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Picture Courtesy: The Hindu

Context:

The persistence of infant deaths in Melghat, a tribal-dominated region in Maharashtra, is a complex issue rooted in both systemic and socio-cultural factors. Despite three decades of government interventions, malnutrition and maternal health challenges continue to claim lives among the Korku tribal communities.

What is Malnutrition?

Malnutrition refers to an imbalance in nutrient intake—either deficiencies or excesses—or impaired nutrient utilization in the body. It affects overall health, growth, and development.

• Undernutrition: Insufficient intake of calories or essential nutrients.
• Overnutrition: Excess intake leading to overweight, obesity, and diet-related noncommunicable diseases.

Forms of Malnutrition:

Wasting

• Wasting refers to a condition where a child’s weight is significantly lower than what is expected for their height.
• It usually indicates acute malnutrition, often caused by sudden food shortages, infections, or illnesses that reduce nutrient absorption.
• Wasted children are at a higher risk of mortality because their bodies lack the reserves to fight infections.

Stunting

• Stunting is defined as low height-for-age and reflects chronic malnutrition.
• It develops over a long period due to prolonged inadequate nutrition, repeated infections, or poor maternal health during pregnancy.
• Stunting affects physical growth, cognitive development, school performance, and long-term economic productivity.

Underweight

• Underweight measures low weight-for-age and can reflect both acute and chronic malnutrition.
• It is a composite indicator that may result from wasting, stunting, or a combination of both.
• Underweight children are more vulnerable to illnesses and may experience delayed development and reduced immunity.

Micronutrient Deficiencies

• These occur when essential vitamins and minerals are insufficient in the diet, even if calorie intake is adequate.
• Common deficiencies include iron (causing anemia), iodine (leading to goiter and cognitive delays), and vitamin A (affecting vision and immunity).
• Micronutrient deficiencies can impair growth, weaken immunity, reduce learning ability, and increase susceptibility to infections.

Picture Courtesy: NDTV

Current Status of Malnutrition in India:

• According to the 2025 State of Food Security and Nutrition in the World (SOFI) report, about 12% of India’s population (172 million people) were undernourished in 2024.
• Based on NFHS‑5 (2019–21):
• Stunting (chronic undernutrition):5% of children under five are stunted.
• Wasting (acute malnutrition):3% of children under five are wasted.
• Underweight:1% children (under five) are underweight
• According to UNICEF, 7% of women aged 15–49 is anaemic (around 203 million women).
• According to UNICEF, overweight and obesity are rising across all age groups, including very young children.
• In the 2025 Global Hunger Index (GHI), India has a score of 8, which places it in the “serious” category. Key contributing factors are high child wasting rate, undernourishment, and under‑five mortality.

Key reasons for persistent malnutrition among the children in the tribal population of Melghat:

Severe malnutrition and maternal undernutrition

• Many children are born with low birth weight because mothers enter pregnancy underweight and anaemic.
• Intergenerational malnutrition weakens infants’ immunity, making them highly vulnerable to infections.
• As of November 2024, about 10,000 children in Melghat were suffering from Severe Acute Malnutrition (SAM).

Limited access to healthcare

• Melghat’s hilly terrain and poor road connectivity delay critical medical care.
• Primary healthcare centres (PHCs) and hospitals are insufficient, and multispeciality facilities are slow to upgrade.
• There is a shortage of doctors, particularly paediatricians and gynaecologists, with high absenteeism and staff retention issues.

Fragmented government programmes

• Multiple departments work in silos, resulting in inconsistent delivery of nutrition supplements and irregular monitoring.
• Poor coordination weakens the impact of even well-intended schemes like the hot food programme (eggs and bananas provided four times a week).

Prevalence of co-morbidities

• Many deaths attributed to pneumonia, diarrhoea, anaemia, or sickle cell disease are compounded by malnutrition.
• Untreated infections due to delayed care can rapidly become fatal in malnourished infants.

Socio-cultural factors

• Tribal communities often rely on traditional healers (bhoomkas) rather than modern medical treatment, delaying timely intervention.
• Substance abuse and low awareness of maternal-child healthcare further exacerbate the situation.

Infrastructure and civic deficits

• Poor road maintenance, unreliable electricity, and lack of basic civic facilities hinder both healthcare delivery and community participation.

Government initiatives for tackling malnutrition in India:

Way Forward:

Strengthen Convergence Across Departments: Malnutrition interventions often fail due to fragmented execution. Convergence of health, women & child development, tribal welfare, rural development, and public works departments is critical. Example: In Odisha’s Mission Shakti project, coordination between ICDS, health, and panchayat departments improved supplementary nutrition delivery and growth monitoring, reducing child stunting by 5% in target districts over five years.

Focus on Tribal & Hard-to-Reach Areas: Remote areas like Melghat (Maharashtra) or Jawadhu Hills (Tamil Nadu) face high infant mortality due to geographic isolation. Deploy mobile health units, strengthen village-level Anganwadi centers, and offer incentives for doctors to serve in these regions.

Address Intergenerational Malnutrition: Maternal undernutrition leads to low birth weight and perpetuates malnutrition cycles. Programs must provide pre-pregnancy and antenatal nutrition, including micronutrients. Example: The Anemia Mukt Bharat initiative, coupled with community counselling in Rajasthan, improved maternal hemoglobin levels by 12% over three years, reducing incidence of low-birth-weight babies.

Leverage Technology for Real-Time Monitoring: Growth monitoring, SAM case tracking, and supplementation delivery often fail due to delayed data. Example: The Poshan Tracker in Maharashtra allows tracking of malnourished children at village level; in districts where it is actively used, treatment completion rates for SAM children increased from 60% to 85%.

Conclusion:

Malnutrition in India remains a persistent challenge, especially among children, pregnant women, and tribal communities, due to a combination of undernutrition, micronutrient deficiencies, and socio-economic disparities. Despite multiple government initiatives like POSHAN Abhiyaan, ICDS, and Anemia Mukt Bharat, gaps in implementation, infrastructure, and convergence continue to limit impact. Sustainable progress requires targeted interventions in vulnerable regions, strengthened healthcare and nutrition systems, community engagement, and data-driven monitoring, ensuring that both mothers and children receive timely and adequate nutrition.

Source: The Hindu