**Executive Summary**
This document is a response to Lok Sabha Unstarred Question No. 2478, due to be answered on February 13th, 2026, regarding malnutrition, infant mortality, and maternal mortality among tribal communities in India, particularly in Kerala. The Minister of Health and Family Welfare provides data and details on government schemes aimed at addressing these issues. The response includes annexures with specific data.
**Key Points / Main Content**
* **Data on Malnutrition, IMR, and MMR:**
* Prevalence of malnutrition among Scheduled Tribes across India and Kerala, based on the National Family Health Survey 5 (2019-21) as per Annexure I.
* Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR) at the National, State, and UT level, including Kerala, as per the Sample Registration System 2023 Report of Registrar General of India (SRS-RGI report) as per Annexure II and III.
* **Government Initiatives and Strategies:**
* Implementation of the Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N) strategy under the National Health Mission (NHM).
* Various programs to address health and nutrition concerns:
* Nutrition Rehabilitation Centres (NRCs) for children under 5 with malnutrition.
* Anaemia Mukt Bharat (AMB) to reduce anemia prevalence.
* Mothers' Absolute Affection (MAA) Program to improve breastfeeding.
* Lactation Management Centres for safe milk access.
* National Deworming Day (NDD).
* Vitamin A Supplementation Programme.
* Facility Based Newborn Care: Special New-born Care Units (SNCUs) and Newborn Stabilization Units (NBSUs).
* Community Based care of Newborn and Young Children: Home Based New-born Care (HBNC) and Home-Based Care of Young Children (HBYC).
* Janani Shishu Suraksha Karyakram (JSSK) for free delivery and treatment.
* Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS)
* STOP Diarrhoea campaign.
* Rashtriya Bal Swasthya Karyakram (RBSK)
* Janani Suraksha Yojana (JSY)
* Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
* Extended PMSMA strategy
* Surakshit Matritva Aashwasan (SUMAN)
* Optimizing Postnatal Care
* Functionalization of First Referral Units (FRUs)
* Village Health Sanitation and Nutrition Days (VHSNDs)
* Outreach camps
* Birth Waiting Homes (BWH)
* Mother and Child Protection (MCP) Card and Safe Motherhood Booklet
* Regular IEC/BCC activities.
* **Financial Allocations:**
* State/UT-wise details of Central funds released ST category-wise under National Health Mission (NHM) from F.Y. 2022-23 to 2024-25 as per Annexure IV.
**Impact Analysis**
**Tribal Communities:**
* **Impact:** Improved access to healthcare, nutrition, and reduced malnutrition, infant mortality, and maternal mortality.
* **Action Required:** Engage with health programs and utilize available resources and facilities.
**Healthcare Workers (ASHAs, Frontline Workers, Medical Officers):**
* **Impact:** Increased responsibilities in implementing and monitoring health programs, additional incentivization for specific tasks.
* **Action Required:** Implement outlined programs, participate in capacity building, and track high-risk cases.
**Pregnant Women and Mothers:**
* **Impact:** Access to free and quality antenatal care, institutional delivery, and postnatal care, along with improved awareness of healthcare practices.
* **Action Required:** Utilize available services, attend regular check-ups, and follow recommended health practices.
**Government (Ministry of Health and Family Welfare):**
* **Impact:** Accountable for the effective implementation of health programs and allocation of resources.
* **Action Required:** Monitor program progress, allocate funds, and address gaps in healthcare delivery.
Key Entities Referenced
National Health Mission (NHM): A program implemented by the Ministry of Health and Family Welfare to address health and nutrition concerns, including among children and women in tribal areas.
Ministry of Health and Family Welfare: The central government ministry responsible for implementing policies and programs related to health and family welfare, including those targeted at reducing malnutrition and infant mortality among tribal communities.
Kerala: A state in India, which is specifically mentioned in the document in the context of malnutrition, infant mortality, and maternal mortality among tribal communities.
National Family Health Survey 5 (NFHS-5): A survey used to assess the prevalence of malnutrition among scheduled tribes across the country and specifically in Kerala.
Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N) strategy: A strategy implemented under the National Health Mission (NHM) to address health and nutrition concerns in a life cycle approach.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENTOFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2478
TO BE ANSWERED ON13thFEBRUARY2026
MALNUTRITION, INFANTMORTALITYANDMATERNALMORTALITY
AMONG TRIBAL
2478. SHRI BENNY BEHANAN:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleasedtostate:
(a) the prevalence of malnutrition, infant mortality and maternal mortality among tribal
communities in the country, State/UT-wise, particularly in Kerala;
(b) whether the Government is aware of reports of starvation deaths and lack of access to
primary healthcare services in tribal hamlets of Kerala;
(c) the funds allocated and utilised under tribal health schemes during the last three years;
and
(d) the steps taken by the Government to improve last-mile healthcare delivery in remote
tribal areas?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY
WELFARE
(SMT. ANUPRIYAPATEL)
(a) As per National Family Health Survey 5 (2019-21), the prevalence of malnutrition
among scheduled tribes across the country and in the State of Kerala are as placed at
Annexure I.
The information as available in the Sample Registration System 2023 Report of Registrar
General of India (SRS-RGI report) regarding the Infant Mortality Rate (IMR) and Maternal
Mortality Ratio (MMR) at the National and State/ UT level including State of Kerala is
placedat Annexure II andIII.
(b) and (d) The Ministry of Health and Family Welfare is implementing Reproductive,
Maternal, Newborn, Child, Adolescent Health andNutrition (RMNCAH+N) strategy in a life
cycle approach under National Health Mission (NHM) to address health and nutrition
concerns amongchildren andwomen across the country, including remote areasand schedule
tribesacross the state of Kerala asplacedbelow:1. Nutrition Rehabilitation Centres (NRCs) are set up at public health facilities to
provide in-patient medical and nutritional care to children under 5 years of age suffering
from Moderate and Severe Acute Malnutrition (MAM and SAM) with medical
complications. In addition to curative care, special focus is given on improving the skills
for motherandcaregiversoncomplete age-appropriatecaringandfeedingpractices.
2. Anaemia Mukt Bharat (AMB) is implemented to reduce prevalence of anaemia
among six beneficiary groups - Children 6-59 months, Children 5-9 years,
Adolescents 10-19 years, Pregnant women, lactating mother and Women of
Reproductive Age (20-49 years). The interventions are Prophylactic Iron and Folic
Acid Supplementation, deworming among children 1-19 years and pregnant women,
Intensified Behaviour Change Communication (BCC) Campaign, Provision of IFA
fortified food in government funded public health program and addressing non-
nutritional causes of anaemia in endemic pockets with special focus on malaria,
haemoglobinopathiesandfluorosis, implementedvia robust institutional mechanism.
3. Mothers’ Absolute Affection (MAA) Program is implemented to improve
breastfeeding coverage emphasizing on early initiation of breastfeeding and exclusive
breastfeeding for first six months followed by age-appropriate complementary feeding
practices through capacity building of frontline health workers and comprehensive IEC
campaigns.
4. Lactation Management Centres are established to ensure availability of Mother’s
Own Milk or safe, pasteurized Donor Human Milk for feedingof sick, preterm, lowbirth
weight babies admitted in Neonatal Intensive Care Units and Special Newborn Care
Units.
5. Under National Deworming Day (NDD), albendazole tablets are administered in a
single fixed day approach via schools and anganwadi centres to reduce worm infestation
amongallchildren(1-19 years).
6. In Vitamin A Supplementation Programme, all children age 6–59 months are
administered Vitamin A dose every 6 months in two rounds during Village Health
SanitationandNutrition Daysor in campaignapproach.
7. Facility Based Newborn Care: Special New-born Care Units (SNCUs) are
established at District Hospital and Medical College level, Newborn Stabilization Units
(NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres
(CHCs) for care of sick andsmall babies.
8. Community Based care of Newborn and Young Children: Under Home Based
New-born Care (HBNC) and Home-Based Care of Young Children (HBYC) program,
home visits are performed by ASHAs to improve child-rearing practices and to identify
sick newborn andyoungchildreninthe community.
9. JananiShishuSuraksha Karyakram(JSSK)entitlesallpregnantwoman delivering
in public health institutions to have absolutely free and no expense delivery, including
caesareansection. Theentitlementsincludefree drugs,consumables,free dietduringstay,
free diagnostics, free transportation and free blood transfusion, if required. Also, Sick
infant up toone year of age is entitledto free treatment inpublic healthinstitutions along
with the provisionof free transport, diagnostics, medicines, bloodandconsumables.10. Social Awareness and Actions to Neutralize Pneumonia Successfully
(SAANS) initiative implemented since 2019 for reduction of childhood morbidity and
mortalitydue toPneumonia.
11. STOP Diarrhoea campaign is implemented for promoting use of ORS and
Zinc andfor reducingmorbidityand mortalitydue tochildhooddiarrhoea.
12. Rashtriya Bal Swasthya Karyakram (RBSK): Children from 0 to 18 years
of age are screened for 32 health conditions (i.e.Diseases, Deficiencies, Defects and
Developmental delay) under Rashtriya Bal Swasthya Karyakram (RBSK) to improve
child survival. District Early Intervention Centres (DEICs) at district health facility level
are established for confirmation andmanagementof childrenscreened underRBSK.
13. Janani Suraksha Yojana (JSY) is a demand promotion and conditional cash
transfer scheme for promotinginstitutional delivery.
14. PradhanMantriSurakshit MatritvaAbhiyan(PMSMA)providespregnant
women a fixed day, free of cost, assured and quality antenatal check up by a
Specialist/Medical Officeronthe 9thdayof everymonth.
15. ExtendedPMSMAstrategy ensures quality antenatal care (ANC) to pregnant
women, especially to high-risk pregnant (HRP) women and individual HRP tracking
until a safe delivery is achieved by means of financial incentivization for the identified
high-risk pregnant women and accompanying ASHA for extra 3 visits over and above
the PMSMAvisit.
16. Surakshit Matritva Aashwasan (SUMAN) provides assured, dignified,
respectful and quality healthcare at no cost and zero tolerance for denial of services for
every pregnant woman and new-born visiting public health facilities to end all
preventablematernal andnewborn deaths.
17. OptimizingPostnatal Careaims to strengthen the quality of post-natal care
by laying emphasis on detection of danger signs in mothers and incentivization of
Accredited Social Health Activists (ASHAs) for prompt detection, referral & treatment
of such high-risk postpartum mothers.
18. Functionalization of First Referral Units (FRUs) by ensuring manpower,
bloodstorage units, referral linkagestoimprove the accesstoquality of care for pregnant
women
19. Village Health Sanitation and Nutrition Days (VHSNDs) are observed for
provision of maternal and child health services and creating awareness on maternal and
child-care including nutrition in convergence with Ministry of Women and Child
Development.
20. Outreach camps are provisioned for improving the reach of health care
services especially in tribal and hard to reach areas. This platform is used to increase the
awareness for the Maternal & Child health services, community mobilization as well as
totrackhigh-risk pregnancies.
21. Birth Waiting Homes (BWH) are established in remote and tribal areas to
promote institutional delivery andimprove accesstohealthcarefacilities.
22. Mother and Child Protection (MCP) Card and Safe Motherhood Booklet
are distributed to the pregnant women for educating them on diet, rest, danger signs of
pregnancy, benefitschemesandinstitutional deliveries.23. Regular IEC/BCC is also a part of all the schemes for greater demand
generation.Health and nutrition education through mass and social media is also
promotedtoimprove healthypractices andtogeneratedemandfor service uptake.
(c) The State/UT-wise details of Central funds released ST category-wise under National
HealthMission (NHM) from F.Y.2022-23 to2024-25 are placedat Annexure IV.
*****Annexurereferredtointhereplytopart(a)ofLokSabhaUnstarredQuestionNo.2478foranswer
on13.02.2026
Annexure I
State/UT-wise prevalence of malnutritioninchildren underage 5 yearsamongscheduledtribes
Children under Childrenunder Childrenunder5
SNo. State/UT 5 yearswhoare 5yearswhoare yearswhoare
stunted wasted underweight
INDIA 40.9 23.2 39.5
1 Andaman& Nicobar 21.9 15.8 18.1
2 Andhra Pradesh 44.5 20 45.2
3 Arunachal Pradesh 27.9 13.2 13.7
4 Assam 31.0 19.1 26.4
5 Bihar 46.9 23.8 45.9
6 Chandigarh 61.9 61.9 61.9
7 Chhattisgarh 38.6 21.0 36.0
8 DNH&DD 50.5 23.9 51.4
9 Delhi 36.2 9.9 31.7
10 Goa 27.1 21.2 14.7
11 Gujarat 46.1 30.3 49.1
12 Haryana 22.2 12.7 20.6
13 HimachalPradesh 31.3 15.0 20.3
14 Jammu & Kashmir 28.3 19.3 24.7
15 Jharkhand 45.1 25.7 47.4
16 Karnataka 41.2 22.2 36.7
17 Kerala 32.4 14.8 21.8
18 Ladakh 34.8 17.4 22.6
19 Lakshadweep 36.1 16.6 23.7
20 Madhya Pradesh 40.4 21.2 39.5
21 Maharashtra 43.1 33.9 46.3
22 Manipur 27.1 10.2 12.7
23 Meghalaya 46.4 11.9 25.9
24 Mizoram 28.7 9.5 12.6
25 Nagaland 32.7 17.9 26.2
26 Odisha 42.9 22.7 42.1
27 Puducherry 0 0 0
28 Punjab 27.7 0 16.9
29 Rajasthan 35.4 18.7 31.9
30 Sikkim 23 10.4 16
31 Tamil Nadu 28.4 20.3 30.7
32 Telangana 34.3 23.5 33.5
33 Tripura 34.4 20.4 30.7
34 Uttar Pradesh 47.1 23.4 47.335 Uttarakhand 25.3 10.5 16.8
36 West Bengal 37.7 25.6 43.3
Source: NFHS-5,2019-21Annexurereferredtointhereplytopart(a)ofLokSabhaUnstarredQuestionNo.2478foranswer
on13.02.2026
Annexure II
State/UT-wise InfantMortalityRate
S
State/UT InfantMortalityRate
No.
INDIA 25
1 A&N Islands 9
2 Andhra Pradesh 19
3 Arunachal Pradesh 20
4 Assam 30
5 Bihar 23
6 Chandigarh 7
7 Chhattisgarh 37
8 D&N Haveli andDaman& Diu 9
9 Delhi 14
10 Goa 6
11 Gujarat 20
12 Haryana 26
13 HimachalPradesh 14
14 Jammu & Kashmir 14
15 Jharkhand 29
16 Karnataka 14
17 Kerala 5
18 Ladakh 4
19 Lakshadweep 9
20 Madhya Pradesh 37
21 Maharashtra 14
22 Manipur 3
23 Meghalaya 34
24 Mizoram 13
25 Nagaland 10
26 Odisha 30
27 Puducherry 7
28 Punjab 17
29 Rajasthan 29
30 Sikkim 6
31 Tamil Nadu 12
32 Telangana 18
33 Tripura 15
34 Uttar Pradesh 37
35 Uttarakhand 20
36 West Bengal 17
Source:Sample Registration System,RGI 2023Report
Unit: Per1000live birthsAnnexurereferredtointhereplytopart(a)ofLokSabhaUnstarredQuestionNo.2478foranswer
on13.02.2026
Annexure III
State-wise MaternalMortalityRatio
Maternal
S
State/UT MortalityRatio
No.
88
INDIA
1 Andhra Pradesh 30
2 Assam 110
3 Bihar 104
4 Jharkhand 54
5 Gujarat 51
6 Haryana 89
7 Karnataka 68
8 Kerala 30
9 Madhya Pradesh 142
10 Chhattisgarh 146
11 Maharashtra 36
12 Odisha 153
13 Punjab 90
14 Rajasthan 86
15 Tamil Nadu 35
16 Telangana 59
17 Uttar Pradesh 141
18 Uttarakhand 91
19 West Bengal 104
Source: RegistrarGeneralof India SampleRegistration System2021-23Annexurereferredtointhereplytopart(c)ofLok SabhaUnstarredQuestionNo.2478foranswer
on13.02.2026
Annexure IV
State/UT-wise Centralfunds*released STcategory-wise underNationalHealth
Mission(NHM) fromFY2022-23 to FY2024-25
(Rs incrores)
S.No. State/UT 2022-23 2023-24 2024-25
1 AndamanandNicobar Islands 0.00 0.00 3.10
2 Andhra Pradesh 130.16 76.50 88.37
3 Arunachal Pradesh 124.85 172.99 113.07
4 Assam 262.34 169.84 159.66
5 Bihar 30.39 24.50 35.74
6 Chhattisgarh 311.13 256.28 307.03
7 Goa 3.88 2.90 7.08
8 Gujarat 128.10 226.41 201.92
9 HimachalPradesh 58.55 32.88 43.00
10 Jammu andKashmir 14.45 47.78 49.08
11 Jharkhand 212.29 165.04 253.05
12 Karnataka 103.40 70.55 132.79
13 Kerala 46.64 3.16 103.49
14 Madhya Pradesh 429.36 293.60 572.98
15 Maharashtra 321.66 277.31 234.18
16 Manipur 18.74 30.32 33.49
17 Meghalaya 134.56 141.61 33.57
18 Mizoram 67.37 63.34 30.33
19 Nagaland 49.68 112.32 91.93
20 Odisha 454.37 316.26 472.97
21 Punjab 0.00 0.00 5.71
22 Rajasthan 142.88 232.87 324.85
23 Sikkim 22.30 16.43 13.48
24 Tamil Nadu 15.81 90.58 27.09
25 Tripura 54.48 54.77 43.02
26 Uttar Pradesh 187.84 189.84 40.84
27 Uttarakhand 20.43 38.54 74.42
28 West Bengal 75.21 50.88 30.75
29 Telangana 50.87 41.38 93.25
Source: NHM Finance
*The above releases relate toCentral Govt. Grants & donot include State share contribution.
*****