |                    10.6 |                      12.7 |
| 30      | Rajasthan                          |                    31.8 |                        27.6 |                    16.8 |                      19.6 |
| 30      | Sikkim                             |                    22.3 |                        13.1 |                    13.7 |                       5.8 |
| 31      | Tamil Nadu                         |                    25   |                        22   |                    14.6 |                      12.6 |
| 32      | Telangana                          |                    33.1 |                        31.8 |                    21.7 |                      18.8 |
| 33      | Tripura                            |                    32.3 |                        25.6 |                    18.2 |                      16.2 |
| 34      | Uttar Pradesh                      |                    39.7 |                        32.1 |                    17.3 |                      19   |
| 35      | Uttarakhand                        |                    27   |                        21   |                    13.2 |                      13.9 |
| 36      | West Bengal                        |                    33.8 |                        32.2 |                    20.3 |                      14.8 |
|         | India                              |                    35.5 |                        32.1 |                    19.3 |                      18.7 |

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