Despite decades of targeted welfare programmes and special government interventions for Particularly Vulnerable Tribal Groups (PVTGs), chronic malnutrition, widespread anaemia, childhood stunting and poor maternal health continue to afflict Odisha's most marginalised tribal communities. This has been revealed by one of the largest field-based studies conducted in the state recently.
PVTGs are the most marginalised tribes in India, marked by low development, primitive livelihoods, and declining populations.
The study titled ‘Technical Report on Health, Nutrition and Socio-Cultural Status of Odisha's Particularly Vulnerable Tribal Groups', released by the Centre of Excellence in Studies on Tribal and Marginalised Communities (CoE-STMC) at Utkal University, paints a stark picture of persistent health deprivation despite sustained policy attention.
The study also presents a contrasting picture of remarkable cultural resilience.
Traditional governance systems, oral heritage and ecological knowledge remain largely intact, while nearly half the surveyed population is below 19 years of age, offering what researchers describe as a potential demographic dividend if supported by sustained investments in health, nutrition and education.
However, while improvements have been recorded in family planning awareness and antenatal care in some communities, the benefits of welfare interventions have yet to translate into better nutrition, maternal health and living conditions for a large section of the population.
Based on a survey of 9,222 individuals from 2,041 households across 10 of Odisha's 13 PVTGs, the report documents high levels of undernutrition, widespread anaemia, continued dependence on home deliveries, poor menstrual hygiene, inadequate sanitation and limited access to safe drinking water and electricity.
The study covered the Bonda, Didayi, Dongria Kandha, Kutia Kandha, Juang, Paudi Bhuiya, Hill Kharia, Mankidia, Lodha and Lanjia Saora communities across the tribal-dominated districts of Malkangiri, Rayagada, Kandhamal, Keonjhar, Deogarh, Mayurbhanj and Gajapati.
Researchers combined household surveys, anthropometric assessments and ethnographic fieldwork with documentation of tribal languages, oral traditions and socio-cultural practices.
The findings assume importance as India seeks to improve health and nutrition outcomes among its 75 PVTGs, which remain among the country's most socio-economically disadvantaged populations despite targeted welfare programmes.
The study found that chronic undernutrition remains widespread, with children's height-for-age and weight-for-age measurements continuing to fall below World Health Organization standards, indicating persistent stunting and underweight prevalence.
At the same time, researchers observed the early emergence of metabolic disorders among adults, suggesting that these communities are beginning to experience a double burden of malnutrition, where undernutrition coexists with non-communicable disease risk.
Anaemia emerged as another major concern. More than one-third of adult men were found to be anaemic, while researchers said the burden among women was even higher, exceeding half of the adult female population in several communities.
Early signs of hypertension and prediabetes were also detected, indicating that chronic diseases are beginning to affect populations that have traditionally battled infectious diseases and undernutrition.
Maternal healthcare indicators also revealed substantial gaps. Nearly 59 per cent of births still occur at home, raising concerns over access to skilled birth attendance and emergency obstetric care. Only 19 per cent of women reported using sanitary napkins, pointing to inadequate menstrual hygiene awareness and limited availability of reproductive health services.
Researchers noted that although awareness of family planning has increased to 68 per cent, and antenatal care coverage has improved among communities such as the Juang and Dongria Kandha, these gains have yet to translate into uniformly better maternal and child health outcomes.
The report also highlights wider social determinants affecting health. Nearly 39 per cent of the surveyed population remains non-literate, while housing, sanitation, electrification and access to safe drinking water continue to vary considerably across tribal settlements.
According to the researchers, these disparities underline the need for development strategies tailored to the unique cultural and geographical context of each tribal community rather than adopting uniform welfare models.
"Considering the high cultural diversity among these communities, a one-size-fits-all solution is not useful."
“There is a need for PVTG-specific and culturally sensitive development plans covering education, livelihood diversification, housing, language preservation, maternal and child health, nutrition, safe drinking water, sanitation, non-communicable disease screening and reduction in school dropouts," said Dr. Subhendu Kumar Acharya, scientist at the ICMR-Regional Medical Research Centre, Bhubaneswar, and co-lead of the study.
The researchers have also recommended strengthening adolescent reproductive health services, improving antenatal and postnatal care, ensuring universal iron-folic acid supplementation, expanding institutional deliveries, introducing community-based growth monitoring and establishing routine screening for hypertension and diabetes.
Behaviour-change programmes targeting tobacco and alcohol use, along with support for agroforestry, non-timber forest produce value chains and rural micro-enterprises, have also been proposed.
Prof. Prasanna Kumar Patra, Coordinator of the Centre of Excellence, said the findings reflected both hope and concern.
"What stands out most is the resilience of these communities. Their oral traditions, governance systems and ecological knowledge continue to survive, and nearly half the population is below 19 years of age. But this resilience should not overshadow the health challenges."
“Anaemia among women, childhood stunting and the high proportion of home deliveries indicate that essential maternal and nutritional services are still not reaching these communities consistently," he said.
Beyond Odisha, the report has broader policy implications. Based on the findings, Utkal University has recommended replicating similar interdisciplinary studies across PVTG-dominated states such as Jharkhand, Chhattisgarh and West Bengal before expanding the model to all 75 PVTGs across the country.
This would enable governments to design more targeted interventions, monitor progress over time and allocate resources based on the specific needs of each tribal community rather than relying on broad national averages, said the researchers.
The report also argues that strengthening surveillance, continuous monitoring and impact evaluation using disaggregated data will be essential if India is to bridge longstanding health and development gaps among its most vulnerable tribal populations while preserving their unique cultural identity.
