Question : NUTRITION IN INDIA

(a) whether the Government has taken note of recent report by the World Bank titled `Nutrition in India`, which has pointed towards huge losses to the Gross Domestic Product (GDP) of the country due to under nutrition in children and vitamin and mineral defi- ciencies every year;

(b) if so, the details thereof and the reaction of the Government thereto along with the corrective measures taken/being taken by the Government in this regard;

(c) whether the number of stunted and wasting/wasted children is on the rise in the country;

(d) if so, whether the Government has conducted/ proposes to conduct any survey to ascertain the percentage of such children in the country along with the reasons for the same, if so, the details and the outcome thereof State/UT-wise; and

(e) the details of the schemes/ programmes being implemented by the Government to overcome the aforesaid problems and the funds allocated/ released and utilized along with the achievements made thereunder during each of the last three years and the current year, State/UT-wise?

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

(a) & (b): As per the World Bank Report titled ’Nutrition in India’, India loses over 12 billion U.S. Dollar in Gross Domestic Product due to vitamin and mineral deficiencies in Indian population. It also reports significant direct and indirect economic losses due to under-nutrition associated with direct productivity losses estimated at more that 10 percent of lifetime individual earnings and about 2-3 percent loss of GDP. Indirect losses are due to poor mental development and schooling, and increased costs of healthcare.

(c) & (d): As per the comparison from second and third National Family health Survey conducted in 1998-99 and 2005-06 respectively, the prevalence of stunting among children under-three years of age has declined from 51 per cent to 44.9 percent, however the prevalence of wasting among children under age three years has increased from 19.7 per cent to 22.7 percent.

(e) The Government has accorded high priority to the issue of malnutrition in the country and is imple- menting several schemes/programmes under different Ministries/Departments through State Governments/UT Administrations, the details being as follows:

# Under multi-sectoral approach for accelerated action on the determinants of malnutrition in targeting nutrition in schemes/programmes of all the sectors. The schemes/programmes include the Integrated Child Development Services (ICDS), National Health Mission (NHM), Mid-Day Meal Scheme, Rajiv Gandhi Schemes for Empowerment of Adolescent Girls (RGSEAG) namely SABLA, Indira Gandhi Matritva Sahyog Yojna (IGMSY) as direct targeted interventions. Besides, indirect Multi-sectoral interventions include Targeted Public Distribution System (TPDS), National Horticulture Mission, National Food Security Mission, Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), Swachh Bharat Abhiyan, National Rural Drinking Water Programme etc. All these schemes address one or other aspect of Nutrition.

# The specific interventions targeted towards the vulnerable groups include children below 6 years. The main schemes/programmes of Ministry of Women and Child Development which have a bearing on the nutritional status includes the Integrated Child Development Services (ICDS) Scheme which provides a package of six services namely supplementary nutrition, pre-school non-formal education, nutrition & health education, immunization, health check-up and referral services.

# Under National Health Mission of Ministry of Health & FW, the remedial steps taken are as follows:

# Promotion of appropriate infant and young child feeding practices that include early initiation of breastfeeding, exclusive breastfeeding till 6 months of age and appropriate complementary feeding after 6 months of age.

# 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.

# Treatment of children with severe acute malnutrition at special units called the Nutrition Rehabilitation Centres (NRCs), set up at public health facilities. Presently 875 such centres are functional all over the country.

# Specific program to prevent and combat micronutrient deficiencies of Vitamin A and Iron & Folic Acid (IFA) in under-five children, children of 5 to 10 years of age, and adolescents.

# 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.

The State wise performance available from surveys and reports received from States of above mentioned inter- ventions in last three financial years is placed in Annexure I, II, III.

The interventions under National Health Mission are not funded as a separate scheme, but funds are provided to the States for comprehensive activities under Reproductive and Child Health Programme.

The details of funds approved and utilised under ICDS Scheme of Ministry of Women & Child Development, and Child Health programme of National Health Mission of Ministry of Health & FW, in last three financial years, State/UT wise are placed in Annexure IV & V respectively.