Lok Sabha Question No. 311 (STARRED), answered on 2026-03-13
Subject: Severe Acute Malnutrition
Ministry: WOMEN AND CHILD DEVELOPMENT
Asked by: Shri Brijendra Singh Ola, Shri Rahul Kaswan

## GOVERNMENT OF INDIA MINISTRY OF WOMEN AND CHILD DEVELOPMENT

## LOK SABHA

## STARRED QUESTION *311

TO BE ANSWERED ON 13.03.2026

## SEVERE ACUTE MALNUTRITION

## *311.  SHRI RAHUL KASWAN:

SHRI BRIJENDRA SINGH OLA:

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

- (a) whether the children with Severe Acute Malnutrition (SAM) are at higher risk of death from illness due to weakened immunity, if so, the details thereof;

- (b) whether the Government has directed the States and Union Territories to identify, register and regularly monitor children with SAM;

- (c) if  so,  the  number  of  such  children  identified  till  date  along  with  the  response  of  the States/UTs thereto including Rajasthan; and

- (d) the details of the steps/relief measures currently being taken by the Government to eradicate, prevent and provide treatment to the children suffering from SAM along with the status of their implementation?

## ANSWER

MINISTER OF WOMEN AND CHILD DEVELOPMENT (SHRIMATI ANNPURNA DEVI)

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

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## STATEMENT REFERRED TO IN REPLY TO PARTS (A) TO (D) OF LOK SABHA STARRED  QUESTION  NO.  311  TO  BE  ANSWERED  ON  13.03.2026  REGARDING 'SEVERE ACUTE MALNUTRITION'

(a)to(d)    Severe Acute Malnutrition (SAM) is a form of malnutrition in children below five years of age, characterised by very low weight in relation to height. As per the Cause of Death Report (2021-23) released  by  the  Sample  Registration  System-Registrar  General  of  India  (SRS-RGI), malnutrition has not been identified as a direct cause of death in the children under 0-4 years in India. According to the report, major causes of child death in India under mentioned age group are Pneumonia  (Rural-16.5%,  Urban-14.7%),  Birth  asphyxia  &  birth  trauma  (Rural-9.7%,  Urban10.6%), Diarrhoeal diseases (Rural-4.4%, Urban-3.8%), Fever of unknown origin (Rural-4.2%, Urban-2.8%), Prematurity & low birth weight (Rural-30.3%, Urban-32.5%), Congenital anomalies (Rural-5.5%, Urban-7%), Other Non-Communicable Diseases (Rural-8%, Urban-10.1%), Injuries (Rural-4.4%, Urban-3%), Sepsis (Rural-3.9%, Urban-3.4%), Ill-defined or cause unknown (Rural9.9%, Urban-9.3%) etc. Details are available in the Report at the given link: https://censusindia.gov.in/nada/index.php/catalog/46176.

Government has accorded high priority to the issue of malnutrition in the country and has taken several  initiatives  to  break  the  intergenerational  cycle  of  malnutrition.  Adopting  a  whole  of Government  approach,  both  the  Ministry  of  Women  and  Child  Development  and  Ministry  of Health and Family Welfare undertake targeted interventions to improve the health and nutritional status of children in the country, including identification and management of children with Severe Acute Malnutrition.

Under  Mission  Saksham  Anganwadi  and  Poshan  2.0,  Anganwadi  worker  undertakes  regular Growth Monitoring of registered children (under 6 years of age) at Anganwadi Centre by recording height and weight every month in the Poshan Tracker Application. On the basis of this information, the nutritional status of the children is assessed, including Severe Acute Malnutrition (SAM). The details  of  children  who  underwent  growth  measurement  at  Anganwadi  Centres  (AWCs)  and percentage of identified SAM children for all the States and UTs including the State of Rajasthan are available at the link: https://www.poshantracker.in/statistics.

Under Mission Poshan 2.0, interventions have been designed to meet the nutrition requirements of the  registered  beneficiaries  that  is  adolescent  girls,  pregnant  women,  lactating  mothers  and children, by adopting a lifecycle approach. The details of the interventions being taken to address malnutrition among children are as under:

- Anganwadi Workers undertake a total of 22 home visits for counselling of parents and caregivers with a special emphasis on promoting optimal nutrition and care practices.
- To  educate  people  on  adoption  of  good  nutrition  habits,  sensitisation  activities  are conducted  in  the  form  of  Jan  Andolans  during  Poshan  Maah  and  Poshan  Pakhwada celebrated in the months of September and March-April respectively. Since 2018, more than 150 crore Jan Andolan activities have been conducted through 15 Jan Andolans.
- The bi-monthly Community Based Events (CBEs) at Anganwadi Centres have also served as a significant strategy in changing nutritional practices among people. Since 2018, 9.55 crore CBEs have been reported by the States and UTs.
- To improve diet-diversity  and  increase  the  intake  of  micronutrients,  particularly  in  the younger ages, Poshan Vatikas are being set up at Anganwadi Centers across the country.

Identification  of  malnourished  children  including  Severe  Acute  Malnutrition  (SAM)  and  their treatment and management at the community level is also one of the integral components of the Mission Poshan 2.0. Accordingly, a Protocol for Management of Malnutrition in Children has been jointly released by Ministry of Women and Child Development and Ministry of Health and Family Welfare in 2023. The protocol provides detailed 10 steps for identification and management of malnourished children at the Anganwadi level. These steps majorly include growth monitoring and identification of SAM children, conducting appetite test, nutritional management, referral for medical assessment and further care for children with medical complications, nutrition and health counselling and follow up visits by the Anganwadi Worker.

Further, Supplementary Nutrition is provided to Children (6 months to 6 years), Pregnant Women, Lactating  Mothers  and  Adolescent  Girls  (14-18  years)  in  accordance  with  the  nutrition  norms contained in Schedule-II of the National  Food Security Act, 2013,  with special provisions for undernourished children. A normal child is provided 200 Kcal and 08-10 gram protein for 6-12 months age; 400 Kcal and 15-20 gram protein for 1-3 years age; and 400 Kcal and 15-20 gram protein for 3-6 years, along with recommended 7 essential micronutrients. Whereas, a SAM child is  provided 400 Kcal and 15-20 gram protein for 6-12 months age; 700 Kcal and 25-30 gram protein for 1-3 years age; and 800 Kcal and 25-30 gram protein for 3-6 years age, along with recommended 7 essential micronutrients.

Additionally, Anganwadi Workers, during Home Visits, sensitize parents and caregivers of SAM children  on  nutrition,  diet  quality,  and  optimal  Infant  and  Young  Child  Feeding  practices, including quality and adequacy of age-appropriate complementary feeding, and WASH practices.

In addition to the above interventions, Ministry of Health and Family Welfare implements the Reproductive,  Maternal,  Newborn,  Child,  Adolescent  Health  and  Nutrition  (RMNCAH+N) strategy  in  a  lifecycle  approach  under  National  Health  Mission  (NHM),  which  includes interventions for addressing Infant Health and Child Nutrition, as placed below:

- Nutrition Rehabilitation Centres (NRCs), which are approximately 1198 in number, are set up at public health facilities to provide in-patient medical and nutritional care to children under 5 years of age suffering from Moderate and Severe Acute Malnutrition (MAM and SAM) with medical complications. In addition to curative care, special focus is given on improving the skills for mother and caregivers on complete age-appropriate caring and feeding practices. ASHA workers are provided financial incentives of Rs. 300/- for referral to NRC and follow up of SAM children. Wage compensation is also provided to mothers of SAM children.
- Under Home Based New-born Care (HBNC) and Home-Based Care of Young Children (HBYC) program, home visits are performed by ASHA worker to improve child-rearing practices and to identify sick newborn and young children in the community (6 home visits under HBNC and 5 visits under HBYC).
- Mothers' Absolute Affection (MAA)  Program  emphasizes on early initiation of breastfeeding and exclusive breastfeeding for first six months followed by appropriate age

complementary feeding practices through capacity building of frontline health workers and comprehensive IEC campaigns.

- Lactation Management Centres are established to ensure availability of mother's own milk or safe, pasteurized donor human milk for feeding of sick, preterm, low birth weight babies admitted in Neonatal Intensive Care Units and Special Newborn Care Units.
- Anemia  Mukt  Bharat  (AMB)  strategy  is  implemented  to  reduce  anemia  among  six beneficiary age groups - 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.
- Under National Deworming Day (NDD), Albendazole tablets are administered in a single fixed day approach via schools and Anganwadi centres to reduce worm infestation among all children (1-19 years).
- Village Health Sanitation and Nutrition Days (VHSNDs) are observed for provision of maternal  and  child  health  services  and  creating  awareness  on  maternal  and  child-care including nutrition in convergence with Ministry of Women and Child Development.
- In Vitamin A Supplementation Programme, all children age 6 -59 months are administered Vitamin  A  dose  every  6  months  in  two  rounds  during  Village  Health  Sanitation  and Nutrition Days or in campaign approach.
- Mother and Child Protection (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.

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