Lok Sabha Question No. 291 (STARRED), answered on 2015-12-18
Subject: Nutritional Status and Deficiencies
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KINJARAPU RAM MOHAN NAIDU

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 291 TO BE ANSWERED ON THE 18 TH DECEMBER 2015 NUTRITIONAL STATUS A ND DEFICIENCIES

## *291. SHRI RAM MOHAN NAIDU KINJARAPU:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether any survey on the nutritional status and nutritional deficiencies esp women and children in the villages under the National Rural Health Mission (N conducted and if so, the details thereof;
- (b) the details of the schemes/ programmes implemented by the Government to overcome nutritional  deficiencies  along  with  the  steps  taken  to  include  the  nutritio Village Health Plan;
- (c) the funds allocated, released and utilized along with the achievements made over come malnutrition in the villages under the NRHM during each of the last and the current year, State/UT - wise; and
- (d)  whether  the  Government  proposes  to  integrate  and  align  the  schemes/  prog nutrition under NRHM with the National Nutr ition Policy in order to adopt a multi - sectoral strategy for achieving optimum nutrition for all and for monitoring the nutriti the country and if so, the details thereof?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

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

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 291* FOR 18 TH DECEMBER, 2015

Yes, Under  National  Rural  Health  Mission  (NRHM),  periodic  surveys  are  carried  out  to understand the nutritional status and nutritional deficiencies in women and children in the form of National Family Health Survey (NFHS), Annual Health Survey (AHS) and District Level Health  Survey  (DLHS).  The  last  survey  was  National  Family  Health  Survey-3  (NFHS-3) conducted in 2005-06. This was followed by DLHS survey in 21 States in 2012-13 and AHS for 9 states in 2014. Besides this, Ministry of Women and Child Development and UNICEF has also conducted Rapid Survey of Children (RSOC) in 2013 to assess the nutritional status of children and women. The details of the nutrition status of women and children from these two National level surveys are as below:

|                                                                            | India            | India           |
|----------------------------------------------------------------------------|------------------|-----------------|
| Indicators related to Nutrition                                            | NFHS-3 (2005-06) | RSOC (2013- 14) |
| Under-weight prevalence in under-five children (%)                         | 42.5             | 29.4            |
| Stunting prevalence in under-five children (%)                             | 48               | 38.7            |
| Wasting prevalence in under-five children (%)                              | 19.8             | 15.1            |
| Severe Acute Malnutrition (SAM) prevalence in under- five children (%)     | 6.4              | 4.6             |
| Early Initiation of Breastfeeding within an hour of Birth (%)              | 24.5             | 44.6            |
| Exclusive Breastfeeding for six months (%)                                 | 46.4             | 64.9            |
| %of Children aged 12-35 months who received at-least one dose of Vitamin-A | 18.1             | 45.2            |
| Households using adequately iodized salt (%)                               | 51.1             | 67.4            |

Various activities are carried out under the National Health Mission of Ministry of Health & Family Welfare and the Integrated Child Development Scheme (ICDS) of Ministry of Women and Child Development to reduce malnutrition among women and children. These activities are:

1. Promotion of appropriate infant and young child feeding practices that include early initiation of breastfeeding and exclusive breastfeeding till 6 months of age.
2. Treatment of sick children with severe acute malnutrition at special units called the Nutrition Rehabilitation Centres (NRCs), set up at public health facilities. Presently 891 such centres are functional.
3. Micronutrient  supplementation  such  as  Vitamin  A  and  Iron  Folic  Acid  for  children from 6 months to 5 years.
4. Village Health and Nutrition Days and Mother and Child Protection Card are the joint initiative of the Ministries of Health & Family Welfare and the Ministry of Woman and Child for addressing the nutrition concerns in children, pregnant women and lactating mothers. Monthly Village Health and Nutrition Days (VHND) are monthly days held at village level in Anganwadi centre to increase the awareness and bring about desired changes in the dietary practices including the promotion of breastfeeding.
5. Promotion for intake of iodised salt and monitoring salt quality through testing under National Iodine Deficiency Disorders Control Programme.
6. Management  of  malnutrition  and  common neonatal  and  childhood  illnesses  at community  and  facility  level  by  training  service  providers  in  IMNCI  (Integrated Management  of  Neonatal  and  Childhood  Illnesses)  training and  implementation  of Universal Immunization Programme.
7. Under  Integrated  Child  Development  Services  Scheme of  Ministry  of  Women  and Child Development, Supplementary Nutrition is provided to bridge the gap between the Recommended Dietary Allowance (RDA) and Average Dietary Intake (ADI).

The details of fund allocation under RCH flexi-pool of National Health Mission for last three years are at annexure.

It  is  proposed  to  integrate  and  align  various  schemes  of  nutrition  being  implemented  by different Ministries under proposed National Nutrition Mission of Ministry of Women and Child  Development. This  will  be  carried  out  by  establishing  institutional  mechanism  for convergence  and using ICT tool for tracking the beneficiaries and monitoring  the programme on a real time basis.

Annexure Statement showing of State/UTs wise SPIP Approval  & Expenditure under RCH Flexible Pool for F.Ys 2012-13 to 2015-16

## Rs. In Crore

| S.No.                | State             | 2012-13       | 2012-13     | 2013-14       | 2013-14     | 2014-15       | 2014-15     | 2015-16       | 2015-16     |
|----------------------|-------------------|---------------|-------------|---------------|-------------|---------------|-------------|---------------|-------------|
| S.No.                | State             | SPIP Approval | Expenditure | SPIP Approval | Expenditure | SPIP Approval | Expenditure | SPIP Approval | Expenditure |
| A. High Focus States |                   |               |             |               |             |               |             |               |             |
| 1                    | Bihar             | 876.84        | 614.78      | 1,103.79      | 729.30      | 971.58        | 706.31      | 956.79        | 55.30       |
| 2                    | Chhatisgarh       | 270.87        | 167.00      | 330.68        | 175.47      | 269.05        | 185.19      | 297.22        | 85.16       |
| 3                    | Himachal          | 66.28         | 38.27       | 49.95         | 63.78       | 68.45         | 60.92       | 81.74         | 19.61       |
| 4                    | J & K             | 145.90        | 112.89      | 251.16        | 151.89      | 221.48        | 147.27      | 252.74        | 92.59       |
| 5                    | Jharkhand         | 327.03        | 166.32      | 534.92        | 215.52      | 370.74        | 230.90      | 425.26        | 113.64      |
| 6                    | MP                | 560.49        | 466.07      | 729.07        | 600.37      | 740.97        | 675.61      | 906.63        | 293.00      |
| 7                    | Orissa            | 325.92        | 260.03      | 365.31        | 283.88      | 375.32        | 296.42      | 413.33        | 139.75      |
| 8                    | Rajasthan         | 622.20        | 441.66      | 687.74        | 460.25      | 661.98        | 524.52      | 718.71        | 206.06      |
| 9                    | UP                | 1,204.16      | 674.71      | 1,352.42      | 956.34      | 1,410.28      | 1,011.02    | 1,464.76      | 290.22      |
| 10                   | Uttarakhand       | 88.12         | 71.20       | 108.01        | 84.07       | 117.72        | 101.95      | 124.14        | 38.98       |
|                      | Sub Total         | 4,487.84      | 3,012.91    | 5,513.05      | 3,720.87    | 5,207.56      | 3,940.10    | 5,641.33      | 1,334.29    |
| B. NE States         |                   |               |             | -             | -           |               |             |               |             |
| 11                   | Arunachal Pradesh | 22.08         | 16.47       | 30.98         | 25.26       | 38.02         | 21.00       | 51.66         | 12.41       |
| 12                   | Assam             | 488.95        | 446.70      | 543.44        | 436.39      | 674.20        | 461.07      | 591.51        | 185.15      |
| 13                   | Manipur           | 27.42         | 15.01       | 29.00         | 24.57       | 42.80         | 25.45       | 46.72         | 10.55       |
| 14                   | Meghalya          | 44.09         | 20.50       | 41.67         | 14.95       | 56.04         | 26.55       | 66.95         | 11.81       |
| 15                   | Mizoram           | 28.22         | 22.37       | 29.49         | 24.44       | 38.94         | 17.17       | -             | 13.80       |
| 16                   | Nagaland          | 43.80         | 33.54       | 49.94         | 33.89       | 43.76         | 24.13       | 43.96         | 12.73       |
| 17                   | Sikkim            | 12.79         | 9.04        | 14.52         | 11.46       | 16.12         | 12.12       | 16.61         | 5.41        |
| 18                   | Tripura           | 37.45         | 21.23       | 30.70         | 23.49       | 39.94         | 26.66       | 41.42         | 10.42       |
|                      | Sub Total         | 704.81        | 584.86      | 769.74        | 594.46      | 949.82        | 614.14      | 858.83        | 262.28      |
| C. Non- High Focus   |                   |               |             |               |             |               |             |               |             |
| States 19            | Andhra            |               | 325.51      | -             | - 319.42    |               | 259.86      | 321.33        | 94.25       |

|                      |                      | 539.65   |          | 584.99   |          | 328.58   |          |           |          |
|----------------------|----------------------|----------|----------|----------|----------|----------|----------|-----------|----------|
| 20                   | Goa                  | 9.16     | 4.79     | 10.88    | 5.85     | 13.16    | 6.73     | 12.82     | 2.98     |
| 21                   | Gujarat              | 312.87   | 221.49   | 360.53   | 212.61   | 330.23   | 236.38   | 340.78    | 97.24    |
| 22                   | Haryana              | 152.92   | 116.19   | 173.23   | 154.74   | 185.53   | 162.13   | 163.64    | 72.94    |
| 23                   | Karnatak             | 265.52   | 205.41   | 275.29   | 218.81   | 363.63   | 229.23   | 385.74    | 99.64    |
| 24                   | Kerala               | 161.55   | 160.43   | 134.25   | 150.71   | 157.98   | 130.34   | 161.81    | 57.64    |
| 25                   | Maharashtra          | 453.37   | 384.10   | 577.18   | 485.92   | 679.69   | 477.44   | 620.75    | 157.17   |
| 26                   | Punjab               | 134.28   | 93.21    | 119.35   | 100.78   | 176.24   | 124.85   | 178.77    | 59.96    |
| 27                   | Tamilnadu            | 463.93   | 228.56   | 419.18   | 365.83   | 503.24   | 467.92   | 477.69    | 158.38   |
| 28                   | Telangana            | -        | -        | -        | -        | 248.45   | 144.70   | 246.20    | 64.78    |
| 29                   | West Bengal          | 514.35   | 337.70   | 563.00   | 384.03   | 669.17   | 494.75   | 563.07    | 227.11   |
|                      | Sub Total            | 3,007.60 | 2,077.37 | 3,217.89 | 2,398.70 | 3,655.90 | 2,734.35 | 3,472.61  | 1,092.09 |
| D. Small States/ UTs |                      |          |          | -        |          |          |          |           |          |
| 30                   | Andaman & Nicobar    | 11.38    | 6.80     | 7.16     | 8.57     | 11.37    | 8.14     | 12.07     | 2.95     |
| 31                   | Chandigarh           | 10.24    | 4.79     | 7.16     | 8.52     | 12.63    | 9.95     | 11.44     | 3.51     |
| 32                   | Dadra & Nagar Haveli | 5.48     | 3.08     | 3.65     | 4.71     | 9.66     | 4.95     | 10.92     | 1.63     |
| 33                   | Daman                | 5.38     | 2.86     | 5.85     | 4.18     | 6.60     | 3.71     | 7.05      | 2.64     |
| 34                   | Delhi                | 139.13   | 56.31    | 68.94    | 63.22    | 66.60    | 49.63    | 59.96     | 14.11    |
| 35                   | Lakshyadweep         | 4.04     | 2.36     | 2.11     | 0.53     | 4.39     | 0.72     | 4.30      | 0.22     |
| 36                   | Puducherry           | 10.13    | 6.42     | 12.40    | 8.52     | 11.95    | 8.50     | 9.51      | 3.73     |
|                      | Sub Total            | 185.79   | 82.62    | 107.26   | 98.25    | 123.19   | 85.60    | 115.26    | 28.79    |
|                      | Grand Total          | 8,386.04 | 5,757.77 | 9,607.93 | 6,812.27 | 9,936.48 | 7,374.19 | 10,088.03 | 2,717.45 |

## Note:

- a) SPIP- State Programme Implementation Plan.
- b) Above statement is inclusive of Maternal Health (JSY, JSSK), Child Health (SNCU, NRC), Family Planning, Rashtriya Kishore Swasthya Karyakram, Rashtriya Bal Swasthya Karyakram, Tribal RCH, PNDT Activities,  Human Resources, Training, PROGRAMME / NRHM MANAGEMENT COST and Vulnerable Groups activities under RCH Flexible Pool
- c) Above mentioned Expenditure figures are as reported by States/UTs up to 30.09.2015
- d) Above Expenditure is inclusive of previous year unspent balance