Question : Nutritional Status and Deficiencies


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

(a) whether any survey on the nutritional status and nutritional deficiencies especially among women and children in the villages under the National Rural Health Mission (NRHM) was 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 nutritional needs in the Village Health Plan;

(c) the funds allocated, released and utilized along with the achievements made thereunder to overcome malnutrition in the villages under the NRHM during each of the last three years and the current year, State/UT-wise; and

(d) whether the Government proposes to integrate and align the schemes/ programmes of nutrition under NRHM with the National Nutrition Policy in order to adopt a multi-sectoral strategy for achieving optimum nutrition for all and for monitoring the nutrition levels across the country and if so, the details thereof?

Answer given by the minister

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 18TH 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:
Indicators related to Nutrition India
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 2013-14 2014-15 2015-16
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 539.65 325.51 584.99 319.42 328.58 259.86 321.33 94.25
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

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