India’s Adivasi scheduled tribe population is disproportionately affected by undernutrition and anemia, thereby prevailing in the poorest wealth deciles denominated as socially and economically vulnerable. This study was designed to assess the extent of child undernutrition (conventional and composite index of anthropometric failure (CIAF) classification), as well as the burden of anemia in children and its independent nutrition specific and sensitive drivers, moreover to reflect the living conditions of Santal Adivasis. The research survey was conducted in 21 Santal villages, Birbhum District, West Bengal, in 2015. An overall 307 children (aged 6–39 months) and their mothers (n = 288) were assessed for their hemoglobin (Hb) levels (HemoCue Hb201+) and anthropometric indices such as height/length, weight and mid-upper arm circumference (MUAC). Moreover, socio-demographic household characteristics were surveyed. The study confirmed Adivasi children lagging behind national average with a high prevalence of undernutrition (height-for-age z-score (HAZ) 51.9%, weight-for-age z-score (WAZ) 49.2%, weight-for-height z-score WHZ 19.0% and CIAF 61.6%) and of moderate and severe anemia (Hb < 10 g/dL, 73.3% altogether). Child’s age <24 months, low WAZ scores, morbidity (any fever, diarrhea or respiratory infection) on the checkup day or during previous week, low maternal Hb level, and lack of dietary diversification were identified as predictors for anemia, thereby warrant targeted interventions to decrease the high anemia rates assessed in the study site.

Background: In West Bengal, according to the National Family Health Survey (NFHS-4) 2015-16, undernutrition and anemia are particularly common among scheduled tribe women and children. The purpose of this research is to assess the nutritional status of Adivasi mothers and child feeding patterns, relevant for clinical practice and the design of future preventive actions. These baseline characteristics were obtained in the scope of a feeding trial aimed at improving the hemoglobin concentration of the index child (6-39 months). Methods: In February 2015, the baseline survey was conducted in 21 tribal villages. In total, 288 mothers and 307 children were recruited for their hemoglobin levels (HemoCue Hb201+), as well as anthropometric indices height/ length, weight and MUAC. By questionnaire-based interview aspects on child feeding practices, childcare, family scheduling, and prenatal care were elucidated. Results: The majority of mothers belong to the Santal tribe (93.8%). Nearly half of mothers suffered from underweight including severe forms (BMI < 18.5: 49.4%), and the majority of mothers were anemic (Hb < 12 g/dl: 86.2%). Similarly, undernutrition was highly prevalent among the index children. Ever breastfeeding was almost universal in the study area (99.6%), with all infants aged < 12 months at the time of the interview still being breastfed. The majority of children were breastfed within the first hour after birth (75.7%), still every third child (32.2%) was deprived of colostrum. Merely 32.9% of infants were exclusively breastfed for 6 months (180 days) according to the recommendations of the WHO/UNICEF. When relating to the proposed complementary feeding (CF) indicator then 89.6% of children have received CF (mainly family foods/biscuits/plain rice) during the first 6 to 8 months, and 46.8% of children aged 6 to 23 months fulfilled the minimum acceptable diet (2 to 3 meals per day and ≥ 4 food groups per day), corresponding to 58.1% among children aged 12 to 23 months versa 25% among infants aged 6 to 11 months.

Background and objectives: Malnutrition associated with anemia remains a leading cause of morbidity and mortality among Adivasi children in India. The present trial aimed to test three possible ways of designing improved supplementary meals and to define their role in decreasing rates of anemia, thus increasing hemoglobin (Hb) concentrations as primary health objective: diversified meals only (intervention group 1 (IG 1)), with the addition of locally producible Amaranthus tricolor/Moringa oleifera leaf powders (ALP/MLP) in the ratio 2:1 (IG2) or with an adjusted amount of commercially produced micronutrient powder TopNutri (IG3). Methods: Cluster-randomization of 21 villages resulted in the inclusion of n=293 children aged 6-39 months after baseline assessment. The trial duration was 18 months, beginning in February 2015 (baseline assessment), with application of study meals three times a week at community level. Anthropometric, Hb (HemoCue201+) and morbidity data were collected in a total of four assessment points. At baseline a socio-economic questionnaire was performed. Results: Adjusted for age and Hb concentrations at baseline, time between assessment points, and gender; IG1 showed significant higher Hb concentrations as compared to the control group (CG) throughout the intervention period. The Hb of the remaining intervention groups IG2 or IG3, remained comparable to the CG at all assessment points. The effect on growth indices was less consistent, however most positive tendencies related to nutrition status (stunting, underweight, wasting) and morbidity reduction were attributable to IG3, indicating the beneficial role of a holistic nutrient composition in addressing undernutrition and infectious diseases. Conclusion: This low-dose intervention trial proofed the feeding of diversified diets alone (IG1) to be sufficient to significantly increase Hb concentrations of study children. On the way of achieving diversified diets for Santal children the promotion of kitchen garden programs combined with interactive awareness trainings may be a key measure. Trial registration: the trial was retrospectively registered at the German Clinical Trials Register on the 1 st July 2019 (DRKS00017388). URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017388