Tribal malnutrition: India’s hidden epidemic
Despite constitutional protection, positive discrimination policies and earmarked budgets, India’s 104 million tribal people remain among the poorest and most nutritionally deprived social groups. In 2005-06, 54% of tribal children under five years of age were stunted, which is a measure of chronic undernutrition; this is well above the national average of 48%. Studies carried out between 2006 and 2013 in different states reveal that the percentage of tribal children who are stunted remains stubbornly high at above 50%.
Though deaths due to undernutrition among these children are hardly uncommon, only a few catch the headlines. This situation is a reflection of multiple deprivations that the tribal population has faced over the years. Poverty rates among tribals are high (at 47% in rural areas and 30% in urban areas) and nearly every second tribal family is food-insecure, with low caloric and protein consumption 25% to 53% below the recommended dietary allowance.
There is also government commitment to address the existing inequities: Starting from the fifth five-year plan (1974-75), a separate tribal sub-plan (TSP) within the umbrella of the overall state plan provides need-based funds for tribal-dominated administrative blocks. However, most TSP items are focused on infrastructure with limited attention to interventions that address nutrition. Most state and central ministries plans do not apportion funds for TSP as per the schedule tribe proportion. Even when it is done, the apportioning lacks prioritisation, purpose or tracking of allocation usage. To this end, the question remains whether these investments are leading to improvements in the nutrition status of tribal children.
The consequences of chronic under-nutrition are irreversible and lifelong. At least 45% of child mortality is attributable to poor nutrition. Those who survive have impaired physical and mental development and are likely to do poorly in academics and grow up to be unhealthy, less economically productive adults.
It is clear that improving the ‘nutrition of tribal children’ needs to become the heart of the equity agenda cutting across departments for significant and sustained impact. First, civil society and faith-based organisations should be involved to generate community demand to reach out to mothers with information, counselling and support on a periodic basis.
Second, the statistical profile of scheduled tribes needs to be available and used to inform policy programme decisions and scope of the National Nutrition Monitoring Bureau tribal nutrition surveys. Third, addressing undernutrition should focus on scaling up proven nutrition interventions during the first 1,000 days of life, improving livelihoods, increasing access to essential nutrition services, as well as enhancing tribal leadership for sustained results.
Finally, vigilance against limited legislative enforcement is paramount to address the core reasons fuelling persisting poverty and hunger.
Accelerating multi-sectoral commitments for improving the nutrition of India’s tribal children is a moral imperative. This calls for a rethinking on differential programming strategies, budget and government accountability mechanisms where tribal communities are not just informants but partners and influencers of change.
Louis-Georges Arsenault is country representative, Unicef India
The views expressed by the author are personal