Objectives
Chronic undernutrition affects 47% tribal women, while 36% are among non-tribal women in India. This study aimed to explain the disparities, in terms of access to essential interventions.
Methods
This study, conducted over nine months in 2014 is based on sampled 977 interviews and 120 FGDs with adolescent girls, women of reproductive age, field workers, and government representatives across three tribal dominant states – Odisha, Chhattisgarh and Jharkhand.
Results
All centrally sponsored schemes are implemented in the study states but women in tribal belts have limited access to services through existing platforms, especially during early pregnancy. Micronutrient supplementation coverage is less than 30%; it is lower in tribal belts; despite awareness and incentives efforts, less than half eligible couples use family planning services; and nearly 100% households have no access to sanitation facilities in two of three study states. States with better coverage of essential nutrition interventions have institutional mechanisms for tribal development and organized involvement of community members and field workers in service delivery. Automated systems have improved efficiency of supply chains in food safety nets, increasing coverage in tribal regions.
Conclusions
All national schemes should be reviewed with equity lens, as excluded tribes are most likely to be left out from existing social-safety nets. Advocacy for scaling-up proven effective measures like strengthening tribal development nodal agencies, expanding automation of supply chain management for food, micronutrients and drugs, and organized community engagement in hard to reach areas is suggested. Inter-divisional coordination is critical for effective delivery of flagship programs.
