Despite being one of India’s most resource-rich states, a paradox has perpetually existed in Jharkhand in the form of child malnutrition. The nutritional status of children in Jharkhand has first shown some improvement post-NFHS-4 on every count. Between the 4 years of NFHS-4 and NFHS-5, the level of stunting has come down: from 45% to 40%. Wasting percentages, too, have decreased between NFHS-4 (29%) and NFHS-5 (22%), as have underweight children from 48% to 39% during the four years between
Despite being one of India’s most resource-rich states, a paradox has perpetually existed in Jharkhand in the form of child malnutrition. The nutritional status of children in Jharkhand has first shown some improvement post-NFHS-4 on every count. Between the 4 years of NFHS-4 and NFHS-5, the level of stunting has come down: from 45% to 40%. Wasting percentages, too, have decreased between NFHS-4 (29%) and NFHS-5 (22%), as have underweight children from 48% to 39% during the four years between NFHS-4 and NFHS-5. Yet, these levels of undernutrition still remain a huge problem. NFHS-5 (2019–21) states that almost one in three infants become wasted within the first 6 months, while around 67% of children and 65% of women are anaemic. The situation is most severe in tribal-populated districts like West Singhbhum, Dumka, and Godda, where poverty, poor maternal health, and an irresolute health system collectively augment deprivation.
During our field visit earlier this year to Murum, a village in the Kanke subdivision of Ranchi district, the reality of Jharkhand’s malnutrition crisis was palpable. Located barely five kilometres from the sub-district headquarters, Murum shows how deprivation persists even in areas close to administrative centres. Families spoke of diets dominated by rice with little protein or vegetables, frequent bouts of diarrhoea linked to unsafe water, and non-functional toilets that forced them back to open defecation despite official claims of ODF status. The local anganwadi centre operated in a cramped space, with irregular supply of nutrition supplements, leaving mothers anxious yet resigned about their children’s frail health. Here, malnutrition was not an isolated medical condition, but a lived reality.
As per the National Family Health Survey-5 (NFHS-5, 2019–21), about 40% of children under five in Jharkhand are stunted, 22% wasted, including more than 9% severely wasted, and 39% underweight, all of which are far more than the national averages of 35.5%, 19.3%, 32.1%, and 7.7%, respectively, for severe wasting. Anaemia plagues about 67% of children and 65% of women. The statistics are far from being coincidental; rather, those are anticipated results of structural deprivation. While undernutrition trends have witnessed a downslide from NFHS-2 through NFHS-5, the slow pace defines the existing challenge, which alerts the pressing need for stronger intervention to address child malnutrition and its social determinants.
The phase-wise approach has been taken by Jharkhand to address child malnutrition in six districts, namely: West Singhbhum, Godda, Sahibganj, Simdega, Chatra, and Latehar, states the report of NITI Aayog, Transforming Child Nutrition: State-Level Approaches and Practices for Community-Based Comprehensive Care and Management of Acute Malnutrition. Some of the innovative interventions highlighted by the report include Johar Poshan in West Singhbhum, launched on March 31, 2021, to improvise child nutrition through community engagement and awareness. On December 29, 2021, SAAMAR (State Action for Addressing Malnutrition and Advancing Resilience) was launched as a complementary program to develop a comprehensive framework through which children can be identified and treated for undernourishment, and, at the same time, communities can be enabled to take ownership of nutrition-related solutions in their areas. Through these programmes, health workers, self-help groups, and community platforms such as gram sabhas and village health, sanitation, and nutrition days offer both food and medical support and simultaneously raise awareness on dietary diversity, anaemia, breastfeeding, and hygiene practices.
The persistence of malnutrition in Jharkhand is not only about food scarcity but also about entrenched poverty and gender inequality. According to the NITI Aayog Multidimensional Poverty Index, 2021, Jharkhand ranked among the poorest states, with nearly 42.16% of its population identified as multidimensionally poor. This translates into low dietary diversity, limited access to health care, and restricted agency for women in making nutritional decisions. Low female literacy compounds the problem as mothers are unable to access or process health information often delaying treatment, and young girls themselves grow up malnourished before entering motherhood, perpetuating the cycle.
The POSHAN/International Food Policy Research Institute (IFPRI) State Nutrition Profile for Jharkhand in its report stated that only about one-third (33%) of women in the state have ten or more years of schooling, just 57% of households use improved sanitation, and only about 10% of children aged 6–23 months receive an adequate diet.
Oscar Lewis, in his theory of the Culture of Poverty, argued that scarcity shapes not only material deprivation but also social expectations. Families accustomed to low-quality diets or irregular food intake normalise undernutrition as part of life. As Abhijit Banerjee and Esther Duflo emphasised in their book Poor Economics, poor households often prioritise short-term survival choices over long-term nutritional investments, not out of ignorance but as rational decisions in a context of chronic uncertainty.
The NITI Aayog- UNICEF Transforming Nutrition in India: Community Management of Acute Malnutrition (CMAM) in its report stated that around 80% of children with Severe Acute Malnutrition (SAM) who have no medical complications can be treated in their communities through outpatient care, therapeutic feeding, and regular counselling. Jharkhand’s SAAMAR (Strategic Action for Alleviation of Malnutrition and Anaemia Reduction) campaign has incorporated these approaches, including appetite tests during VHSNC (Village Health Sanitation and Nutrition Committee) days, standardised antibiotic and micronutrient protocols, and counselling in tribal languages.
Shishu Shakti, a locally developed nutrition mix, has emerged as a hopeful intervention in such a gloomy backdrop. A recent study by the department of community medicine, RIMS Ranchi, in its field trial report, stated that 78% of the severely malnourished children of Chakradharpur block of West Singhbhum in their investigation recovered after the administration of Shishu Shakti between January and May 2025-a recovery rate of almost double compared to conventional nutrition protocols. Made of ragi, wheat, gram, peanuts, milk powder, and soya oil, the mix is an energy-dense, protein-rich nutrition supplement, and culturally acceptable, standing out as a very rare example of innovation based on local food systems.
The Constitutional Amendment 73rd (1992) empowered Panchayati Raj Institutions to handle health, nutrition, and sanitation at the village level. Yet most of the gram panchayats in Jharkhand remain under-resourced and under-utilised in the true sense. The village health and sanitation committees, which are to prepare a health plan every year, in most cases exist only on paper. This might have transformative implications if one were to envisage functioning of Panchayats more as healthy governance units. Providing them with budgets, technical learnings and training would enable him or her to design context responsive intervention for example mapping of malnourished children, ensuring local water supply, or monitoring anganwadi food quality. While important, innovations like Shishu Shakti are not a trade-off for systemic reform. Fighting malnutrition requires an abandonment of piecemeal schemes in favour of a model of governance integrating food security, health, sanitation and education. Malnutrition is not a medical, but a societal issue
The Supreme Court has progressively expanded the ambit of Article 21 to include the Right to Food, read with Articles 39(a) and 47. People’s Union for Civil Liberties v. Union of India (2004) 12 SCC 108, W.P. (C) No. 196/2001 institutionalised the Right to Food through continuing mandamus and directed the State to operationalise schemes such as ICDS, Mid-Day Meals, and Public Distribution System against hunger and malnutrition. It has thus fully converted the Right to Food from a principle into a justiciable entitlement and since then stands as the cornerstone of India's constitutional law on malnutrition. Shishu Shakti has proved what locally adapted, scientifically justified, and culturally appropriate interventions can achieve. Unless reinforced by enduring structural reforms in areas of poverty mitigation, gender equality, sanitation, and health governance, it will probably remain yet another isolated success story in a field rife with neglect. Malnutrition in Jharkhand is beyond being an issue of calories, it is an issue concerning justice, dignity, and the immediate need to transition from schemes to rights.
This article is authored by Jisu Ketan Pattanaik, assistant professor, sociology and Sumit Kumar Singh, research assistant, National University of Study and Research in Law, Ranchi.
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