Bhubaneswar: While the COVID 19 pandemic has aggravated the health and nutritional insecurity of the tribal communities across the country, recent data from the tribal areas in Odisha has shown that despite the COVID 19 pandemic, community level nutrition services continued to be delivered to the most vulnerable tribal groups.
(NFHS-4 2015-16 )
|Severe Acute Malnutrition (SAM)||6.4||8.8|
|Children weighed within 24hrs of birth *||85.2||65.5|
|Mothers received 4 and more ANC *||50.3||36.4|
|Households having unimproved source of drinking water*||12.9||16.7|
|Open defecation *||77.7||94.9|
|Children who had diarrhoea and received treatment||14.7||16.7*|
|Women married before legal age||21.3||44.9*|
The status of nutritional services for tribal communities during COVID 19 and focussed programmes for marginalised communities were discussed in an orientation organized by UNICEF, Odisha on Monday where experts including Dr Monika Nielsen, Chief of Field Office, UNICEF Odisha, Dr. Prajna Paramita Giri, Assistant Professor, Community and Family Medicine (CM&FM), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Sourav Bhattacharjee, Nutrition Specialist, UNICEF Odisha, Radhika Srivastava, Communication and Advocacy Specialist, UNICEF Odisha, Dr Lopamudra Tripathy, C4D Specialist, UNICEF Odisha and Abinas Nayak, current title holder, Master Chef India participated in the discussion. Few community members such as Poshan Sakhi, women from Self Help Group and NGO functionary also attended the orientation and shared their experiences.
Speaking on UNICEF’s focus on tribal Nutrition, Dr. Monika Nielsen, Chief of Field Office, UNICEF Odisha said, “The government of Odisha recognizes the needs to focus more on tribal communities and we have seen some good progress through a number of programmes that have been put in place. With more challenges from COVID 19, we need to ensure our collective commitment especially to support tribal children survive and thrive remains strong and we continue to deliver results for marginalised communities.”
Odisha is home to 80 lakh persons from tribal communities accounting for more than 22 per cent of the state’s population. A majority of these communities are marginalised, poor and report low health and nutrition indicators. Several programmes have been designed to support these communities and improve overall health and quality of life. Among these tribal communities, there are groups that are even more vulnerable than the rest. These groups are categorised as the Particularly Vulnerable Tribal Groups (PVTGs) and Odisha has 13 PVTGs of the total 75 in the country.
Speaking on undisrupted nutrition services to PVTGs during lockdown, Sourav Bhattacharjee, Nutrition Specialist, UNICEF Odisha said, “The PVTGs are vulnerable mostly because they live in places that are hard to reach. Due to the convergent efforts of several departments of Govt. of Odisha and fieldworkers such as Anganwadi Workers, ASHA members and ANM, the nutrition services to the PVTGs were made available even during the pandemic. To ensure monitoring of activities continued, a tele-monitoring system was put in place which showed encouraging results for various indicators such as institutional deliveries, Infant and Young Child Feeding practices and maternal and child care.”
The Government of Odisha recognises that development has not been uniform across all social groups requiring more focussed efforts for marginalised populations. Programmes such as JibanSampark, Sampurna Barta and Swabhiman are aimed at improving health and nutrition of vulnerable groups, improve child survival and encourage social and behaviour change for overall development and wellbeing. [more details in annexure].
During the pandemic, data through tele-monitoring from the PVTG communities living in 12 districts in Odisha has shown that services under Village Health Sanitation Nutrition Day such as early registration of pregnancy, regular antenatal care and postnatal care, growth monitoring and referral of sick children, health awareness and nutrition counselling continued to be organised in more than 90 per cent of the tribal villages. Similarly, immunization sessions were also held in a majority of villages though the coverage between June and September was less than March and April.
While the lockdown closed anganwadi centers temporarily disrupting nutrition services for children below 5 and pregnant and mothers with babies upto 2 years, the services picked up June onwards. Data shows that though at the start of the pandemic the services dropped to 68% in April, the services covered more than 95% of children and mothers in September.
The consumption of minimal acceptable diet for tribal children, comprising breastfeeding, adequate number of meals and food diversity remains a challenge. Despite the provision of eggs and dry ration to families, only around 40% of children were reportedly consuming minimal acceptable diet in June. However, the situation has seen an improvement with intense counselling and September figures show that around 52% of children were consuming the acceptable diet.
Young children also did not have sufficient access to a variety of foods during the pandemic, the data showed. While 85% consumed grains and roots, only 20 to 30% consumed meat, fish, liver etc. Around 58% consumed fruits and vegetables rich in Vitamin A.
Tribal communities report high levels of malnutrition among children. According to National Family Health Survey 4 (NFHS4), around 48% of tribal children below 5 are malnourished making them vulnerable to stunting and severe acute malnutrition (SAM) and face the risk of diseases and poor growth. This underlines the importance of timely and holistic nutrition services including educating communities, improving access to nutrition and monitoring and referral of children at risk. Tribal women and adolescent girls are also vulnerable due to barriers in accessing Institutional delivery, Antenatal Care (ANC) and Postnatal Care (PNC) services, drinking water, sanitation and hygiene services, prevalence of child marriage and open defecation.
Speaking on efforts made towards behaviour change for better nutrition results, Dr. Lopamudra Tripathy, C4D Specialist, UNICEF Odisha said, “Communication plays a vital role to encourage positive behaviour change and ensure food habits that include adequate nutrition especially for children and women. The Sampurna Barta initiative supported by UNICEF reaches out to tribal communities with awareness, counselling and behaviour change for dietary diversity and inclusion of traditional and nutritional foods in diets.”
Highlighting the challenges and gain associated with tribal nutrition, Dr. Prajna Paramita Giri, Assistant Professor, CM&FM, AIIMS Bhubaneswar said, “Nutrition is not only about good food rather it has different socio-cultural and economic aspects. Tribal people are culturally very vibrant, they have an indigenous knowledge system, they are at various level of economy and they are very culture bound. If you look at some issues in tribal areas, they have extremely low literacy, high IMR MMR and scanty economic and employment opportunities. There are some by-default good practices such as breastfeeding and less gender discrimination.” Innovative programmes that aim to bring holistic change such as JibanSampark have the potential to create lasting impact, she said.
Participating in the discussion, Abinas Nayak, current title holder, Master Chef India said, “Traditional Oriya food not only has good nutrition but is also affordable and easy to access. As a chef I am excited by the opportunity to not only popularise traditional food preparations but also help the younger generation appreciate the nutritive value of such food.”