ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a) to (c): Government has taken special measures for children suffering from malnutrition in the country including Bundelkhand.
Government of India has launched POSHAN (Prime Minister Overarching Scheme for Holistic Nourishment) Abhiyaan, to address malnutrition challenges in India by engaging all the important stakeholders in a convergent approach. The goals of POSHAN Abhiyaan is to prevent and reduce stunting, underweight and low birth weight by 2% per annum and the reduction of anemia by 3% per annum.
The Government of India has also launched several schemes under the aegis of Ministry of Women and Child Development (MWCD) to tackle malnutrition in the country including Anganwadi Services, Scheme for Adolescent Girls (SAG) and Pradhan Mantri Matru Vandana Yojna (PMMVY) to improve the nutritional and health status of children in the age-group 0-6 years. The Anganwadi Services scheme provides a package of six services i.e. Supplementary Nutrition, Pre School Non-formal Education, Nutrition and Health Education, Immunization, Health checkups and referral services. Under National Health Mission (NHM), support is provided to the States /UTs to strengthen their health care systems including strengthening of infrastructure, and adequate manpower based on the proposals received from the States in their Programme Implementation Plans (PIPs). These PIPs are appraised in the National Programme Coordination Committee (NPCC) meetings and approvals are accorded to States/ UTs in the form of Record of Proceedings (RoPs). Further, in order to address child mortality and morbidity, the Government of India is supporting in implementation of Reproductive, Maternal, Newborn, Child, Adolescent health and Nutrition (RMNCAH+N) strategy. The detail of various health and nutrition interventions under National Health Mission (NHM) is as follows:
• Promotion of Institutional deliveries through cash incentive under Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) which entitles all pregnant women delivering in public health institutions to absolutely free delivery including Caesarean section, post-natal care and treatment of sick infants till one year of age. Pradhan Mantri Matru Vandana Yojana (PMMVY) is another maternity benefit programme under which cash incentive of Rs. 5000 is provided to pregnant women and lactating mothers.
• Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted under Mothers’ Absolute Affection (MAA) in convergence with Ministry of Women and Child Development.
• Home Based Care for Young Children (HBYC) has been initiated as an extension of Home Based Newborn Care (HBNC) to provide community based care by ASHA workers with focus on improvement in child rearing practices, nutrition counselling and breastfeeding promotion till 15th month of life.
• Treatment of sick children with Severe Acute Malnutrition (SAM) at special units called the Nutrition Rehabilitation Centres (NRCs), set up at public health facilities.
• Universal Immunization Programme (UIP) is being supported to provide vaccination to children against life threatening diseases such as Tuberculosis, Diphtheria, Pertusis, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by Haemophilus Influenzae B. The Rotavirus vaccination has also been rolled out in the country for prevention of Rotaviral diarrhoea. “Mission Indradhanush is targeted to immunize children who are either unvaccinated or partially vaccinated i.e. those that have not been covered during the rounds of routine immunization for various reasons.
• Vitamin A supplementation (VAS) for children till the age of 5 years.
• National De-worming Day as a fixed day strategy to administer Albendazole tablets to all the children in the age group of 1-19 years through the platform of AWCs and schools for good nutritional outcomes and prevention of anaemia.
• Prevention of childhood illness such as diarrheal diseases which in turn prevents childhood malnutrition. Control of childhood diarrhoea is being carried out by conducting annual Intensified Diarrhoea Control Fortnight (IDCF) and Defeat Diarrhoea Initiative.
• ‘Anemia Mukt Bharat (AMB)’ for supplementation and treatment of anaemia in children, adolescents, pregnant and lactating women, and women of reproductive age group in programme mode through life cycle approach. This involves, bi-weekly IFA syrup supplementation to children 6 – 59 months, weekly IFA tablet supplementation to children 5 – 10 years and adolescents 10 – 19 years, and IFA tablets to pregnant and lactating women.
• 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 in convergence with Ministry of Women and Child Development. Health and nutrition education through mass and social media is also promoted to improve healthy practices and to generate demand for service uptake.
• Mother and Child Protection Card is the joint initiative of the Ministry of Health & Family welfare and the Ministry of Woman and Child Development which addresses the nutrition concerns in children, pregnant women and lactating mothers.
• Under “Rastriya Bal Swasthya Karyakaram” (RBSK) children of 0 - 18 years of age are screened for selected health conditions classified into 4Ds - Diseases, Deficiencies, Defects and Developmental delays including screening for Severe Acute Mal-nutrition and provides free referral and treatment facilities for identified children.
• The Government is also promoting use of fortified wheat flour, fortified rice, fortified oil and double fortified salt in public funded supplementary nutrition programmes.
All these programs address one or other aspects related to nutrition and have the potential to improve nutritional outcomes in the country.
(d) & (e): The funds allocated to carry out the various activities to curb the malnutrition under POSHAN Abhiyaan (Annexure-I) and RCH flexipool of National Health Mission (Annexure-II) is annexed
Government has set up POSHAN Abhiyaan on 18.12.2017 for a three year time frame commencing from 2017-18. 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 with fixed targets.
The results of the POSHAN Abhiyaan can be known after the programme has completed its approved tenure. However, in the meantime, as per the report of Comprehensive National Nutrition Survey (CNNS) conducted by UNICEF, prevalence of stunting, wasting and underweight among children is 34.7%, 17% and 33.4% respectively, which is a reduction from the levels reported by NFHS-4.
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