India is home to over 104 million tribal people (2011 Census), constituting about 8.6% of the country’s population. Despite various constitutional safeguards and welfare programs, tribal communities continue to face persistent health inequities. Andhra Pradesh, with its significant tribal population living in Fifth Schedule and sub-plan areas, reflects these broader trends while also presenting unique regional challenges.
Between 2021–2022 and 2024–2025, the tribal areas of Andhra Pradesh witnessed mixed trends in maternal and child health outcomes, with notable progress in some indicators and concerning reversals in others.
One of the most significant improvements was in the Maternal Mortality Ratio (MMR), which declined markedly from 150 per 100,000 live births in 2021–2022 to 91 in 2024–2025. This sharp decline suggests improved maternal care services, possibly due to expanded institutional deliveries and better antenatal coverage. The state’s continued focus on maternal health infrastructure and frontline worker engagement may have played a key role in this achievement.
In contrast, the Infant Mortality Rate (IMR) rose slightly, from 13 to 15 per 1,000 live births during the same period. A similar upward trend was observed in the Under-Five Mortality Rate, which increased from 15 to 16 per 1,000 live births. These small but significant increases indicate that, while maternal care may be improving, postnatal and early childhood care still face quality and access gaps. Contributing factors could include neonatal infections, poor nutrition, and delayed referrals in remote tribal hamlets.
Another concern is the declining trend in Pregnant Women (PW) registration, which fell from an impressive 101% in 2021–2022 to 89% in 2024–2025. This drop may suggest weakening early antenatal outreach or under-reporting in hard-to-reach tribal populations. Similarly, full immunization coverage declined from 101% to 93% over the same period. While coverage remains relatively high, this decline could reflect lapses in service delivery consistency, missed follow-up visits, or increasing vaccine hesitancy.
On a positive note, institutional deliveries have shown steady improvement, increasing from 98.55% to 99.63%. This near-universal rate of institutional births is commendable and reflects the success of incentive-based programs, better transport services, and increased trust in health facilities. Within this, government institutional deliveries rose marginally from 76.52% to 76.81%, indicating consistent reliance on public health infrastructure despite the growing presence of private-sector services.
To sustain and accelerate progress, the state must prioritize strengthening community outreach, ensuring timely follow-ups, addressing service delivery gaps, and improving data tracking in remote areas. Continued investments in tribal health systems, supported by culturally responsive care and local participation, will be key to reversing negative trends and ensuring holistic health gains across the tribal belts of Andhra Pradesh.
When compared to the National Family Health Survey (NFHS-5) data from 2019–20, tribal health figures in Andhra Pradesh—though slightly better than the national averages—still demand urgent intervention. For instance, India's overall stunting rate is 35.5%, while Andhra Pradesh stands at 31.2%. The national underweight rate is 32.1%, compared to 29.6% in Andhra Pradesh. Tribal areas perform marginally better, but internal disparities across districts remain stark.
As of March 2025, 27.4% of tribal children in the state were stunted, 15.26% were underweight, and 8.89% suffered from wasting. In contrast, non-tribal children show significantly lower rates: 16.73% stunted, 6.88% underweight, and 4.5% wasted. These disparities highlight deep-rooted inequities not just in nutrition, but in overall development—spanning access to healthcare, sanitation, education, and food security.
Some districts like Alluri Sitharama Raju (ASR), Prakasam, and Anakapalli emerge as high-burden zones. For instance, ASR recorded the highest rates in the state: 33.98% stunting, 20.07% underweight, and 11.28% wasting. These figures suggest that a significant portion of children in ASR are not achieving optimal growth and are at risk of long-term physical and cognitive impairments.
Conversely, districts such as Kakinada, Nandyal, and Palnadu have demonstrated relatively better outcomes. Kakinada, for example, reported just 12.58% stunting and 5.87% underweight. This implies that localized policies, better infrastructure, and potentially more effective Anganwadi Center (AWC) services are contributing to improved child health outcomes.
Interestingly, access to essential services—such as electricity, toilets, and clean drinking water—correlates with better nutritional outcomes in several districts. Yet, even in areas with adequate infrastructure, nutrition levels can remain poor due to factors like limited dietary diversity, poor maternal nutrition, or lack of awareness about child-feeding practices.
These findings suggest that systemic nutritional inequality in tribal areas goes beyond mere food insecurity. They point to structural issues in development and service delivery. Despite the presence of schemes like ICDS (Integrated Child Development Services), SNP (Supplementary Nutrition Programme), and POSHAN Abhiyaan, the persistent gaps indicate challenges in accessibility, implementation, and local adaptation of these programs.
The high rates of stunting among tribal children are particularly alarming, as stunting reflects chronic undernutrition and has irreversible consequences on physical and cognitive development. Likewise, high levels of underweight and wasting signal both chronic and acute deficiencies in dietary intake and health status.
Addressing tribal child malnutrition requires community-specific, culturally sensitive, and geographically tailored interventions. Enhanced outreach, stronger community engagement, and robust monitoring mechanisms are essential to ensure that the benefits of nutrition and health programs reach every tribal household. Efforts must also include capacity-building for frontline workers, improving infrastructure at Anganwadi Centres, and incorporating local food habits into nutrition planning.
A multi-pronged strategy is necessary. Enhancing Take-Home Ration (THR) programs with diverse and culturally accepted food items, strengthening community engagement through ASHA and Anganwadi workers, and institutionalizing monthly growth monitoring are critical steps. Additionally, expanding the reach and quality of nutrition education and health services in tribal belts is vital to reversing these trends.
While Andhra Pradesh has made some commendable progress in addressing child malnutrition and maternal health, the situation in tribal regions remains fragile. With targeted policy measures, data-driven interventions, and active community involvement, it is possible to improve the nutritional landscape and secure a healthier future for tribal children across the state.
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