The story so far: The Bombay High Court, on November 12, pulled up the Maharashtra and Union governments for an “extremely casual” approach to the disturbing number of deaths due to malnutrition among infants in the State’s tribal-dominant-region, Melghat, in Amravati District.
During the hearing, a petitioner claimed that from June 2025 to date, 65 infants aged between zero and six months had died due to malnutrition in Melghat, while more than 220 children were in the SAM (Severe Acute Malnutrition) category, out of which 50% may die if no help is provided. The Court slammed the government over negligence in following previous court orders in this regard. The Division Bench directed officials to submit a detailed action-taken report and asked the principal secretaries of the public health, tribal affairs, women and child development, and finance departments to appear in court on November 24.
Where do Melghat and Maharashtra stand today?
The issue of infant deaths due to malnutrition and maternal deaths due to lack of maternal healthcare has always persisted in Melghat, home to Korku tribal communities, despite three decades of government interventions. The main causes of malnutrition have been a lack of food, infections, poor access to healthcare, and anaemia, which triggers a spike in fatalities.
Fatalities have fluctuated over the past decade. Melghat comprises two taluks Dharni and Chikaldhara – consisting of 324 villages. According to data from Amravati Zilla Parishad, in 2023, from April to March, 140 infants died; from April 2024 to March 2025, 96 infants died, and in the last seven months of this year, 61 children have died. Officials from the Amravati Zilla Parishad office however state the cause of most of these recorded deaths is not just malnutrition but other underlying issues, including anaemia, sickle cell disease, pneumonia, delays in treatment due to lack of connectivity, and others.
An affidavit filed in Court on October 16, states that as of November 2024, about 10,000 children were suffering from malnutrition, under the SAM category. In Dharni Taluka, 1,290 children have been identified, while in Chikhaldara Taluka, 788 children have been indentified.
“All these deaths are not because of malnutrition but other issues. We are running a hot food scheme in the Melghat areas, providing eggs and bananas four times a week. We have set up the village child development centre (VCDC) in all gram panchayats to monitor SAM cases,” said Amravati ZP Chief Executive Officer, Sanjita Mohapatra, adding that peripheral issues still needed to be addressed.
The petitioner however, argued that even though the cause of death has been recorded as pneumonia or other causes. malnutrition is also a reason. The argument was that the government is unable to treat the illnesses — pneumonia, diarrhoea, fever, dehydration and others — which can turn fatal if medical care is not given on time.
Maharashtra’s Women and Child Welfare Department Minister, Aditi Tatkare, who provided Poshan tracker data on malnutrition for February 2025 in the Maharashtra Assembly, stated that the tracker recorded 1,82,443 malnourished children across the State, including 30,800 with Severe Acute Malnutrition (SAM) and 1,51,643 with Moderate Acute Malnutrition (MAM). The Indian Institute of Population Sciences (IIPS), Mumbai, noted that Maharashtra continues to perform poorly on child nutrition, with 35% of children under five stunted, 35% underweight, and 26% wasted.
What are the challenges?
Peripheral issues that State government point to include lack of proper roads to reach a hospital in time, inadequate electricity supply to homes, lack of primary healthcare centres (PHC), the prevalence of substance abuse and more. According to experts working in Melghat, the multiple government departments that execute programmes here operate in silos, resulting in inconsistent supplement delivery, irregular monitoring, and weak coordination to sustain implemented policies. Appointments of specialists, shortage of medical staff, and the slow upgradation of of multispeciality hospitals are issues that continue to remain unaddressed.
“The roads are in poor condition and not maintained. Why would anyone work if the government fails to provide basic civic facilities?” asked tribal activist Bandu Sane, referring to the shortage of doctors.
Finding and retaining doctors, including paediatricians, gynaecologists, and other hospital staff members, remains a major challenge as the absconding rate (absent from work) is high. For instance, from September 2 to October 10, three paediatricians and three OBGYNs were enrolled into service in Melghat. Among them, one did not join, and four joined but subsequently absconded, as per data from the District Health Officer, Zilla Parishad Amravati.
Ms. Mohapatra says the salary and incentives have increased, but the mindset of doctors remains unchanged. She also pointed out that Infant Mortality Rate (IMR), which is a key indicator of child health, has improved in Melghat, i.e., 16.5% while Maharashtra’s IMR is 15 as per the Sample Registration System data (SRS survey 2023).
The other challenge the preference for faith and traditional healing. Many from the tribal community still prefer to consult traditional healers bhoomkas for treatment, who may use damma methods (burning the skin with red-hot iron tongs) in attempts to heal.
Intergenerational malnutrition presents another challenge, as women often enter pregnancy severely underweight and anaemic, leading to low-birth-weight babies, who then have weakened immunity and vulnerable to infections. Limited access to healthcare can then add to problems, as infections may not be treated on time.
What are expert-approved solutions?
The eradication of malnutrition is not limited to providing mid-day meals or food supplies say experts, but also involves creating a well-oiled healthcare system, where nutrition is provided for both mothers and children; creating a cadre of ASHA workers with a strong knowledge of health in order to be able to identify cases of malnutrition and take action; caring for co-morbidities through coordinated health and nutrition programmes; promoting community-centred behavioural change, and developing civic and health infrastructure.
Ending the infant deaths and improving maternal healthcare needs convergence, experts stress. All departments: health, women and child, rural development, social welfare, tribal department, and PWD, have to work together. Due diligence when it comes to appointing doctors and ensuring doctors stay and complete their tenures must also be prioritised, they say.
