Question : Severe Acute Malnutrition (SAM)

(a) whether India has twice the number of underweight children than sub Saharan Africa and if so, the details thereof;
(b) whether food fortification has proved to be one of the most effective ways to supplement the nutrition needs of the population and if so, the details thereof;
(c) whether packaged fortified food has shown remarkable result in treating patients with Severe Acute Malnutrition (SAM) in Africa but has proved much less effective in trials conducted in India, if so, the reasons therefor;
(d) whether the Government has also received concerns from the experts cautioning against ‘quick fixes’ of buying commercial products instead of focusing on sustainable measures such as care and support for mothers, clean drinking water and food security in this regard, if so, the details thereof; and
(e) the steps taken by the Government for the awareness of malnutrition and protective method to eradicate this problem?

Answer given by the minister

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

(a) As per the UNICEF report entitled “The State of the World’s Children” 2016, 19% children under 5 years were underweight in Sub-Saharan Africa and as per National Family Health Survey (NFHS) – 4 conducted by Ministry of Health and Family Welfare in 2015-16, 35.7% children under 5 years are underweight in India.

(b) Food fortification is a “Complementary strategy” and “not a replacement of balanced, diversified diets” to address malnutrition.

(c) This Ministry is not aware of any such trial. However, in India children with Severe Acute Malnutrition are treated at the Nutrition Rehabilitation Centres established by the Ministry of Health and Family Welfare.

(d) The Government has accorded high priority to the issue of malnutrition and is implementing several schemes/programmes of different Ministries/Departments through States/UTs to address various aspects related to nutrition. This Ministry is implementing schemes like Anganwadi Services, Scheme for Adolescent Girls and Pradhan Mantri Matru Vandana Yojna under the Umbrella Integrated Child Development Services Scheme as direct targeted interventions to address the problem of malnutrition in the country. Care and support for mothers, clean drinking water and food security are some of the components to treat malnutrition.


(e) Government has set up POSHAN Abhiyaan on 18.12.2017 for a three year time frame commencing from 2017-18 with an overall budget of Rs. 9046 Crore. To ensure a holistic approach, all 36 States/UTs and districts have been covered. The goals of POSHAN Abhiyaan are to achieve improvement in nutritional status of Children from 0-6 years, Adolescent Girls, Pregnant Women and Lactating Mothers in a time bound manner during the three years with fixed targets as under:

S.No Objective Target
1. Prevent and reduce Stunting in children (0- 6 years) By 6% @ 2% p.a.
2. Prevent and reduce under-nutrition (underweight prevalence) in children (0-6 years) By 6% @ 2% p.a.
3. Reduce the prevalence of anemia among young Children(6-59 months) By 9% @ 3% p.a.
4. Reduce the prevalence of anemia among Women and Adolescent Girls in the age group of 15-49 years. By 9% @ 3% p.a.
5. Reduce Low Birth Weight (LBW). By 6% @ 2% p.a.

The Abhiyaan aims to reduce malnutrition in the Country in a phased manner, through a life cycle approach, by adopting a synergised and result oriented approach. The Abhiyaan will ensure mechanisms for timely service delivery and a robust monitoring as well as intervention infrastructure. Target is to bring down stunting of the children in the age group of 0-6 years from 38.4% to 25% by the year 2022. The major works undertaken under this Abhiyaan are ensuring convergence with various other programmes; Information Technology enabled Common Application Software for strengthening service delivery and interventions; Community Mobilization and Awareness Advocacy leading to Jan Andolan- to educate the people on nutritional aspects; Capacity Building of Frontline Functionaries, incentivizing States/ UTs for achieving goals etc.

Anganwadi Services, which aims to improve the nutritional and health status of children in the age-group 0-6 years, pregnant women & lactating mothers and reduce the incidence of mortality, morbidity and malnutrition. Under the Scheme, a package of six services is provided through a network of Anganwadi Centers, which include supplementary nutrition, pre-school non-formal education, nutrition & health education, immunization, health check-up and referral services.

Pradhan Mantri Matru Vandana Yojana, which is a centrally sponsored Conditional Maternity Benefit scheme of the Ministry for pregnant and lactating women. Under the scheme, cash incentives are provided partly compensating for their wage loss subject to fulfilment of health and nutrition conditions.

Ministry of Health and Family Welfare is implementing various Child Health Programmes at national level such as Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakaram ( JSSK), Special Newborn Care Units ( SNCU), Newborn Stabilization Units ( NSBU) , Kangaroo Mother Care ( KMC) units, Comprehensive Lactation Management Centers, Home Based Newborn Care, Village Health and Nutrition Days, MAA Programme, Universal Immunization Programme, etc.

Food and Nutrition Board under this Ministry, through its regional field units, conducts training programmes in nutrition and generates awareness through nutrition education programmes on the importance of healthy balanced diets especially through the use of locally available foods, mass awareness campaigns and use of electronic and print media.

Behaviour change communication and nutrition education is also addressed through different Government programmes such as POSHAN Abhiyaan, Anganwadi Services, Mothers’ Absolute Affection (MAA), etc.

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