Framework for enhancing maternal nutrition: addressing under nutrition in tribal children inhabiting Central India

Abstract

Our world is transitioning into a new generation of governance with much greater emphasis on targeted actions and mission mode programmes to achieve global sustainable goals (SDG). India with its Twenty-point programme which directly maps national and state programmes to global SDGs has been pacing up for 2030 targets. One of the major programmes that has been the prime focus is Integrated Child Development Services Scheme. India ranked 103^rd among 119 countries on global hunger index, 2018. Significant reduction in malnutrition was seen among children below 6 years but the pace of reduction has been slow over the past decade. The path of malnutrition reduction of central belt states (tribal population dominant) deviates from rest of the country.

Our analysis of National Family Health Survey-4 (NFHS) found that 42% of tribal children are underweight (i.e. 1.5 times higher than non-tribal children), over 50% of prevalence of malnutrition is in tribal population. 100% Mother & Child Protection registration do not reciprocate to 100% all Anti-Natal Care visits showing faults in monitoring system indicating that the investment by government in all fronts, economic development has not translated into desired reduction in malnutrition. Their 8.6% population accounts to 30% cases of malaria translating to 50% malarial deaths indicative of higher disease burden. Malnutrition crisis among tribals begins way early manifesting in higher rates of Low Birth Weight deliveries (LBW) which is 3–4% higher compared to non-tribal population. This is due to low nutrient diet, laborious work during gestational period and high disease burden.

The focus of Maternal nutrition enhancement projects by Tribal Welfare Depts in these states should include nutrition sensitive along with nutrition specific interventions targeting the population under risk as well as entering risk. Now with district level data (NFHS) available every 4 years can aid in district level planning, shifting focus from population based to prevalence and exclusive planning for tribals. Our study involves developing a robust framework to enhance maternal nutrition through strong community mobilization and partnership. It also addresses the convergence issue being faced in the current system and paves a way forward for convergence among inter departmental schemes for larger participation by people and greater coverage of the scheme and its benefits.