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Malnutrition continues to grip the nation, with its disproportionate impact concentrated among socioeconomically disadvantaged groups, particularly indigenous populations
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This essay is part of the series: World Health Day 2025: Healthy Beginnings, Hopeful Futures
Malnutrition is a leading risk factor for mortality in children under the age of five. Malnourished children have a higher risk of mortality from common childhood illnesses such as diarrhoea, pneumonia, and malaria. Globally, nutrition-related factors contribute to about 45 percent of deaths in under-5 children In India, malnutrition accounts for 68.2 percent of the total under-5 deaths and is attributable to 67·1 percent of the total Disability-Adjusted Life Years (DALYs) in under-5 children. The first two years of life are the “critical window” for the promotion of growth, health, and behavioural and cognitive development. A wealth of studies indicates links between optimal infant and young child feeding practices (IYCF) such as exclusive breastfeeding for six months followed by age-appropriate complementary feeding practices and nutrition outcomes in children. It is believed to prevent almost one-fifth of deaths in under-5 children.
Infant and young child feeding practices in these communities report prolonged breastfeeding practices together with insufficient quantities and inadequate quality of complementary foods which are the direct risk factors for undernutrition among tribal children.
In India, there is a substantial intra and inter-state heterogeneity in the prevalence of child malnutrition with poor nutrition indicators in several individual districts often masked due to better indicators in other districts. This disproportionate burden is clustered within socioeconomically disadvantaged groups such as the indigenous populations with a staggering stunting prevalence of 40.9 percent in children belonging to Scheduled Tribes. Factors such as geographic isolation, poor access to healthcare facilities, illiteracy, seasonal food insecurity and concurrent morbidity due to lack of sanitation and hygiene often lead to poor health and nutrition outcomes in tribal communities. Infant and young child feeding practices in these communities report prolonged breastfeeding practices together with insufficient quantities and inadequate quality of complementary foods which are the direct risk factors for undernutrition among tribal children.
According to the Census (2011), around 104 million tribal people are spread across 705 tribes and constitute 8.6 percent of India’s population. With 32 different tribes making up about 26.3 percent of the state's total population, the central-eastern state of Jharkhand is endowed with the richest biodiversity in the country. The indigenous communities in the state have traditional ecological knowledge about their natural environment and food sources which are local and have the potential to improve diet quality through dietary diversity. Despite this, Jharkhand reports high child malnutrition prevalence with child wasting, stunting, and undernutrition at 22.4 percent, 39.6 percent, and 39.4 percent, respectively. As part of a larger study, the indigenous food systems of tribal communities of Jharkhand including the Sauria Paharias—one of the particularly vulnerable tribal groups (PVTGs)—were explored. After systematically documenting the indigenous foods of the Sauria Paharia tribal community, the role of these foods in dietary diversity among children was analysed. Information on the IYCF practices, dietary diversity and nutritional status of the children along with household-level information in this community was gathered by visiting 194 households with children in the age group of six months to five years (n=72, 6 months to 2 years; n= 122, 3-5 years) in 18 villages in Godda district of Jharkhand.
After systematically documenting the indigenous foods of the Sauria Paharia tribal community, the role of these foods in dietary diversity among children was analysed.
The community was aware of more than 190 indigenous foods with over 10 rice varieties, 35 varieties of GLVs, 30 edible wild mushrooms, 19 varieties of wild fruits, 20 tuber varieties and 40 varieties of flesh foods. However, only 50 percent of these were routinely consumed at the household level. Many of these IFs were rich in micronutrients like calcium, iron, zinc, folic acid, vitamin A, and vitamin C.
The IYCF practices revealed that nearly all children in the age range of six months to 24 months, (98 percent) were ever breastfed; early initiation of breastfeeding was reported in 65 percent; pre-lacteals were reported in around a fourth; colostrum feeding was reported in 81 percent of the children. The optimal practice of exclusive breastfeeding for six months was reported only in 31 percent of children, however, extended exclusive breastfeeding beyond 6 months was practised in 53.8 percent of these children. Complementary feeding practices also showed significant gaps. Only 27 percent of the children received solid, semi-solid, or soft foods at six months of age. While another 25 percent received complementary feeding between seven to nine months. A dietary survey during the rainy season highlighted that only 7 percent of children aged 6–23 months achieved the minimum dietary diversity[1] (consuming food from at least five food groups). The mean dietary diversity score[2] (DDS) was 3 ± 1.22. The minimum meal frequency[3] (MMF) was met by only 7 percent of children, with a mean MMF of 1 ± 0.85. The proportion of children receiving a minimum acceptable diet[4] (MAD), which accounts for both dietary diversity and meal frequency, was alarmingly low wherein only two children were fed a minimum acceptable diet. Around one-third of the children received indigenous foods are part of their complementary feeding. The consumption of unhealthy foods high in salt, sugar, and fat was high. Around 91.7 percent of children consumed unhealthy snacks such as chips, biscuits, cakes, and traditional but commercial fried foods was also there on the previous day of dietary recall. The intake of nutrient-rich foods such as eggs and flesh foods was critically low, with only 6.9% (n=5) of children consuming them on the previous day of dietary recall. Along with the poor dietary diversity, diets lacked vegetables and fruits, with 36.1 percent of children not consuming any fruits or vegetables on the previous day and around a third of children aged 6–23 months consuming indigenous foods.
The optimal practice of exclusive breastfeeding for six months was reported only in 31 percent of children, however, extended exclusive breastfeeding beyond 6 months was practised in 53.8 percent of these children.
The nutritional status assessment using anthropometric measurements revealed a high prevalence of malnutrition with around 57 percent of children (6 months to 5 years) being underweight, 26 percent wasted and 53 percent stunted.
The IYCF practices, especially the complementary feeding of children in the age range of 6 months to 23 months in the Sauria Paharia community, were suboptimal. This was reflected in their poor nutritional status. The utilisation of traditional ecological knowledge on indigenous food systems and enhancing their access through training, motivation and aspiration to grow and procure nutrient-rich local indigenous foods is critical. The provision of nutrition education on the importance of dietary diversification and optimal IYCF practices with a focus on timely, diverse and adequate complementary feeding utilizing nutrient-rich local foods has the potential to enhance the nutritional quality of diets of children in this community, thereby enhancing the micronutrient intake. A sustained effort towards promoting the production, procurement and consumption of local indigenous foods with nutrition education and counselling can go a long way in addressing nutrition security in children of the Sauria Paharia community.
Suparna Ghosh-Jerath is a nutritionist by training and has more than 28 years of experience as a clinical, academic, and research nutritionist.
[1] percentage of children 6–23 months of age who consumed foods and beverages from at least five out of eight defined food groups during the previous day.
[2] variety of food groups consumed by a child during the previous day, serving as a proxy indicator for nutritional adequacy and diet quality
[3] percentage of children 6–23 months of age who consumed solid, semi-solid or soft at least the minimum number of times during the previous day.
[4] percentage of children 6–23 months of age who received at least the minimum dietary diversity and minimum meal frequency for their age during the previous day
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Dr Suparna is a nutritionist by training and has more than 28 years of experience as a clinical, academic, and research nutritionist. At The George ...
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