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policy changes due to mahan

Advocacy for child deaths & Malnutrition: Dr. Ashish with Maharashtra Chief Minister

Policy Changes

27 State Govt. Policies newly framed / modified current policies / Models Implemented/ Replicated

Doctor's Visit

Member of Policy making bodies

12 Bodies Across Various Sectors

Research, Analysis, Advocacy & Public Interest Litigation (PIL) by MAHAN & KHOJ over the period, resulted into state govt. framing new policies, improving existing policies & replicating the models developed by MAHAN at other places

Policy Changes

1) Counsellor Program for government hospitals :

  •  Benefitted > 5 Lakh tribal patients. Increased hospitalization of sever malnourished children (12 times) and hospital deliveries(twice). Statistically significant Improvement in Hospitalized severely malnourished babies. "P" value <0.0001.

  •  It has been replicated in Rajasthan.

  •  In the reply submitted by Public Health Department, Govt. of Maharashtra, it has been mentioned that counsellor post for government hospitals in other tribal areas of Maharashtra will be proposed in next PIP under NHRM. On the verge of replication in in Maharashtra.

2) Proper surveillance :

  • ‘Rajmata Jijau Mother and Child, Health & Nutrition mission of Maharashtra Govt., accepted the MAHAN’s finding about real status of severe malnutrition (>9%)& child deaths(IMR >60/1000 live births) in   Melghat (September 2005 ); after our recommendations , later on observed similar findings in all tribal blocks of Maharashtra. This has impact on state level policies for malnutrition management. Initially government plans were for management of 1.2% of severe malnutrition and remaining 8% of severely malnourished children were not given special treatment. Now after our
    intervention those ~1 lakh children were given special attention and care. It has benefitted 1 lakh severely underweight and malnourished children. National Family Health Survey 4 has validated that the prevalence of SAM and SUW is very high in all tribal areas of Maharashtra. After our PIL,
    UNICEF has verified that IMR in Melghat is very high. (HBCC and Survey for prevalence before that)

3) ‘Village Child Developmental Centers’ (VCDC);-

Modified version of ‘Home Based Feeding’ concept, devised by MAHAN, is accepted by Rajmata Jijau Mission of Govt. of Maharashtra as state wide policy. MAHAN is part of planning policy committee for the VCDC for the entire state of Maharashtra. It has been implemented throughout Maharashtra since 2008-2009 benefitting > 1Lakh severely and >2 lakh moderately malnourished children. (HBCC)

4) Hot cook food :

Instead of Take Home Ration (prepared by industries), fresh  hot cooked food (prepared by self-help group of tribal/ ICDS workers) is being given to children below the age of 3 years (> 30000) to prevent malnutrition in whole Melghat since May 2011. By this change, lives of thousands of
malnourished children are saved & crores of government money has been utilized properly.


5) AIDS detection center have been started in Melghat.

6) Reclassification of severe malnutrition:

WHO and UNICEF reclassified malnutrition in 2005-06 and advised government of India to give special treatment to only severely acute malnourished (SAM) children. Due to this lakhs of children who were severely underweight (SUW) but not SAM , were denied special care and many of them died. MAHAN after scientific study in Melghat could convince honorable high court of Maharashtra to give order to Government of Maharashtra to use ‘SAM’ as well as ‘SUW’ criteria for classification and management of severe malnutrition. (May 2011) This has benefited lakhs of children of Maharashtra.

7) Rajmata Jijau Mother and Child Health and Nutrition Mission have been

started by government and UNICEF from 2005 after our activism, research and assembly questions. This has saved lakhs of children and pregnant mothers of Maharashtra from malnutrition and deaths. There was increment in the funds, number as well as rejuvenation of Village Child Developmental Centers & Child development centers in Maharashtra. It has benefitted  >3 lakh severely malnourished children.

8) IAS/ IFS officer as Integrated Tribal Development Project Officer (PO):

Government has appointed IAS/ IFS officers as PO for eight tribal blocks, who are overall in charge (Additional Collector) of tribal areas &amp; special nodal officer for coordination of all government schemes of tribal areas. It is in practice since May 2011 years and improved government working system. As a result of above thousands of lives have been saved

9) The public distribution system (PDS) :

New ration shops will be handed over to the self-help groups of tribal female instead of commercial private people. It will empower hundreds of tribal female. (High court order May 2011)

10) Tribal Ashram School inmates death prevention technical committee:

Dr. Ashish Satav was member of the committee. Government of Maharashtra has changed 5 policies as per recommendations of the committee to reduce deaths of students in Ashram schools of Maharashtra. (Since July 2017) 

11) Training of other NGO:

UNICEF and Rajmata Jijau Mission of Government of MAHARASHTRA have supported training of 20 NGO working in other tribal area of Maharashtra for treating severe malnutrition as per MAHAN model. It will reduce deaths due to severe malnutrition in other 100 tribal blocks of Maharashtra.

12) Compulsory rural/tribal practice for MBBS doctors 

in government hospital for 1 year, failing which they will not be given admission to PG. (PIL :
July 2013)


13) Every year > 10000 children are dying due to infectious diseases in tribal area of Maharashtra due to lack of antibiotic treatment in villages. After our recommendations, government grass root ASHA workers or Anganwadi worker’ have been empowered to treat infectious diseases with the help of antibiotic . It will prevent 10000 child deaths every year in tribal area since 2013. (Since 2013 to 2022- ~100000)

14) Transfer policies for doctors who worked for 3 years in tribal areas.

(PIL govt reply 25.8.22)

15) Promotion of doctors who worked in tribal areas for 3 years.

16) Reservation of PG seats in government medical colleges 

for doctors who served tribal government hospitals for 5 years (50% PG diploma seats and 20% PG seats) .(PIL : 23 September, 2022)

17) SOPs regarding treatment protocols and referrals have been prepared by health department. (10.10. 2022 high court PIL order)

18) Intensive BCC activities in tribal areas  started by Government (10.10. 2022 high court PIL order)

19) WCD department has started 3 rd party verification of vital statistics and various government schemes by independent agency UNICEF. (10.10.2022 high court PIL order)

20) Government has made available 7.5% of the resource endowment to the public health department, DMER and WCD. (10.10. 2022 high court PIL order)

21) Kitchen garden project has been started by government around public institutes. (10.10. 2022 high court PIL order)

22) Community based monitoring of government schemes has been started. (10.10. 2022 high court PIL order)

23) Reimbursement of bond amount of Rs.50 Lakh from those MBBS doctors who will not join government service. PIL : 23 September, 2022)

24) Due to our PIL, (2014) in MREGS now government is using man-days who were provided work as outcome indicator.

25) Involvement of local voluntary organizations in government program especially for reducing malnutrition has been accepted by state tribal department. (PIL : 16.12.22 TDD Secretary response)

26) Upgradation of government hospitals in Melghat. (PIL : govt reply 2023 Jan)


27) Tobacco and alcohol deaddiction planning has been started. (PIL : Jan2023


Other than govt.

28) Maternal and child hospital:Due to my recommendations, Kasturba Health Society and Mahatma Gandhi Institute of Medical Sciences Sevagram has started maternal and child hospital in Melghat saving many children and pregnant mother. MAHAN has provided basic infrastructure for hospital and residence of doctors for 3 and half years.

Policy changes in pipe line –will be implemented in near future:


  •  Tribal Mission for reducing child deaths and malnutrition.

  •  Counselor program in Maharashtra


  •  MITS

Member of various Government Policy level committees:


1. European Society of Pediatric Research’.

2. ‘Bhavishya Alliance’, an international trisectorial alliance working for reducing malnutrition in Maharashtra. This group has set many recommendations to reduce malnutrition in tribal area of Maharasthra. Government of Maharashtra has implemented few recommendations benefitting

> 1Lakh tribal children.

3. Member of Special study group for Tribal health improvement of Vidarbha ‘Statutory Development Board’, appointed by Governor of Maharashtra.

4. Member of state level ‘Village Child Development’ Committee of ‘Rajmata Jijau Mission’ of Govt. of Maharashtra.

5. Member of state level policy making committee for ‘Antibiotic use by ASHA or Anganwadi worker’.

6. Member of tribal subcommittee of high level Maharashtra Equal Development Kelkar committee-Dr. Satav was given the responsibility to prepare health and nutrition recommendations for reducing child deaths and malnutrition in tribal area of Maharasthra. Government is seriously thinking to implement its various recommendations . It will benefit more than 8 million tribal people of

7. Dr. Satav was regional representative of state advisor to commissioner of honourable supreme court of India for food security bill. Due to our recommendations, many schemes related to food security, malnutrition and maternal health have been implemented properly in whole Melghat like mid day meal scheme (MDM), PDS, Janani Suraksha Yojana, etc.

8. Member of high level MDM Joint Review Monitoring committee of Government of India for Maharashtra. It has exposed the real bad situation of MDM and school student health check up programs of Government of Maharashtra and recommendations for its improvement have been given to government of Maharashtra. It will improve status of MDM and school health check up program in Maharasthra.

9. Member of Ashram School Children Death Audit Salunke Committee.

10. Member of district ‘Navsanjeevan Committee’ for monitoring child health and nutrition activities. Due to our regular monitoring many of government schemes like water, road, transport, electricity, agriculture, kitchen garden, MREGS work, ICDS work, PDS distribution, mid day meal schemes have
been streamlined in Melghat. It has benefitted thousands of tribal children.

11. Member of mentoring committee of district ‘National Rural Health Mission’.

12. Secretary of Coordination committee of counsellor program for govt. hospitals
in Melghat.

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