Abstract

Nutrition and health are important for everyone, but they are especially significant for children as it is directly linked to their growth and development; factors which will have a direct impact on their health as adults. Nutrition and the health of the children of the age group 0–5 years is an important focus area as onset malnutrition at this stage can have long term and long-lasting repercussions. Children are particularly vulnerable to malnutrition in the first two years of their life. If proper care is taken, these two years can become window of opportunity for tackling poor health and nutritional status of the children. Children belonging to the marginalized sections like Dalits and Tribes are especially vulnerable to poor nutritional and health status. This study was an attempt to assess the various factors which may be directly or indirectly influencing the nutritional health status of the study population in the study area.

Introduction

Malnutrition has been defined as “a pathological state resulting from a relative or absolute deficiency or excess of one or more essential nutrients.” It consists of four forms: Under- nutrition, Over-nutrition, Imbalance and the Specific Deficiency (Srilakshmi, 2006). It is, therefore, one of the major public, administrative challenges faced by most of the developing nations. Malnutrition is serious and one of the major concerning issues in the public and administrative space of the developing countries and is the underlying cause of the death of around half out of the ten to eleven million children every year under six years of age. The latest HUNGAMA Report (2012) released says ‘every third malnourished child on the planet is an Indian’. The report is said to have represent the first statistically valid study on malnutrition since 2006 and the data in the report covers vast portion of the Indian villages and the children of the 100 poorest districts (defined by the UNICEF in 2009) called the 100 Focus Districts. In study, majority of the children under five years of age were underweight and were stunted. India’s Global Hunger Index (GHI, 2009) score on malnutrition says that India has the largest number of stunted, wasted and underweight children in the world with twelve Indian states having ‘alarming’ level, and the condition of Madhya Pradesh, known as the heart state of India, is ‘extremely alarming’ and is same also according to the Indian State Hunger Index (IFPRI) and received a severity rating between Ethiopia and Chad.

With the above issues, and the importance for study of the nutritional health status of the tribal children, the present paper shows important factors related to the issue of the nutritional health status of the tribal children. The study was conducted To understand the Socio-economic, demographic, cultural practices of the study population., to understand the nutritional status of the study population, To understand the health care services availability and utilization of the study population, to understand various programs (ICDS, PDS, Mid-Day Meals, and NREGA) related to the present study in the study area, to evolve appropriate strategies related to the programs and policy implementation for the welfare of the population of the study area.

Laying the Frame and Context of the Study

Maharashtra (Abbreviated as MH) is a state in the western region of India and is the nations and also the world’s second–most populous sub–national entity. It has over 110 million inhabitants and its capital, Mumbai, has a population of approximately 18 million. Mumbai is also the financial capital of the nation and the headquarters of all major banks, financial institutions and insurance companies in the country. India‘s Hindi film industry, Bollywood, and Marathi film and television industry are also located in this state. Maharashtra‘s business opportunities along with its potential to offer a higher standard of living attract migrants from all over India.

Nandurbar

Nandurbar (मराठी: नंदुरबार) was a larger part of Dhule before 1^st July, 1998. Earlier in 1906, Dhule, Jalgaon and Nandurbar districts together formed what was known as Khandesh District. Later from administrative point of view, Khandesh was bifurcated into West and East Khandesh. According to some followers, Khandesh means the country of Lord Krishna. Later on, 1^st July, 1998 Dhule district was bifurcated into new districts viz. Dhule and Nandurbar. Nandurbar, which is also known as Nandanagri, which is named after the ruler of the territory, Nandaraja. Nandurbar is located in the North-west side of Maharashtra state. The district headquarters of Nandurbar district is Nandurbar. This district is bounded to the south and south-east by the Dhule district, the west and the north by Gujarat state and the north and north-east by the state of Madhya Pradesh. The northern boundary of the district is defined by the great Narmada River.

The District Nandurbar is newly formed from the district Dhule. It came into existence with effect from 1st July 1998. Headquarter of this district is Nandurbar itself. The ancient name of this region was Rasika. Later under the Yadavas, it was called as Seunadesa after king Seunachandra who ruled over it. With the advent of Muslims, the name was changed to Khandesh to suit the title Khan given to the Faruki Kings. The entire area of Khandesh included two-district viz., Dhule and Jalgaon and was administered as one district with headquarters at Dhule. However, in 1906 for administrative purposes the Khandesh was divided into two districts known as west Khandesh and East Khandesh.

In the year 1950, a new Tahsil Akkalkuwa was created and with the reorganization of states in 1956, the region was included in Bombay State and subsequently i.e. in 1960 it became a part of Maharashtra state. While doing so, 38 villages, each from Nandurbar and Nawapur tahsils, 43 villages from Taloda and 37 villages from Akkalkuwa tahsils were transferred to Gujarat State. In 1971 Census, Akrani Mahal was upgraded as Akrani Tahsil. In 1961, the name of the district was changed from west Khandesh to Dhulia and later on to Dhule district with Dhule as its headquarters. In July 1998, after creation of Nandurbar district, 6 Tahsils comprising of 933 villages were transferred to Nandurbar district.

Nandurbar district consists of six tahsils viz. Akkalkuwa, Akrani, Taloda, Shahada, Nandurbar and Nawapur. There were 930 villages in 1991 Census, which rose to 947 with 17 new villages in 2001 Census. In 2011 census, the number of villages decreased to 943.

Demographics of Nandurbar

In 2011, Nandurbar had population of 1,648,295 of which male and female were 833,170 and 815,125 respectively. In 2001 census, Nandurbar had a population of 1,311,709 of which males were 663,511 and 648,198 were females. Nandurbar District population constituted 1.47% of total Maharashtra population. In 2001 census, this figure for Nandurbar District was at 1.35% of Maharashtra population. There was change of 25.66 percent in the population compared to population as per 2001. In the previous census of India 2001, Nandurbar District recorded increase of 23.45 percent to its population compared to 1991. 

Taloda

Nandurbar has six blocks and area-wise Taloda is the smallest block in the district. It is surrounded in the north by Akkalkuwa, Akrani and Shahada blocks and the south border touches the state of Gujarat. It has mountainous range of Satpura on its north and the river Tapi on the southern side. King Shivaji, 5^th January, 1664, attacked the wealthy port city Surat of the Mughal Empire. The attack was very sudden and the populated city of Surat was burned down. On their journey to sack this city, the forces halted at the banks of the Tapi River. The unique identity and the name to this block were derived from this significant event. It was known as the place of halt. (Tal in Marathi means a place of halt).

The People

Religion and Tribe: There are two main tribes in the study area viz. Bhills and Pawra. Majority of the tribal population belong to Hindu religion however a small portion of tribal population follow Christianity. Few of the families also follow Islam and Buddhism.

Language: Bhili is the most commonly used dialect among the tribal population. Ahirani, Marathi, Hindi, Bhilori, Pawri, Gujjar are next most commonly used languages among the people.

Dressing: The women of the Pawra tribe drape one-piece sari called Nathi also known as Ek Vaar Saree (एकवार साडी) while the women of the Bhil tribe drape a three-piece sari (तीनवार साडी). They wear heavy ornaments made of silver. These ornaments are given to the women after marriage as bride price. These also symbolizes that the women are married. Men usually wear Dhoti with Kurta. Young girls’ wear skirts. Young boys are seen with pants and shirts. Newly married women wear saree different from their traditional attire. We can see a modern saree dressing attire in the newly married women.

Marriages: Both, Bhil and Pawra, tribal groups perform the same marriage practices. The people of this region practice both arranged and love marriages. Women and men are both allowed to decide her or his own spouse. In the Bhil community, this practice still persists. However, other tribal sub groups do not follow this old tradition and the selection of the bride is often done by the groom or his family.

Arranged Marriages: The arranged marriages are arranged by the elders of the family and the panch (पंच) of the villages. Panchs are elderly members of the village community. They are 5-7 panchs in one village. The panch are always men. No women are made panchs. While making the decision of the marriage, the opinion of the women is also taken into consideration. The elders and the panch decide the bride price. This decision over the bride price in front of the panch is considered to be final and no more negotiation will be held over it. Arranged marriages are held according to their tradition. There are inter tribe marriages and marriages between Bhill and Pawra tribe are accepted by the community. There is no difference in marriage ceremonies between both these tribes. The only difference is in the amount of bride price. Bhil tribes have a lesser bride price as compared to the Pawra tribe. The marriage date is fixed on any day convenient to both families, however Saturday and Sunday are not preferred. Caution is taken that the marriage date does not clash with another marriage in the village. The marriage is at the bride’s place normally in front of the house. The marriage ceremonies continue till three days. These marriages are not registered in the court.

Love marriages: This is self-selected type of marriage. In this type of marriage, both boy and girl like each other and decide to stay together. This is known as elopement. The couple elopes to another village and begins a family. Later, the groom’s father gives bride price to the bride’s father. Later, after one or two years the couple returns back to their village. There is no separate marriage ceremony for this couple. They are accepted as a married couple by the community. When any marriage function is celebrated in the family this couple participates in every ceremony.

Marriage Ceremony Process: The elders of both the families fix a date for ‘Sakhar Puda’ (साखरपुडा) (Engagement, a pre-marital ceremony). After this ritual, the marriage date is fixed by the elders. It is during this time when the ‘Panch’ (members of the village panchayat) of the village sit together and decide the bride money. The bride’s money is given to the bride by the groom on the day of Sakhar Puda. However, the Panch (पंच) of the village do not have any say on the selection of the bride. It is a complete decision of the groom or his family. Nevertheless, Love marriages are the most common way of marriages taking place. In the case of arrange marriage, the selection or rejection of the bride is notified by the elder family members. In either case, the permission of the bride is sought before the marriage. The marriage dates are selected with the preference so as to avoid coinciding with another marriage in the village. The marriages take place in front of the bride’s house. It is a ceremony for three days. The first day of the ceremony is called the Haldi ceremony which is followed by the morning breakfast to the guests. This ceremony is given the most importance. After the puja (worship), ‘Haldi’ (turmeric) is applied to the couple. With the use of ‘Peepal’ (Ficusreligiosa) leaves, the Haldi is first applied to bride by an unmarried girl aged 8 to 9 years old. Any couple who did not celebrate this function would finally be applied Haldi only at her/his day of last rights. If there is any couple in the family who had love marriage and did not celebrate this ceremony, participates in this ceremony. The turmeric is not special, but purchased from the market.

When the husband of a woman passes away, the woman has the choice to remarry. She can continue staying at with her mother-in-law or move back to her mother’s house. The decision here is totally bestowed upon the woman. The remarriages do not undergo any marital ceremonies. Instead the new couple can stay together. In some cases, the bride pays some amount to the groom. One of the most important folk dances ‘Gondhal’ (गोंधळ) which is believed to be performed during the auspicious occasions to make life less chaotic. This folk dance is performed in their marriages. They also have ‘Dhol’ (ढोल) (drums) in their ceremony. Participation of women is these dances are always encouraged. Entire village is invited for the marriage.

The invitation cards are sent by hands of the family member to the entire village. The food during the marriages is quite normal and simple. During marriages they serve vegetarian food, as marriage is considered to be an auspicious event. After five days of the marriage the girl comes back to her natal home for five days.

The newly wedded bride enjoys the freedom of mobility within the village but however to travel to another village it is imperative to be accompanied by her husband or mother-in-law. A woman is accompanied to places unless she becomes a mother and later enjoys the freedom of mobility.

Mobility of the Women in the community: A newly married woman does not enjoy all the freedom in her marital home. Her mobility is restricted and she is accompanied by marital family members if needed to travel either within the village or outside the village. She is restricted to travel by her own. Usually, husband or mother-in-law will be the one to accompany her while travelling. When the newly married woman becomes a mother, she starts to gain her freedom over mobility within the village and nearby places. However, she will be accompanied by her husband to travel long distances.

Gods and Festivals: Adivasis possesses a unique culture of their own. This ranges from their pantheon of gods – Hirva, Vaghoba, Gaondevi to name a few – to rituals and the celebration of festivals. While traditional Hindu festivals such as Ganesh Utsav, Dassehra and Holi are celebrated in a unique fashion. Ganesh Utsav is celebrated by men, women and children dancing together in circular formulation and singing songs relating to everyday life. The sun, the rain, the animals and so on, reflecting the survival of animism among this indigenous community. Animism is sociological term for indigenous people’s nature worshiping life style. It is interesting to note that there is little connection with the occasion per se which celebrates Rama’s victory over Ravana in battle. This phenomenon seems to symbolize a singular adaptation of tradition with modern religious influence.

Acculturation: Acculturation, the processes of change in artefacts, customs, and beliefs that result from the contact of two or more cultures. The term is also used to refer to the results of such changes. (The Editors of Encyclopedia Britannica, 2008). Acculturation is direct change of one’s culture through dominance over another’s culture through either military or political conquest. At the group level, acculturation often results in changes to culture, customs and social institutions. Noticeable effects of group level acculturation often include changes in dressing, food and language. At the individual level, differences in the way individual acculturate have been shown to be associated not just with changes in daily behaviour, but with numerous measures of psychological and physical well-being. Thus, acculturation means adopting practices of the social groups who are in a higher position so as to get accepted by those groups. The tribals have adopted certain practices from the non-tribal society which has led to a meeting of these two societies culturally, socially.

Agriculture and livelihood

Agriculture is main occupation in this region. The area of Taloda taluka is 34320 hectares out of which 5158 hectares belong to forest. Agricultural land is 7012 hectares. Rice, Wheat, Jowar, Maize and pulses are the main crops cultivated in this taluka.

The Community

Nandurbar district is one of the most populated districts of the Adivasi (Scheduled Tribe) community in the Konkan region of Maharashtra. The Adivasis who are present are the Thakars, Mahadev Koli while the Katkaris are also prominent in the region. These tribes are concentrated in different parts of the district. There is a hierarchy of tribes, but this hierarchy is ambiguous and may not be accepted by a particular tribe in question. In Nandurbar district particularly, the tribal community is often characterized by mutual mistrust. Thakars believe themselves to be superior to Katkaris but Katkaris believe that they are not dominated by any other community. This may happen because the community is polarized along political lines in several villages, where the Kunbi upper strata land owing community also one of the dominant social groups.

Economic Status: The community suffers from a high degree of economic deprivation. Single season subsistence agriculture is the norm, with the second season being taken up by migration to brick-kilns and other sorts of daily wage work. This is despite the fact that the region receives plentiful rainfall in the monsoon. Unfortunately, the absence of rainwater harvesting methods means that rainwater goes waste and water sources dry up by January-February. They are a landless community and depend upon labouring in the farms of land owner tribal as well as those of non-tribal in nearby villages. This migration could be categorized as daily migration as they have to go in search of employment in nearby villages to get work and the two square meals a day. Alcoholism is high in the community, also the consumption of tobacco.

Political Situation: The Indian National Congress Party, Bhartiya Janata Party (BJP) and Shiv Sena are the major influential parties in the area. Following the results of the General Elections in India and Maharashtra in 2014, there has been a tremendous decline and rise in the Indian National Congress Party and the Bhartiya Janata Party (BJP) respectively. However, in spite of these factors, the social-political rivalry does not arise from ideological commitment; party loyalty is dictated by personal gain more than anything else.

Epistemological Considerations

The study area of research is the Taloda Block. It has a substantial tribal population. There are two main tribes in the study area viz. Bhills and Pawra. These are the tribes which have been subjugated for long time in the past and that they are not having access to the resources, facilities make it crucial to study them.

The hamlets where the study is conducted are tribal hamlet. All residents of the village belong to the Bhill Tribe and are followers of Hindu religion. In spite of being in proximity to a city like Nandurbar, the area is still underdeveloped in plethora of aspects. The people are illiterate, landless, unemployed residents. The Tribal Community is one of the marginalized sections of the society and Tribal Children are further vulnerable. Any nation develops when the population of the age group 15-59 is developed physically and psychologically. The process of this development starts right at a very tender age. In this, Nutrition plays an important role of development of the Child. However, there are many children who are affected by the issues of nutrition. There are two types of malnutrition viz. Over-nutrition and under-nutrition. Also, it becomes essential to understand why children were selected. As per international standards, there are five vulnerable groups in any society viz. Children, Adolescent Girls, Pregnant Mothers, Lactating Mothers and Elderly People. Out of them, Children are the foundations of the future development of the society. Therefore, it becomes essential to select and study Children. The rural area faces the grave problem of Malnutrition due to several factors. Also, there is very little awareness regarding Malnutrition in the rural area.

Are the schemes and programs being implemented is the crucial question? Also, there is very less availability of the medical services in the rural area. Therefore, the study of Tribal Malnutrition becomes extremely essential.

Purposive sampling technique was used for the study due to time constraint. A house to house survey was conducted in Taloda Taluka in Nandurbar district of Maharashtra. Mothers who have children less than or equal to 5 years of age are taken as respondents for the study. Sample size of 200 mothers was interviewed for socio-economic, health, nutritional and cultural information. Anthropometric measurements of 200 children were taken. The youngest child under the above-mentioned age group of the family was considered as the sample. A structure interview schedule was prepared for the respondents. A focus group discussion guide was also prepared for discussion between two separate groups viz. the women who were illiterate and mothers who had taken formal education. Focus group discussion aimed to understand the impact of mother’s child care experience on child’s nutritional status and health. Open ended interviews were done with key informants in the village. Along with this, information of various cultural practices has been collected from village elders. The quantitative data has been analyzed by using the Statistical Package for Social Sciences (SPSS). Anthropometric Measurements were used wherein the height and body weight of the child was recorded. For measuring weight, standard weighing machines were used; for height, standard measurement tape and scale were used.

HEALTH STATUS: THE CONCRETE CONDITION

In this chapter, the issues and information about the health care services in the study area are discussed. This part predominantly deals with the medical and health care services in the area. Here, the researcher probes about the sex of the child, age of the child, birth order of the child, Vaccination details, Questions regarding the delivery of the child, illness of the child, treatment given during the child was ill etc. Also, questions regarding the various health care institutions were also asked.

Ante Natal Care Visits for the Mother: All the respondents have availed the facility of Ante Natal Care. It was also confirmed from the ASHA Worker that all the mothers had Ante Natal Care Visits.

Tetanus Shots: All the respondents received Tetanus Shots. This happened due to the constant check by the Anganwadi worker whenever the delivery took place.

Iron and Folic Acid Tablets: All the respondents (100.0%) have consumed Iron and Folic Acid Tablets during the pregnancy of the child.

Vaccination of the Child: All the Children are vaccinated. There is a 100.0% vaccination.

Place of Child Birth: There were four places where the deliveries took place viz. Home, Sub center, PHC and District Hospital. The majority of the deliveries (61.50%) took place at home followed by (22.00%) of the deliveries took place at sub-center while (09.00%) at PHC, (07.50%) at District Hospital in Nandurbar. Data on place of delivery reveals that majority of the births (61.50%) took place in Home. This shows that there are large numbers of non-institutionalized deliveries. Non-institutionalized deliveries are dangerous for both the mother as well as the child. Poor sanitation and hygiene, use of unsterilized equipments and medically untrained persons make non-institutionalized deliveries highly dangerous. This data implies that one needs to push for the awareness about institutionalized deliveries and avoid deliveries taking place at home.

Table 1: Place of Delivery

Non-institutionalized deliveries are dangerous for both the mother as well as the child. Poor sanitation and hygiene, use of unsterilized equipments and medically untrained or inadequately trained persons make non-institutionalized deliveries highly dangerous. Chances of Tetanus and sepsis drastically increase in such scenario. This data implies that one needs to push for the awareness about institutionalized deliveries and avoid deliveries taking place at home.

Type of Delivery: All the deliveries were Normal Deliveries. No Caesarean was observed

Health Personnel Assisted in Delivery of the Child: Deliveries assisted by trained medical professionals are essential for the safety of the mother and child. From the Table (5.2), it can be seen that there was a range in response given by the respondents on the question of who assisted them in their deliveries. As most of the deliveries took place at home, the traditional birth assistant, also known as Dai in the local language, was the one to assist. In all, 61.50% deliveries took place where Dai was the assistant during the time of delivery. In addition, there were (31.00%) deliveries where Auxiliary Nurse Midwife (ANM) was the assistant during the delivery. Also, (07.50%) deliveries were assisted by the doctor. The data shows that only (38.50%) of the deliveries were institutionalized deliveries with majority being the home deliveries.

New Born Child Weighed: All the Children were weighed after their birth.

Health Seeking Behavior of the Child: When asked whether the child has experienced any illness, majority (74.00%) of the respondents stated that the child fell sick. The respondents who said that their child had not represent the less percentage (26.00%)

Place of Treatment: Further when asked about, to whom did you take your child to get treatment, majority of the respondents (34.00%) said they go to private hospitals, followed by responding that they do self-medication (21.00%), while (17.00%) go to government hospitals at Taloda or Nandurbar. There were respondents (23.00%) who said they opt for ‘Other’ treatment options.

Table 2: Place of Treatment

Majority of the respondents (68 respondents) said they go to private hospitals. These accounted to 34.00%. (Table 2)

Colostrum Given to Child: All the respondents have given Colostrum (चीक दूध) to their child immediately after the birth. This is an indicator of the fact that the community supports feeding Colostrum to the new born child. The Anganwadi Workers had special efforts to make the community to understand the importance of the Colostrum to the child. This has benefitted the child immensely.

Number of Months of Breastfeeding: From the data, it is seen that majority of the respondents did breastfeeding for duration of 6 months to 1 year followed by respondents (45.00%) followed by respondents (42.00%) continuing breastfeeding for less than or equal to 6 months from the time of birth. There were also respondents (05.50%) who continued breastfeeding for the period of one year to two years followed by respondents (07.50%) who breastfeed for the period of 2 years to 3 years.

Number of Living Child: Majority of the respondents (44.50%) had 02 living children followed by respondents (25.50%) responding having 03 living children. Also, followed by respondents (22.00%) responded of having one living child; followed by respondents (01.50%) reported of having 05 living children. The least percentage of respondents (01.00%) said that they have 06 living children.

Abortion, Still Births, Born but Died: The respondents of the study have not experienced any Abortion, Still Births, Born but Died deliveries.

NUTRITIONAL STATUS: THE CONCRETE CONDITION

In this section, the information related to nutrition, food habits in general and food habits during the pregnancy etc. are discussed. The researcher also enquires about the taboo food for the mother and the child, the supplementary food and the subsequent information. There are also questions about the usage of various forest products.

Food Habits in the family: The food consumed majority is wheat, rice and products related to wheat and rice like Rotis of Wheat known as Chapattis (चपाती), Rotis of Jowar known as Bhakaris (भाकरी) etc. Generally, these Rotis are consumed with curry of meat (मटण रस्सा), fish curry (मच्छीचा रस्सा) or meat of hen (चिकन रस्सा). They also consume these Rotis with cooked vegetables either in dry form or in gravy. However, in pregnancy, women do not consume any type of meat. However, it is interesting to note that most of the families recorded that consumption of meat is very occasional and not a regular in diet. They consume in generally of Freshwater Crabs (नदीचा खेकडा); Prawns (कोळंबी) etc. consumption of fruits is occasional. However, they generally avoid purchasing fruits from markets due to the high prices.

Staple food during the breakfast: All the respondents noted that they do not have the practice of eating breakfast. When asked about such an unusual practice, the respondents stated that it has been practiced over years and generations. Although they stated that they have the practice of a pre-lunch snack at later in the morning. The snacks include a cup of tea with few biscuits or a plate of onion bhajis. (Bhaji: Marathi: भजी) A bhaji is a spicy Indian snack made primarily of gram flour and vegetables. These vegetables could be onion, potatoes, and chilies. They also consume snacks originating from neighboring state of Gujarat. Patra (Gujrati: પાત્રા Marathi: पात्रा) is another snack which is often consumed. A Patra means a leaf in several Indian languages.

Staple food during the lunch: Majority of the study population (50.00%) eat Rice and Dal (Curry) for their lunch followed by Chapatti and Rice Preparations (28.00%). At times, they also consume Chapattis with Vegetables (20.00%). Majority of the population is engaged in growing Wheat and rice. Therefore, generally, they consume what they grow. Thus, this forms the staple diet. Additionally, they also consume vegetables and pulses during the lunch. They do not consume or Eggs and/or Chicken for lunch. Thus, they consume food which is rich in carbohydrates.

Staple food during the Dinner: All the respondents said that they consume Rice Khichdi during their dinner. They also consume chapattis and vegetables. They occasionally consume pulses curry.

Age When the Supplementary Nutrition Started:

The table shows the information about the Age When the Supplementary Nutrition Started. Majority of the respondents (35.0%) started the supplementary when the child’s age less than six months followed by 15.0% of respondents feeding the child after six months of birth. (Table 3)

Table 3: Age When the Supplementary Nutrition Started

Serving Pattern: The serving pattern is instrumental in analyzing the social conditions, gender dynamics in any community. From the table below, it is evident that all the respondents (100.00%) sit together with their family while having food.

Supplementary Food taken during Pregnancy: The table below depicts the data about the Supplementary Food taken during Pregnancy by the mother. From the table, it is evident that majority of the respondents (48.00%) consume egg or meat as the Supplementary Food taken during Pregnancy followed by fruits and vegetables (26.00% each) (Table 4)

Table 4: Supplementary Food taken during Pregnancy

Taboo Food for Mother: Majority of the population avoids eating food like Papaya, Jackfruit, and Regular Consumption of Non-Veg Food. Under the option, ‘Any of the above’ the respondents (56.50%) recorded that at times the respondents may be avoided certain food items but may be allowed to eat other food items. For instance, a mother may be avoided from eating Papaya and Non-veg but she may eat Jackfruit. This happens because the family checks the health status, present condition of the mother, so if the mother suffers from allergy of Jackfruit, she may be advised not to eat Jackfruit; however, other mother may eat Jackfruit but not eggs or meat. Therefore, there are more than half of the respondents (56.50%) who recorded the response ‘Any of the above’. Also, under the option ‘All of the above’, the respondents (26.00%) said that they avoid eating food like Papaya, Jackfruit, Non-Veg food, Food Causing heat in the body. There are few respondents (12.00%) who responded that they did not know about Taboo food.

Anthropometric Measurements: In this section, there are only two questions which are helpful in calculating the height and weight of the child. Anthropometric Measurements are one of the main methods to analyze the nutritional status of children. Changes in body dimension reflect the overall health and welfare of individual and population. In this regard, anthropometric data such as weight and height of the child was collected during the survey. This data is analyzed using the standards of Indian Council of Medical Research (ICMR). ICMR Standards are based on 1990 growth standards for Indians which are gender based standard height and weight measurements.

Indian Council of Medical Research (ICMR) Growth Standards: Data on the growth standard is being analyzed in the following section. Anthropometric measurements for male and female children are analyzed separately as they grow at different pace at different ages. The analysis will be done by taking average height and weight for different age groups of children and comparing the same with the standards given by ICMR.

Mean Height of the Boy Child: The above table shows the distribution of mean height of the Boy Child in comparison to the Mean Height of the Indian Council of Medical Research Data, 1990. Data shows that children belonging to all the age groups have not achieved desired level of growth in terms of height.

Table 5: Mean Height of the Boy Child

The above Table shows the distribution of mean height of the Boy Child in comparison to the Mean Height of the Indian Council of Medical Research Data, 2010. Data shows that children belonging to all the age groups have not achieved desired level of growth in terms of height. All the age groups are very much behind the prescribed standards. In the age group of 1 to 2 Years, the standard height is 87.80 cms. while, the mean height of the boys of the study population is 77.928 cms. The difference between the ICMR standard height and the observed mean height is -12.66%. Also, similar trends are observed in other age groups. In the age group of 2 Years 1 Month to 3 Years, the standard height is 96.10 cms. while, the mean height of the boys of the study population is 75.55 cms. The difference between the ICMR standard height and the observed mean height is -27.20% The age group of 3 Years 1 Month to 4 Years of age, the standard height is 103.30 cms. while, the mean height of the boys of the study population is 85.66 cms. The difference between the ICMR standard height and the observed mean height is -20.59%. The standard height for the age group of 4 Years 1 Month to 5 Years is 110.00 cms. while the mean height is 92.22 cms. The difference between the ICMR standard height and the observed mean height is -19.27%. There is a negative difference in the actual mean heights of the boy child and the standard height standards by the ICMR. There is a wide gap in the differences between the ICMR standard height and the observed mean height within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood. (Table 5)

Mean Weight of the Boy Child: The table shows the distribution of mean weight of the Boy Child in comparison to the Mean Weight of the Indian Council of Medical Research Data, 1990.

Table 6: Mean Weight of the Boy Child

Data shows that children belonging to all the age groups are underweight in terms of weight. In the age group of Less Than or Equal to 2 Years, the standard weight is 12.20 kgs., while, the mean weight of the boys of the study population is 8.864 kgs. The difference between the ICMR standard weight and the observed mean weight is -37.63%. In the age group of 1 to 2 Years, the standard weight is 14.30 kgs., while, the mean weight of the boys of the study population is 9.29 kgs. The difference between the ICMR standard weight and the observed mean weight is -53.92%.
similar trends are observed in other age groups. In the age group of 3 Years 1 Month to 4 Years, the standard weight is 16.30 kgs. while, the mean weight of the boys of the study population is 11.36 kgs. The difference between the ICMR standard weight and the observed mean weight is -43.48% Then, in the age group of 4 Years to 5 Years of age, the standard weight is 18.30 kgs. while, the mean weight of the boys of the study population is 12.16 kgs. The difference between the ICMR standard weight and the observed mean weight is -50.49%. There is a negative difference in the actual mean weights of the boy child and the standard weight standards by the ICMR. This shows that the study population is under weight. There is a wide gap in the differences between the ICMR standard weight and the observed mean weight within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood. (Table 6)

Mean Height of the Girl Child: The above table shows the distribution of the mean height of the Girl Child in comparison to the Mean Height of the Indian Council of Medical Research Data, 1990.

Table 7: Mean Height of the Girl Child

Data shows that children belonging to all the age groups have not achieved desired level of growth in terms of height. All the age groups are very much behind the prescribed standards. In the age group of 1 to 2 Years, the standard height is 86.40 cms. while, the mean height of the girls of the study population is 72.57 cms. The difference between the ICMR standard height and the observed mean height is -19.05% Also, similar trends are observed in other age groups. In the age group of 2 Years 1 Month to 3 Years, the standard height is 95.10 cms. while, the mean height of the girls of the study population is 75.49 cms. The difference between the ICMR standard height and the observed mean height is -25.97%. In the age group of 3 Years 1 Month to 4 Years of age, the standard height is 102.70 cms. while, the mean height of the girls of the study population is 81.40 cms. The difference between the ICMR standard height and the observed mean height is -26.16%. The standard height for the age group of 4 Years 1 Month to 5 Years is 109.40 cms. while the mean height is 93.11 cms. The difference between the ICMR standard height and the observed mean height is -17.49%. There is a negative difference in the actual mean heights of the girl child and the standard height standards by the ICMR. There is a wide gap in the differences between the ICMR standard height and the observed mean height within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood. (Table 7)

Mean Weight of the Girl Child: The table shows the distribution of the mean weight of the Girl Child in comparison to the Mean Weight of the Indian Council of Medical Research Data, 1990.

Table 8: Mean Weight of the Girl Child

Data shows that children belonging to all the age groups are underweight in terms of weight. In the age group of Less Than or Equal to 2 Years, the standard weight is 11.50 kgs., while, the mean weight of the girls of the study population is 8.62 kgs. The difference between the ICMR standard height and the observed mean height is -33.41%. In the age group of 1 to 2 Years, the standard weight is 13.90 kgs., while, the mean weight of the girls of the study population is 8.94 kgs. The difference between the ICMR standard height and the observed mean height is -55.48%. Similar trends are observed in other age groups. In the age group of 3 Years 1 Month to 4 Years, the standard weight is 16.10 kgs. while, the mean weight of the girls of the study population is 10.33 kgs. The difference between the ICMR standard height and the observed mean height is -55.85%. In the age group of 4 Years to 5 Years of age, the standard weight is 18.20 kgs. while, the mean weight of the girls of the study population is 12.96 kgs. The difference between the ICMR standard height and the observed mean height is -40.43%. There is a negative difference in the actual mean weights of the girl child and the standard weight standards by the ICMR. This shows that the study population is under weight. There is a wide gap in the differences between the ICMR standard weight and the observed mean weight within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood. (Table 8)

Towards a Conceptual Framework: From Context to Text

The Socio-economic characteristics form a major chunk of the research data. This includes information on questions regarding Name of the respondent, tribe of the respondent, age of both the respondent and the spouse of the respondent, categorization of the household by the Gram Panchayat Whether APL or BPL. It also shows the condition of the houses (whether Kaccha, Semi-Pucca or Pucca), the mode of cooking, about the availability of basic infrastructure facilities like toilet, electricity, land etc. The interview schedule also tries to find about the ownership of commodities of livelihood, commodities of daily use, the education of the respondents and their spouses, type of family like joint or nuclear, number of family members etc. Adding to this, this section also shows about the information regarding the occupation, income of the respondent and her spouse, information regarding child, like total number of children, number of male and female children, etc. All the respondents (100.00%) belong to the religion Hinduism. All the respondents (100.00%) belong to the Bhill Tribe.

The respondents were between the ages of 19 to 45 wherein most of the respondents (47.50%) belonged to the age group of 21 to 25 years, followed by the age group 26 to 30 which accounted to 33.00% of the total study population. Also, there were some of the respondents (15.50%) between the age group of 31 to 40 years. There were mothers (02.00%) belonging to the age group of Less than or Equal to 20 years of age. The oldest respondent (of 45 Years) had a child of 49 months (3 Years 11 Months old). The youngest mother (19 Years) had a child of 24 months. In case of the Spouse of the Respondents, they were between the ages of 22 to 55 wherein most of the respondents (46.00%) belonged to the age group of 26 to 30 years, followed by the age group of 31 to 35 years of age which accounted to (22.00%) of the total study population. Also, there were some of the respondents (11.50%) between the age group of 35 to 40 years. There were Spouse of the Respondents (04.00%) belonging to the age group of 35 to 45 years of age, followed by respondents between the age of 46 to 50 years of age which accounted to 01.00%. Some respondents (01.00 %) were from the age group of 51 to 55 years of age. Also, 15.00 % of the total population belonged to the age group of less than or equal to 25 years of age.

The study area had 100.0% of BPL Houses. All the houses in the study area belong to Kaccha house category (100%). There was no Pucca House in the study area. All the respondents (100.0%) owned a house of their own.

In the educational status of the respondent, amongst the respondents, 90.50% of the respondents are illiterate, while 04.50% have studied below primary level. There are 00.50% of them who have passed 5^th standard and another 4.00% who have studied below secondary level. The females in the last group are those who have passed Secondary level. (00.50 %) Amongst the Spouse of the Respondents, 83.00% have No Formal Education, while 03.00% are studied below primary level. There are 06.00% of them who have passed 5^th standard and 05.50% who have studied below secondary level. The males in the former group are those who have passed 5^th standard but could not clear Secondary level. There are 00.50% of them who have passed bachelor degree while there are another 02.00% whose education status is not known. There are two types of families’ viz. Joint Family and Nuclear Family. Majority of the respondents (61.50%) said that they lived in nuclear family followed by respondents stating that they lived in joint family (33.50%). This shows the waning of the joint family system and thereby causing changes of an institution ‘Family’. The respondents recorded their responses which were in between 3 to 10 family members. The maximum number of respondents (33.00%) said that there were 4 members in their family; while, there were respondents (14.50%) whose families had 3 members. Also, another 13.00% had 5 family members. There were 10.50% of families who had 8 members, 09.00% who had 7 members, 07.50 % had 9 family members; while 3.00 % had 10 family members and 05.00% families had members between 11-15. All the marriages (100.00%) are Non-Consanguineous.

The data about the occupation of the mother is derived wherein 95.50% respondents are engaged in household work which means they are unemployed. Also, five women are working in formal sector and earning wage on a daily basis. There was also data about the occupation of the Spouse of the Respondent derived wherein all the men are working in formal sector and earning wage on a daily basis. The income range is between Rs.1, 000 to Rs.08, 000. Among the 200 respondents, majority of the respondents (29.50%) have a monthly income between Rs.04, 001 to Rs.05, 000 and 26.50 % have a monthly income between Rs.01, 000 to Rs.03, 000. There are 19.50 % of the families who earn monthly income between Rs.05, 001 to Rs.06, 000. There are 14.50% of the families who earn a monthly income between Rs.03, 001 to Rs.04, 000. Along with them, there are also 06.00% of the families who earn a monthly income between Rs.07, 001 to Rs.08, 000. The mean family income of the study population is Rs. 04,537.

Out of the 200 children, the male child represents for 52.00% while the female child represents for 48.00%. This shows that the number of the boy child exceeds the girl child. Under the section, Age of the Boy Child, we come to know that there were 104 boy children out of the two-hundred children who were less than or equal to five years of age. Majority of the children (60.58%) were of the age between 2 Years 1 Month to 3 Years followed by children (17.31%) belonging to the age between 3 Years 1 Month to 4 Years. There were 13.46% of the children who were less than or equal to the age of 2 Years. 08.65 % of them were between 4 Years 1 Month to 5 years of age. While under the section, Age of the Girl Child, we come to know that there were 96 girl children out of the two-hundred children who were less than or equal to five years of age. Majority of the children (62.50%) belonged to the age of 2 Years 1 Month to 3 Years followed by children (20.83%) belonging to the age of 3 Years 1 Month to 4 Years. There were 09.38% of the children who were between 4 Years 1 Month to 5 Years of age. 07.29 % children belonged to the age group of Less Than or Equal To 2 Years of age. None of the respondents’ own land, both farming and non-farming (100%). No family in the sample owns farming land. As per the statements of the villagers, they have sold their lands to the other wealthy villagers for monetary gains. These buyers are mostly either the local political persons or property constructers. Therefore, no one is engaged in agriculture or agricultural practices. No family grows any types of crops.

The issues and information about the health care services in the study area are discussed. This part predominantly deals with the medical and health care services in the area. Here, the researcher probes about the sex of the child, age of the child, birth order of the child, Vaccination details, Questions regarding the delivery of the child, illness of the child, treatment given during the child was ill etc. Also, questions regarding the various health care institutions were also asked.

All the respondents have availed the facility of Ante Natal Care. It was also confirmed from the ASHA Worker that all the mothers had Ante Natal Care Visits. All the respondents received Tetanus Shots. This happened due to the constant check by the Anganwadi worker whenever the delivery took place. All the respondents (100.0%) have consumed Iron and Folic Acid Tablets during the pregnancy of the child. All the Children are vaccinated. There is 100.0% vaccination. There were three places where the deliveries took place viz. Home, PHC and District Hospital. Out of the two-hundred respondents, 61.50% of the deliveries (123 families) took place at home. While the data shows that 22.00 % of the deliveries took place at sub-center while 09.00% (18 families) at PHC, 07.50% (15 families) took at District Hospital in Nandurbar. Data on place of delivery reveals that majority of the births (61.50%) took place in Home. This shows that there are large numbers of non-institutionalized deliveries. Non-institutionalized deliveries are dangerous for both the mother as well as the child. Poor sanitation and hygiene, use of unsterilized equipments and medically untrained or inadequately trained persons make non-institutionalized deliveries highly dangerous. Chances of Tetanus and sepsis drastically increase in such scenario. This data implies that one needs to push for the awareness about institutionalized deliveries and avoid deliveries taking place at home. All the deliveries were Normal Deliveries. No Caesarean was observed. As most of the deliveries took place at home, the traditional assistant, also known as Dai in the local language, was the one to assist. In all, 61.50% deliveries took place where Dai was the assistant during the time of delivery. In addition, there were 31.00% (62 families) deliveries where Auxiliary Nurse Midwife (ANM) was the assistant during the delivery. Also, 07.50% (15 families) deliveries were such where the doctor was the assistant during the delivery. The data shows that only 38.50% of the deliveries were institutionalized deliveries with majority being the home deliveries. All the Children were weighed after their birth. When asked whether the child has experienced any illness during last six months, 74.00% said yes while 26.00% respondents said that their child had not experienced any illness during the last six months. Further when asked about, to whom did you take your child to get treatment, majority of the respondents (34.00%) said they go to private hospitals, followed by responding that they do self-medication (21.00%), while (17.00%) go to government hospitals at Taloda or Nandurbar. There were respondents (23.00%) who said they opt for ‘Other’ treatment options. All the respondents have given Colostrum (चीक दूध) to their child immediately after the birth. This is an indicator of the fact that the community supports feeding Colostrum to the new born child. The Anganwadi Workers had special efforts to make the community to understand the importance of the Colostrum to the child. This has benefitted the child immensely. Majority of the respondents (34.50%) said that they breastfeed the child once in a day followed by respondents feeding twice a day (30.00%). There are cases (25.50%) where the child is breastfed three times a day followed by respondents feeding four times a day (10.0%). This shows the different practices related to breastfeeding. Majority of the respondents (45.00%) did breastfeeding for duration of 6 months to 1 year followed by respondents (42.00%) continuing breastfeeding for less than or equal to 6 months from the time of birth. There were also respondents (05.50%) who continued breastfeeding for the period of one year to two years followed by respondents (07.50%) who breastfeed for the period of 2 years to 3 years. The majority of the respondents (45.00%) have responded that the birth order of the child is 2, followed by third birth order (24.00%). Some respondents (23.00%) said that the birth of the child was 1, while some respondents (10.50%) said that the birth order of their child was 4 and another 01.00% as 5. Another 01.50% stated the birth of their child as 6. There were no abortions. There were no still births.

The information related to nutrition, food habits in general and food habits during the pregnancy etc. are discussed. The researcher also enquires about the taboo food for the mother and the child, the supplementary food and the subsequent information. There are also questions about the usage of various forest products.

The respondents’ household food consumption consists of mostly vegetables, rice, cereals and pulses. The food consumed majority is rice and products related to rice like Rotis of Jowar and Bajri (भाकरी) etc. Generally, these Rotis are consumed with curry of meat (मटण रस्सा), fish curry (मच्छीचा रस्सा) or meat of hen (चिकन रस्सा). They consume meat Wild Rabbits (रानटी ससा). The fish meat they consume is generally of Freshwater Crabs (नदीचा खेकडा), Prawns (कोळंबी), etc. Therefore, generally, they consume what they grow. However, they consume cereals like Wheat after getting it from Fair Price Shops under the Public Distribution System (PDS).

All the respondents noted that they do not have the practice of eating breakfast. When asked about such an unusual practice, the respondents stated that it has a been practice over years and generations. Although they stated that they have the practice of a pre-lunch snack at later in the morning. The snacks include a cup of tea with few biscuits or a plate of onion bhajis. (Bhaji: Marathi: भजी) A bhaji is a spicy Indian snack made primarily of gram flour and vegetables. These vegetables could be onion, potatoes, and chilies. They also consume snacks originating from the neighboring state of Gujarat. Patra (Gujrati: પાત્રા Marathi: पात्रा) is another snack which is often consumed. A Patra means a leaf in several Indian languages. Majority of the study population (50.00%) eat Rice and Dal (Curry) for their lunch followed by Chapatti and Rice Preparations (28.00%). At times, they also consume Chapattis with Vegetables (20.0%). Majority of the population is engaged in growing Wheat and rice. Therefore, generally, they consume what they grow. Thus, this forms the staple diet. Additionally, they also consume vegetables and pulses during the lunch. They do not consume or Eggs and/or Chicken for lunch. Thus, they consume food which is rich in carbohydrates. All the respondents said that they consume Rice Khichdi during their dinner. They also consume chapattis and vegetables. They occasionally consume pulses curry. There was data on Consumption of Other Supplementary/Complementary Items during the breakfast, lunch and dinner. This includes items Chutneys, Pickles etc. Majority of the respondents (48.50%) said that they regularly consume these items. Most of the times, these items are consumed during lunch followed by dinner. Also, there were respondents (31.00%) who consumed these items occasionally while there were respondents (20.00%) who did not consume any other Supplementary/Complementary Items. The Supplementary/Complementary Items consumed are pickles, chutneys. Pickles often are made of lemon in contrast to mangoes as made in the other parts of Maharashtra. Sometimes pickles are also prepared of green chilies. The chutneys are made of groundnut as opposed to coconut as it is not grown in this part of the state. There was data about the Age When the Supplementary Nutrition Started. Majority of the respondents (35.00%) started the supplementary when the child’s age less than six months followed by 15.00% of respondents feeding the child after six months of birth. Most of the respondents (31.00%) give their child supplementary food 3 times a day. There are 27.50 % respondents who give supplementary food 4 times a day, followed by 19.00% respondents who give supplementary food 5 times a day. 15.00% respondents give supplementary food 6 times a day and 07.50 % respondents give supplementary food twice a day. The serving pattern is instrumental in analyzing the social conditions, gender dynamics in any community. The present study shows that all the respondents (100.00%) sit together with their family while having food. Majority of the respondents (48.00%) consume egg or meat as the Supplementary Food taken during Pregnancy followed by fruits and vegetables (26.00% each) Majority of the population avoids eating food like Papaya, Jackfruit, and Regular Consumption of Non-Veg Food. Under the option, ‘Any of the above’ the respondents recorded that at times the respondents may be avoided certain food items but may be allowed to eat other food items. For instance, a mother may be avoided from eating Papaya and Non-veg but she may eat Jackfruit. This happens because the family checks the health status, present condition of the mother, so if the mother suffers from allergy of Jackfruit, she may be advised not to eat Jackfruit; however, other mother may eat Jackfruit but not eggs or meat. Therefore, there are more than half of the respondents (56.50%) who recorded the response ‘Any of the above’. Also, under the option ‘All of the above’, the respondents said that they avoid eating food like Papaya, Jackfruit, Non-Veg food, Food Causing heat in the body.

Data on the growth standard was analyzed in the following section. Anthropometric measurements for male and female children are analyzed separately as they grow at different pace at different ages. The analysis was done by taking average height and weight for different age groups of children and comparing the same with the standards given by ICMR.

There was data on the distribution of mean height of the Boy Child in comparison to the Mean Height of the Indian Council of Medical Research Data, 2010. Data shows that children belonging to all the age groups have not achieved desired level of growth in terms of height. In the age group of 1 to 2 Years, the standard height is 87.80 cms. while, the mean height of the boys of the study population is 77.928 cms. Also, similar trends are observed in other age groups. In the age group of 2 Years 1 Month to 3 Years, the standard height is 96.10 cms. while, the mean height of the boys of the study population is 75.55 cms. then, in the age group of 3 Years 1 Month to 4 Years of age, the standard height is 103.30 cms. while, the mean height of the boys of the study population is 85.66 cms. The standard height for the age group of 4 Years 1 Month to 5 Years is 110.00 cms. while the mean height is 92.22 cms. There is a negative difference in the actual mean heights of the boy child and the standard height standards by the ICMR.

Data shows that children belonging to all the age groups have not achieved desired level of growth in terms of height. All the age groups are very much behind the prescribed standards. In the age group of 1 to 2 Years, the standard height is 87.80 cms. while, the mean height of the boys of the study population is 77.928 cms. The difference between the ICMR standard height and the observed mean height is -12.66%. Also, similar trends are observed in other age groups. In the age group of 2 Years 1 Month to 3 Years, the standard height is 96.10 cms. while, the mean height of the boys of the study population is 75.55 cms. The difference between the ICMR standard height and the observed mean height is -27.20% The age group of 3 Years 1 Month to 4 Years of age, the standard height is 103.30 cms. while, the mean height of the boys of the study population is 85.66 cms. The difference between the ICMR standard height and the observed mean height is -20.59%. The standard height for the age group of 4 Years 1 Month to 5 Years is 110.00 cms. while the mean height is 92.22 cms. The difference between the ICMR standard height and the observed mean height is -19.27%. There is a negative difference in the actual mean heights of the boy child and the standard height standards by the ICMR. There is a wide gap in the differences between the ICMR standard height and the observed mean height within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood. There was data on the distribution of mean weight of the Boy Child in comparison to the Mean Weight of the Indian Council of Medical Research Data, 2010. Data shows that children belonging to all the age groups are underweight in terms of weight. In the age group of Less Than or Equal to 2 Years, the standard weight is 12.20 kgs., while, the mean weight of the boys of the study population is 8.864 kgs. The difference between the ICMR standard weight and the observed mean weight is -37.63%. In the age group of 1 to 2 Years, the standard weight is 14.30 kgs., while, the mean weight of the boys of the study population is 9.29 kgs. The difference between the ICMR standard weight and the observed mean weight is -53.92%.

Similar trends are observed in other age groups. In the age group of 3 Years 1 Month to 4 Years, the standard weight is 16.30 kgs. while, the mean weight of the boys of the study population is 11.36 kgs. The difference between the ICMR standard weight and the observed mean weight is -43.48% Then, in the age group of 4 Years to 5 Years of age, the standard weight is 18.30 kgs. while, the mean weight of the boys of the study population is 12.16 kgs. The difference between the ICMR standard weight and the observed mean weight is -50.49%. There is a negative difference in the actual mean weights of the boy child and the standard weight standards by the ICMR. This shows that the study population is under weight. There is a wide gap in the differences between the ICMR standard weight and the observed mean weight within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood. Further, there was also data on the distribution of mean height of the Girl Child in comparison to the Mean Height of the Indian Council of Medical Research Data, 2010. Data shows that children belonging to all the age groups have not achieved desired level of growth in terms of height. All the age groups are very much behind the prescribed standards. In the age group of 1 to 2 Years, the standard height is 86.40 cms. while, the mean height of the girls of the study population is 72.57 cms. The difference between the ICMR standard height and the observed mean height is -19.05% Also, similar trends are observed in other age groups. In the age group of 2 Years 1 Month to 3 Years, the standard height is 95.10 cms. while, the mean height of the girls of the study population is 75.49 cms. The difference between the ICMR standard height and the observed mean height is -25.97%. In the age group of 3 Years 1 Month to 4 Years of age, the standard height is 102.70 cms. while, the mean height of the girls of the study population is 81.40 cms. The difference between the ICMR standard height and the observed mean height is -26.16%. The standard height for the age group of 4 Years 1 Month to 5 Years is 109.40 cms. while the mean height is 93.11 cms. The difference between the ICMR standard height and the observed mean height is -17.49%. There is a negative difference in the actual mean heights of the girl child and the standard height standards by the ICMR. There is a wide gap in the differences between the ICMR standard height and the observed mean height within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood. Also, there was also data on the distribution of mean weight of the Girl Child in comparison to the Mean Height of the Indian Council of Medical Research Data, 2010. Data shows that children belonging to all the age groups are underweight in terms of weight. In the age group of Less Than or Equal to 2 Years, the standard weight is 11.50 kgs., while, the mean weight of the girls of the study population is 8.62 kgs. The difference between the ICMR standard height and the observed mean height is -33.41%. In the age group of 1 to 2 Years, the standard weight is 13.90 kgs., while, the mean weight of the girls of the study population is 8.94 kgs. The difference between the ICMR standard height and the observed mean height is -55.48%. Similar trends are observed in other age groups. In the age group of 3 Years 1 Month to 4 Years, the standard weight is 16.10 kgs. while, the mean weight of the girls of the study population is 10.33 kgs. The difference between the ICMR standard height and the observed mean height is -55.85%. In the age group of 4 Years to 5 Years of age, the standard weight is 18.20 kgs. while, the mean weight of the girls of the study population is 12.96 kgs. The difference between the ICMR standard height and the observed mean height is -40.43%. There is a negative difference in the actual mean weights of the girl child and the standard weight standards by the ICMR. This shows that the study population is under weight. There is a wide gap in the differences between the ICMR standard weight and the observed mean weight within the age group. When the child is younger, it is comparatively healthier than the older stages of childhood.

The data about the Public Welfare Programs/Schemes is also discussed. For instance, the respondents are asked about whether they about the various schemes for the pregnant mothers, newborn child etc. Also, there are questions about the Rationing Method, Quality and quantity of the food, availability of the food etc. Also, questions regarding schemes like MNEREGA were also asked.

All the respondents (100.00%) know about the Janani Suraksha Yojana. All the respondents (100.00%) avail the facilities of Janani Suraksha Yojana. All the respondents (100.00%) knew about the Janani Suraksha Yojana through Accredited Social Health Activist (ASHA). Though there were majority of home deliveries, all respondents claim to have benefits of JSY.

All the respondents (100.00%) said that their child is attending Anganwadi. Majority of the respondents (64.00%) seem to be happy and satisfied with the services of the Anganwadi while there were some respondents (36.00%) who were dissatisfied with the services of the Anganwadi. There were several reasons provided by the respondents for Anganwadi not providing enough care to the people. According to them, negligence by the anganwadi workers is the main reason. The respondents feel that the anganwadi workers do not provide enough care and attention to the children. Some of the Anganwadis in the study area have a greater number of children under one anganwadi worker. This creates more dilution in the care and the attention given by the anganwadi worker to the children. As per the respondents, there is also lack of facilities (both infrastructural and medical facilities), irregular visits by the medical officers.

All the respondents (100.00%) responded that the Anganwadi provides food items like vegetables and snacks during breakfast (Biscuits, laddus etc.) to the children. In addition, some respondents stated that the Anganwadi also gives dal-rice to the children. Since all the families belong to ‘Below Poverty Line Family’, majority of the families (64.00%) have a pink ration card followed by 34.00% respondents having a yellow ration card. There are 02.00% of respondents who don’t have a ration card. The Public Distribution System (PDS) is poorly efficient and operating in the study area. All the families in the Study area are BPL Families. Majority of them (64.00%) have a Pink Ration Card which is an indicator of poor economic status and purchasing power. The purchasing power of the population is very low. This makes them dependent upon the Fare Price Shops in the locality. However, there has been a mixed impact of the shops in the area. These shops have certain items in their shops, while some are available sometimes, while some items are never available. The population does get Rice from the Fair Price Shop regularly. They also get cereals like Wheat, Jowar, and Bajri on a regular basis as these are the staple food and the staple crop of the region. However, majority of the respondents claim that they do not receive Pulses, Oil, Sugar and Kerosene as per the prescribed norms. According to them, they get these items only when they are made available in the shop. Interestingly, majority of the respondents felt that the quality of the food provided in the PDS is of good quality. There were few respondents who were not satisfied with quality of the food. All the respondents responded that they had no opportunities in the employment sector in the government services. The Government Officials registered their names in the directory but no employment was provided. There is plethora of welfare schemes designed for the tribal development. However, few schemes are being implemented properly. The community is deprived of the benefits from the schemes. There are schemes like Mahatma Gandhi National Rural Employment Scheme (MNREGS) for the rural poor, Integrated Child Development Services (ICDS) for the mothers and their child below 6 years of age, National Rural Livelihood Mission (NRLM) for the livelihood options and opportunities for the rural people. However, there have been many administrative, policy level gaps and hindrances in implementing these schemes. The people have not been benefitted from these schemes. For instance, in the study area, only three individuals out of the total study population had houses built under Indira Awaas Yojana. Also, the people have been registered in the government directory; however, have not received any kind of job from the concerned departments. Interestingly, none of the respondents were benefitted from the Mahatma Gandhi National Rural Employment Scheme (MNREGS). As per the respondents’ statements they have been registered in the government directory; however, have not received any kind of job from the concerned departments. When asked what could be the possible reasons for such an incidence, some respondents acknowledged the fact that the region is located in hilly areas with no proper connectivity, negligence from the government authorities. Micro Financing, Self-Financing Institutions include institutions like Co-operatives; Self Help Groups (SHGs). There are no Co-operatives or SHGs in the study area. Therefore, no respondents were part of any Micro Financing, Self-Financing Institutions.

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Abhijit Bansode is currently pursuing his Doctorate Degree from the Tata Institute of Social Science and can be contacted on abhijitbansodemsw@gmail.com