Lok Sabha Question No. 4222 (UNSTARRED), answered on 2024-12-20
Subject: Malnutrition among PVTG
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Shri Saptagiri Sankar Ulaka

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA UNSTARRED QUESTION NO. 4222

TO BE ANSWERED ON 20.12.2024

## MALNUTRITION AMONG PVTG

## 4222.  SHRI SAPTAGIRI SANKAR ULAKA:

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

- (a) the current prevalence of malnutrition among children, pregnant women and nursing mothers in tribal areas of Odisha, especially among the Particularly Vulnerable Tribal Groups (PVTGs);
- (b) the  specific  steps  taken  under  the  Integrated  Child  Development  Services (ICDS)  scheme  to  combat  malnutrition  and  improve  child  development outcomes in these tribal regions;
- (c) whether there are any ongoing or planned initiatives for the capacity-building of Anganwadi workers in these areas and if so, the details thereof;
- (d) the  funds  allocated  and  utilized  under  the  ICDS  scheme  for  tribal  areas  in Odisha over the last five years; and
- (e) the  measurable  outcomes  achieved  so  far  through  ICDS  interventions  in improving nutrition and health indicators in these tribal regions?

## ANSWER

## MINISTER OF STATE IN THE MINISTRY OF WOMEN AND CHILD DEVELOPMENT (SHRIMATI SAVITRI THAKUR)

(a) to (e) Under the 15th Finance Commission, various components like Anganwadi services,  Poshan  Abhiyaan  and  Scheme  for  Adolescent  girls  (of  14-18  years  in Aspirational  Districts  and  North-Eastern  region)  have  been  subsumed  under  the umbrella  Mission  Saksham  Anganwadi  and  Poshan  2.0  (Mission  Poshan  2.0)  to address the challenge of malnutrition through improved nutrition content and delivery. It is a Centrally Sponsored mission, where the responsibility for implementation lies with the States/UTs. Mission is a universal self-selecting umbrella scheme that is being implemented across the country including tribal areas of Odisha.

Nutrition goes beyond mere eating of food; it requires proper digestion, absorption, and metabolism which are influenced by factors like sanitation, education and access to safe drinking water. As malnutrition requires a multi-sectoral approach involving dimensions of food, health, water, sanitation and education, it is crucial to effectively address the issue of malnutrition. The challenge of malnutrition is being addressed under Mission Saksham Anganwadi and Poshan 2.0 by establishing cross cutting convergence amongst 18 Ministries/Departments.

Under Mission Poshan 2.0 a new strategy has been made for reduction in malnutrition and for improved health, wellness and immunity through activities like community engagement, outreach, behavioral change, and advocacy. It focuses on Maternal Nutrition,  Infant  and  Young  Child  Feeding  Norms,  treatment  of  Severe  Acute Malnutrition  (SAM)/  Moderate  Acute  Malnutrition  (MAM)  and  wellness  through AYUSH practices  to  reduce  prevalence  of  wasting,  stunting,  anaemia  and  being underweight.

Under this scheme, Supplementary Nutrition is provided to Children (6 months to 6 years),  Pregnant  Women,  Lactating  Mothers  and  Adolescent  Girls  to  beat  the intergenerational cycle of malnutrition by adopting a life cycle approach. Supplementary nutrition is provided in accordance with the nutrition norms contained in Schedule-II of the National Food Security Act. These norms have been revised and upgraded last year. The old norms were largely calorie-specific; however, the revised norms are more comprehensive and balanced in terms of both quantity and quality of  supplementary  nutrition  based  on  the  principles  of  diet  diversity  that  provides quality protein, healthy fats and micronutrients.

Fortified rice is being supplied to AWCs to meet the requirement of micro-nutrients and to control anaemia among women and children. Greater emphasis is being laid on the use of millets for preparation of Hot Cooked Meal at least once a week and Take Home ration at Anganwadi centers.

Ministries of Women & Child Development and Health & Family Welfare have jointly released the protocol for Community Management of Malnutrition (CMAM) to prevent and treat severely acute malnutrition in children and for reducing associated morbidity and mortality.

Under this Mission, one of the major activities undertaken is Community Mobilization and Awareness Advocacy leading to a Jan Andolan to educate people on nutritional aspects. State and UTs are conducting and reporting regular sensitisation activities under  community  engagement  programmes  during  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 nutritional  practices  and  all  Anganwadi  workers  are  required  to  conduct  two Community Based Events every month.

Various rounds of the National Family Health Survey (NFHS) conducted by Ministry of Health  &  Family  Welfare  since  1992-93  have  shown  improvement  in  malnutrition indicators in children across India. Details of these indicators for children since NFHS1 to NFHS-5 are given below:

| NFHS Survey         |   Stunting% |   Underweight %Wasting% |      |
|---------------------|-------------|-------------------------|------|
| NFHS-1 (1992-93)*   |        52   |                    53.4 | 17.5 |
| NFHS-2 (1998-99)**  |        45.5 |                    47   | 15.5 |
| NFHS-3 (2005-6)***  |        48   |                    42.5 | 19.8 |
| NFHS-4 (2015-16)*** |        38.4 |                    35.8 | 21   |
| NFHS-5 (2019-21)*** |        35.5 |                    32.1 | 19.3 |

* Under 4 years
- ** Under 3 years
- *** Under 5 years

The above table gives a representative picture of malnutrition indicators among all children of 0-3 years, 0-4 years and 0-5 years age at the relevant time.

The projected population of all children up to 5 years in India for the year 2021 is 13.75  crores  approximately  (source:  Population  Projections  for  India  and  States 2011-2036,  National  Commission  on  Population,  Ministry  of  Health  &  Family Welfare).  However,  only  7.54  crores  children  up  to  5  years  are  enrolled  in Anganwadis and registered on Poshan Tracker of the Ministry of Women & Child Development  as  per  the  October  2024  data.  7.31  crores  of  these  children  were measured on growth parameters of height and weight. 38.9% of these children have been found to be stunted, 17% children have been found to be underweight and 5.2% wasted.

As per Poshan Tracker data for the month of October 2024, the malnutrition indicators of  the  children  (0-5  years)  in  Odisha:  Stunting  is  29.1%,  Wasting  -  2.9%  and Underweight - 12.8%.

Further, the projected population of all children in India up to 6 years for the year 2021 is approximately 16.1 crores. As per the October 2024 data of Poshan Tracker, 8.82 crores children (0-6 years) are enrolled in Anganwadis out of whom 8.55 crores were measured on growth parameters of height and weight. 37% of these children (0-6 years) have been found to be stunted and 17% children (0-6 years) have been found to be underweight.

As per Poshan Tracker data for the month of October 2024, the malnutrition indicators of the children (0-6years) in Odisha: Stunting is 27% and Underweight - 13%.

The  analysis  of  the  above  NFHS  data  and  the  Poshan  Tracker  data  shows improvement in malnutrition indicators in children across India.

As per National Family Health Survey 5 (2019-21), the prevalence of anemia in the State of Odisha among all women age 15-49 years is 64.3 percent.

Hon'ble  PM  has  launched  PM-  JANMAN  (Pradhan  Mantri  Janjati  Adivasi  Nyaya Maha  Abhiyan)  on  15th  November,  2023.  The  Mission  is  aimed  at  targeted development  of  75  Particularly  Vulnerable  Tribal  Groups  (PVTGs)  residing  in  18

States and a UT. This Mission focuses on 11 critical interventions related to 9 key Ministries including Ministry of Women and Child Development.

Under PM-JANMAN, total 138.12 crore has been released till now to all States/UTs. As on date, the ministry has sanctioned 90 AWCs for construction of AWCs in the State of Odisha for which funds amounting to Rs. 10.8 crore has been allocated.

National eGovernance Division (NeGD) regularly conducts field level trainings/workshops  directly  for  Anganwadi  Workers  regarding  use  of  the  Poshan Tracker Application. Multiple rounds of trainings have been held both virtually and physically, in various districts across the country.

Poshan Bhi Padhai Bhi (PBPB) launched by MWCD in 2023 is a path breaking Early Childhood Care and Education (ECCE) program to ensure that India has a high-quality pre-school network with well-trained Anganwadi workers which is in alignment with the National Education Policy (NEP) 2020. PBPB advocates for a play-based, joyful lowcost  Teaching  Learning  Materials  (TLMs),  Do-It-Yourself  (DIY)  kit,  activity-based learning pedagogy, targeted specifically at developmental milestones of 0-3-yearold children  as  well  as  3-6-year  old  children.  It  also  advocates  using  simple  teachinglearning  material  and  indigenous  toys  which  are  locally  sourced  and  culturally acceptable.

A Two-Tier Training Implementation Model is being followed throughout the country for Training of functionaries. Tier 1 involves two days training of State Level Master Trainers (SLMTs). Tier 2 involves a 3 Days Training of Anganwadi Workers (AWWs). Up  to  16 th    December  2024,  26,425  SLMTs  have  been  trained  under  PBPB programmes in all States/UTs including 830 SLMTs in Odisha.

Under the Mission Poshan 2.0, funds are released to States/UTs. Details of funds released to Odisha including tribal areas from FY 2021-22 till FY 2023-24 and funds utilized by the State are at Annexure.

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Annexure ANNEXURE REFERRED IN REPLY TO PART (d) OF LOK SABHA QUESTION NO. 4222 FOR 20.12.2024 REGARDING 'MALNUTRITION AMONG PVTG' ASKED BY SHRI SAPTAGIRI SANKAR ULAKA Under the Mission Poshan 2.0, funds are released to States/UTs. Details of funds released and utilized from FY 2021-22 till FY 2023-24 to Odisha are as follows:

| Funds   |   Released (in crore) | Utilized (in crore)                 |
|---------|-----------------------|-------------------------------------|
| 2021-22 |               1065.98 | 871.20                              |
| 2022-23 |                923.92 | 884.96                              |
| 2023-24 |                968.8  | Utilization Certificate not yet due |

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