The chill of winter has subsided in Melghat, a remote tribal-dominated forest area in Maharashtra’s Amravati district, about 680 km from Mumbai, where 25-year-old Budhiya Bhusum is still grappling with the painful memory of losing her son, whom she gave birth to at home in May this year.
A teary-eyed Budhiya looks at the cot where her two other children are sleeping and whispers what could have been: “the child starts eating now, i speak (The child must have started eating and calling me mother).” Her words echo the silent struggles of many women in the region – including Dharani and Chikhaldara taluks – who have seen the death of their children due to malnutrition and poor health infrastructure.
Budhia belongs to the Korku tribe, an indigenous group with Munda ethnic roots, and lives in Domi village of Chikhaldara taluk, which falls under the jurisdiction of Hataru Primary Health Center (PHC). His village is 7 km away from the PHC, which takes about half an hour to reach due to a three km long dilapidated road.
When? The Hindu Visited the PHC, there was no electricity. Irregular power supply is a daily challenge that the facility faces. Villagers say peripheral issues like bad roads and weak cellular connectivity add to the delay in treatment.
According to a medical officer at the PHC, one of the reasons for the death of Budhiya’s newborn son was premature low birth weight (LBW), with the baby weighing just 1.7 kg.
According to Amravati district health department data, between April and October this year, 97 children (under six years of age) died in the Melghat area, including 30 due to stillbirth and 27 due to LBW. Other causes of death were aspiration asphyxia, birth asphyxia, milk asphyxia, neonatal jaundice, pneumonia, anemia, convulsions and snakebite. From April 2023 to March 2024, 39 children died due to LBW and 72 children were born stillborn. Between April 2024 and March 2025, there were 28 LBW deaths and 77 stillbirths.
poor maternal health
“Infants with LBW have a high risk of death due to immature body systems, which is often linked to poor maternal health. In Melghat, at least 30% of women are malnourished, which contributes to LBW deaths and affects infant survival. LBW also causes comorbidities, infections and cognitive delays in babies,” says Dr Ashish Satav, who has worked extensively in the region.
Budhiya weighed 38 kg and was suffering from anemia. Iron deficiency affects fetal development and increases the risk of LBW and premature delivery.
According to official data, 4,170 out of 4,437 pregnant women in Melghat were found anemic between April and October this year.
Raksha Kasture, a 29-year-old Korku woman from Laktu village, 190 km from Amravati city, faces a similar plight. ,I killed your child, right?(Wasn’t it your child who died),” says an ASHA (Accredited Social Health Activist) worker. ,yes, it was the third (Yes, my third child),” replies Raksha, who has suffered two miscarriages before.
Their three-month-old child died in January this year due to malnutrition and congenital anomalies. She is also malnourished and is currently eight months pregnant. “I wanted to have this child, thinking that my dead child had come back to me,” she says, sitting in front of a pile of used clothes in her hut.
Maternal mortality rate has increased in Melghat in the last five years, from 70 in 2021-2022 to 83.17 in 2025. Officials acknowledge maternal undernutrition as a significant problem, but quantitative data are lacking.
Monica Bharve, 30, of Sadarabari village in Dharni, is thin and weak. Her children, aged three and nine, are suffering from severe acute malnutrition (SAM) due to being underweight.
Prajakta Sable, medical officer at Sadarabari PHC, says, “Both the children have been admitted to the nutritional rehabilitation centre. They are being given nutritious food and medicine, but they are not gaining weight. Their growth is slow compared to other children.”
Factors such as malnutrition, early marriage and limited access to health care contribute to high-risk pregnancies and abortions in Melghat.
In 2015, the state government launched the Amrit Aahar scheme under the Integrated Child Development Scheme to provide nutritious food to pregnant women and lactating mothers in tribal areas. However, NGOs working in the area suggest that providing food is not enough and investment in long-term measures is needed.
According to data from the Women and Child Development Department, Melghat recorded 119 SAM cases and 1,646 cases of moderate acute malnutrition (MAM) from April to October this year. In comparison, 2022 saw 110 SAM cases and 1,506 MAM cases. According to nutrition tracker data for February 2025, there are 1.82 lakh malnourished children in Maharashtra, with 30,800 cases of SAM and 1,51,643 cases of MAM.
Inadequate infrastructure compounds the challenges faced by parents in Melghat, which has 324 villages and a population of 3.24 lakh but only 11 PHCs, two rural hospitals and one upazila hospital to cater to their needs.
Due to these constraints, critically ill patients are often referred to district hospitals and superspeciality facilities in Madhya Pradesh’s Amravati city and neighboring Burhanpur.
Budhiya Bhusum and her husband Nilesh Bhusum at their home. , Photo Credit: Emmanuel Yogini
limited health care infrastructure
Budhiya says that her child moved his legs during birth, but did not cry. “The child was taken to Hataru PHC, then referred to the rural hospital in Churni. From there, the child was referred to the upazila hospital in Achalpur, a two-hour drive away. Time simply ran out,” says a medical counselor on condition of anonymity.
Budhiya’s 28-year-old husband Nilesh Bhusum says, “If we had reached (the hospital) on time, this would not have happened.”
Gaza Dhikkar, 28, says he lost his wife, Vanita, 24, and newborn baby because of delays in treatment due to the “never-ending referral process.”
Their five-day-old child died on the way from Churni rural hospital to Achalpur upazila hospital. “They (officials) kept referring us from one hospital to another saying it was pneumonia. In the process I lost my child.”
Gaza says their child died on October 7, five days after Vanitha’s death. She was a patient of sickle cell anemia and had a high-risk pregnancy.
“Referrals occur due to lack of services or specialists in PHCs and sometimes in rural hospitals. To reduce referrals, we need at least one pediatrician and one gynecologist in PHCs. If attention is paid to building infrastructure and improving the living conditions of doctors, there can be zero deaths,” says a medical officer, who did not want to be named.
A defunct ‘Maher Ghar’ for expectant mothers at the Sadarabari Primary Health Center in Dharani taluk of Amravati district, Maharashtra. , Photo Credit: Emmanuel Yogini
turning to traditional methods
Villagers often become victims of superstition and fall into superstition. Bhumakas A doctor from Dharani says (traditional healers) when they realize that getting the necessary treatment for their children may mean traveling to a hospital in Amravati city.
These are of three types Bhumakas In Korku tribe: Priest (Priest), Veda (Ayurvedic physician), and avoidance (Soul Healer). Dr Ashutosh Solanki, medical officer at Hataru PHC, says, “People want their children to get treatment. Sometimes this also causes delay (in medical treatment).”
,Bhumakas They are the ones who mislead people,” says Ashok, a member of the Korku tribe.
While the local administration has suggested that some Bhumakas There is Ayurvedic knowledge which can be used for research and development, doctors with the help of ASHA workers have tried to convince the villagers not to contact Bhumakas For treatment. The administration is now organizing awareness workshops for this Bhumakas. An initiative was launched to encourage villagers to access health centres, but it did not gain momentum as people rarely turned up.
Amravati Collector Ashish Yerekar blames child marriage and girls dropping out of school for poor maternal health. Zilla Parishad schools provide education only up to class 7.ashram schools Started in the 1990s (boarding schools), there has been no improvement in infrastructure and lack of quality education. They are very crowded. Students drop out between classes 7 and 12,” he says.
“We need a paradigm shift in thinking and strict monitoring of school dropouts so that child marriage can be identified,” says the collector.
A Village Child Protection Committee will be set up to monitor child marriages and school dropouts from January 1, 2026. He says sarpanches will be held accountable and disqualified if they fail to report school dropouts and child marriages.
HC intervention
In November this year, Justices Revati Mohite Dere and Sandesh Patil of the Bombay High Court pulled up various departments of the state government, including health and women and child development, over the deaths of infants due to malnutrition in the Melghat area. The court described the deaths as “horrific” and the government’s approach as “extremely casual”.
An affidavit filed in the court highlighted overcrowding at the upazila hospital in Melghat with 38 vacant medical posts and 50 beds. “We are trying to fill the vacant posts, but there are challenges because appointed doctors do not turn up. We need sonologists and radiologists in the sub-centres and we are in the process of making appointments,” says Dr Suresh Asole, district health officer.
He said that two private technicians have been appointed to come to the upazila hospital on two specified days a week for sonography.
‘Reluctance to seek health care’
Medical consultants say reluctance to seek health care has contributed to deaths in the area. In Vanitha’s case, doctors were reluctant to discharge her after delivery, but she insisted on going home.
Ashok Dhikkar, medical counselor at Hataru PHC, says, “Vanita was advised to stay there, but she did not listen. She died a day after discharge.” However, according to her husband Gaza, she wanted to “perform” Prayer And return to PHC after a day”.
In each PHC, two medical counselors and ASHA workers, usually belonging to the Korku tribe, play a key role in convincing women to seek treatment.
Mamta, a counselor at Sadarbari PHC, says, “Some women are willing to come and keep an eye on follow-up appointments. But the men are harsh and do not allow them to leave the house.”
snehal.mutha@thehindu.co.in
Vadapalli Edited by Nitin Kumar
