Context: During my internship with the State Centre of Excellence for Severe Acute Malnutrition Management (Jharkhand), I gained valuable experience through deep fieldwork and meaningful contact with people from various indigenous tribes. This allowed me to learn about their lifestyles, eating habits, and fascinating cultural perspectives. One noteworthy field visit occurred in the Tonto block of Jharkhand’s West Singhbhum district, where I engaged with a lactating mother to learn about her eating patterns and health practices. This experience left a lasting impression on me, encouraging me to conduct a thorough case study on the subject. I attempted to explore cultural misconceptions, healthcare practices, nutritional understanding, and other food-eating habits using the case study. The woman had an underweight infant and anaemia. During the conversation, she discussed how she met her husband while working as a construction labourer before getting married. 

She was independent in terms of eating, going out, and spending time with friends at the time. Her life, however, took a big turn after marriage, when she began living with her in-laws. Due to cultural conventions and prevalent myths in her community, her capacity to choose her dietary intake became limited. It’s just been a month since she gave birth to a baby girl. She has not been permitted to eat much since then, as the family fears that consuming more will cause fat deposition in her body, restricting the flow of breast milk. The case study attempted to comprehend her beliefs and cognitive processes.

Problem Statement: Sobha’s dietary intake has been drastically lowered following childbirth. She now only eats two meals per day, a complete package of white bread in the morning and a basic dinner of chapatti with salt at night. She follows this limited diet because her mother-in-law has ingrained in her the belief that eating more will result in an increase in body fat, making it more difficult for her to effectively breastfeed her child. Over time, there have been many strong myths and taboos developed in the community regarding dietary practices and the standard of diet that lactating mothers must adhere to. This has resulted from a lack of awareness and the persistence of strong community beliefs among indigenous societies. The lack of resources in the community later fuels these beliefs and myths, making women the most vulnerable victims of these myths. Unfortunately, these circumstances contribute to a higher prevalence of anaemia and low BMI among community members, a pattern that Sobha has adopted. Her own struggle with severe anaemia and a low BMI demonstrates the persistent impact of these beliefs, resource restrictions, and cultural convictions.

Root Cause: The limited access to food and nutrition in Sobha’s community can be attributed to various factors: 

• Cultural Practices: Along with our collective perceptions, the community has established stereotyped notions about the ideal appearance of women, embracing factors such as body type, shape, structure, colour, and behaviour. Unfortunately, these elements have contributed to the formation of a negative concept of beauty and appeal, especially in men’s eyes. To implant these notions in women, the community spread myths and erroneous traditional beliefs, which inhibited and discouraged them from maintaining a healthy diet, eventually leading to nutritional inadequacies.
• Economic Deprivation: The allocation of food and resources often prioritises men over women, leaving women, particularly lactating mothers, with limited access to nutritious food.  
• Lack of Awareness: The persistence of dietary myths during both the antenatal and postnatal phases has promoted concepts such as the belief that ingesting dairy products, leafy vegetables, non-vegetarian meals, and greasy items could harm breast milk supply. Because the majority of the community is unaware of optimum nutritional intake, there is widespread confusion about the required amount of food for breastfeeding mothers. As previously said, women’s food choices continue to be severely limited and extensively influenced by family members, primarily male member of the family, who themselves lack adequate understanding about optimal nutrition for the pre- and post-natal periods.

The facilitator and writer illuminated the topic by utilising a visual aid known as the nutritional wheel chart. Field workers frequently use this tool to educate and promote knowledge of healthy eating habits in communities. The dietary wheel chart employs a “tiranga” concept, which employs three essential color-coded food groups important for ingestion by mothers and adolescents. Saffron emphasises the value of adding lentils or dal to one’s diet; white represents the use of dairy products, including eggs; and green depicts the need to consume locally available green vegetables.

In addition, ASHA and Aganwadi personnel were also educated on the moms’ acute food needs. The block coordinators are currently instructing them on how to use the dietary wheel and the “tiranga” paradigm. This will enable them to effectively engage in community-wide mobilisation. With a major emphasis on boosting nutritional diversity and encouraging the use of micronutrient supplements such as vitamin A, calcium, and iron supplements, which are accessible in Anganwadi centres.

Outcome: The intervention aims to raise awareness among Sobha and her community on the necessity of good nutrition for breastfeeding mothers and pregnant women, as well as the value of ingesting micronutrients. It sought to encourage improved nutritional intake and overall well-being for both Sobha and her child by dispelling myths and misconceptions about post-delivery dietary practices.

Learning: This case study emphasises the importance of education and awareness in confronting cultural behaviours and myths that harm maternal nutrition. It also emphasises the importance of community-wide efforts to promote gender parity and focus on women’s nutritional needs during the pre- and post-pregnancy periods.

Writer Profile

This opinion blog is written by Megha Rani and edited by Abhishek Kumar Gupta.

Megha Rani, a TISS alumna, holds dual degrees: “BASW-RD” and “PGDWASH”. She is a former UNICEF Odisha YP and Y4W+ member. Currently pursuing an MPH from IIPH-G, her focus spans gender-nutrition links, WASH, and climate change. Her commitment lies in developing a deeper understanding of tribal and vulnerable communities.