2 Addressing nutritional gaps and suggesting a practical framework to reduce the risk of malnutrition and improve nutrition security in santhal tribal communities in India

Abstract

state in India. A comparison was made between socio-economic conditions, adoption of new technologies, changing cropping pattern, and market access to identify the drivers of dietary diversity in a transitional scenario moving from subsistence agriculture in upland regions towards commercial production in lowland regions. Hilly upland region has thick forests, sparse population, small land holdings and rainfedorganic subsistence agriculture. This region has poor transport, communication, and healthcare facilities. In contrast, lowland region scores better on these development parameters. Here, cropping pattern is dictated by market trends and farmers use irrigation facilities and modern farm implements for high productivity. Through our Nutrition Awareness Programme this study also focused on analysing dietary behaviours of primary school children in the villages. Methods Qualitative methods used were semi-structured interviews, seasonal calendar, 24 hrs. dietary recall and focussed group discussions. The data was quantitatively analysed using Stata 12.0 and AnthroPlus 1.0.4. Results Results (at 95% confidence) indicated a high household dietary diversity score (HDDS) and Women’s Dietary Diversity Score (WDDS) amongst the adult population in both the regions – Upland: HDDS 6.4, WDDS 4.0; Lowland: HDDS 7.3 and WDDS 4.7. Upland students exhibited a balanced dietary pattern of different food groups with Dietary Diversity Score (DDS) of 7 whereas for lowland it stood at 6. However, over 50% of upland students were stunted with HAZ < -2; over10% risked being overweight; 50% were wasted with low BAZ scores. Higher percentage of upland students were malnourished despite higher DDS, especially, girls exhibited a lower DDS and were more severely wasted. Conclusions The study establishes that improved irrigation, livestock ownership, crop diversification, and easy access to the markets have scope to increase dietary diversity in this region.