​Policy Changes:

​​

1. Counsellor Program for government hospitals :

   • Benefitted >5,25,279 tribal patients. Increased hospitalisation of severely malnourished children(12 times) and hospital deliveries(twice). Statistically significant Improvement in Hospitalized severely malnourished babies. P < 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 replicationin 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), a modified version of ‘Home Based Feeding’ concept, devised by MAHAN, is accepted by RajmataJijau 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 >100000 severely and >200000 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 centre have been started in Melghat due to our recommendations.

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 >300000 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 & 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) Number of beneficiaries to be calculated.

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 in government hospital   for 1 to 2 years for MBBS doctors, 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,  17.2.2026 GR)- Government employee working in tribal areas will be transferred to their preferred locations as per their request after serving for 3 years.

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. Government has started intensive behaviour change communication (BCC) activities in tribal areas. (10.10. 2022 high court PIL order). Government will enhance efforts for BCC and community participation with cooperation from the petitioners/organisations representing the community. (Response of govt. health department on 9.2.26 in response to PIL _133 of 2007). 

19.  The public Health Department has acknowledged the importance of working with community organizations and traditional healers to cocreate a healthy lifestyle. Raising awareness and bringing collective behavioral change with community organizations, traditional healers, and the community is crucial for promoting healthy lifestyles and preventing harmful practices. (Response of govt. health department on 9.2.26 in response to PIL _133 of 2007). Govt. has started training Bhumakas every year since 2023.  Till 9th Feb. 2026, total 18 trainings has been conducted and total 654 Bhumkas have been trained. An IEC van , live demonstration was used to raise awareness among the people against superstitions.

20.  WCD department has started 3rd party verification of vital statistics and various government schemes by independent agency UNICEF. (10.10. 2022 high court PIL order)

21. 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)

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

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

24. Reimbursement of bond amount of Rs.50,00,000 from those MBBS doctors who will not join government service. PIL : 23 September, 2022)

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

26. 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)

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

28. Tobacco and alcohol deaddiction planning has been started. (PIL: Jan 2023) 

29.  HBCC and treatment of pneumonia and diarrhea by antibiotics to be delivered by ASHA from 2026 (Reply of government of Maharashtra Public Health Department in Feb. 2026 as reply to our PIL_No. 133 of 2007)

30. HBNC: neonatal sepsis treatment, by antibiotics to be delivered by ASHA from 2026 (Reply of government of Maharashtra Public Health Department in Feb. 2026 as reply to our PIL_No. 133 of 2007)

31. CTC will be continued from 2026 (Reply of government of Maharashtra Public Health Department in Feb. 2026 as reply to our PIL_No. 133 of 2007).

32.  Intensive Malaria Action Plan implemented in all endemic tribal area. (Reply of government of Maharashtra Public Health Department in Feb. 2026 as reply to our PIL_No. 133 of 2007).

33.  Availability of Rapid Diagnostic Kit (RDK) and the ACT tablets to diagnose and treat malaria to be done by ASHAs, ANMs. (Action planned by government ? Implemented or not?)

34.  MJPJAY- Continuous advocacy with govt, state human rights commission- NIV package has been included in ARDS cases who does not need intubation but can be managed with NIV only. (2024-25)

35.  MJPJAY- Continuous advocacy with govt, state human rights commission: Now if patient do not want to stay in hospital for a duration as per recommendations of MJPJAY, he or she can be discharged, and the hospital will get reimbursement for the duration of hospital stay of the patient. (2024-25)

36.  MJPJAY- Continuous advocacy with govt, state human rights commission: NSTEMI who won’t require Thrombolytic therapy, can receive benefit under MJPJAY scheme. (2024-25)

37.  MJPJAY- Continuous advocacy with govt, state human rights commission: STEMI who require Thrombolytic therapy, can receive benefit under MJPJAY scheme for raised CPKMB also. (2024-25)

38.  MJPJAY- Continuous advocacy with govt, state human rights commission:    MD doctors can treat many of the superspecialist patients e.g. cardiology, gastroenterology, endocrinology. (2024-25)

39.  MJPJAY- Continuous advocacy with govt, state human rights commission:    If patient is admitted with more than one medical condition, then reimbursement is done for all conditions.  I Procedure =100% + II Procedure=50%. The package which costs more will be reimbursed at rate of 100% and lower at 50%. (2024-25)

40.  Pollution control board approved vehicle is collecting biomedical waste from all Melghat hospitals-effect of continuous advocacy with state government health department and Maharashtra Pollution Control Board.

41. Infrastructural facilities will be created to enable specialist doctors and MBBS doctors to reside in and around the PHC where they are deployed.

42. The District Health Officer, Amaravati is authorized to timely release salaries of the doctors.

43.  Vacant positions of doctors in tribal PHCs, rural hospitals and sub-district hospitals were filled through deputations until permanent appointments are made.  A policy to fill these vacant positions of doctors temporarily through external contracts is being considered.   To grant urgent approval for filling sanctioned additional medical specialists positions at the Dharni SDH, Chikhaldara and Churni Rural hospitals on a priority basis. (Response of govt. health department on 9.2.26  in response to PIL _133 of 2007).

44. Post of nutritionist has been sanctioned in Nutrition Rehabilitation Unit of Dharni subdistrict hospital.

45.  Policy for doctors: The salaries of doctors MBBS and specialists have been increased. (Response of govt. health department on 9.2.26  in response to PIL _133 of 2007).

46.   Policy for doctors: (Response of govt. health department on 9.2.26 in response to PIL _133 of 2007).  Public Health Department will recruit candidates who have passed the post-graduate degree under the service will first be deputed in the Tribal areas and after filing up all the posts in Tribal area, only then the posts in the non-tribal area will be filled up.

47.   Policy for doctors: A comprehensive training program has been scheduled for officers and employees within health department pertaining to Melghat area. (Response of govt. health department on 9.2.26 in response to PIL _133 of 2007). 

48.  Upgradation of tribal hospitals as per Indian Public Health Standards (IPHS) 2022: (Response of govt. health department on 9.2.26 in response to PIL _133 of 2007). Recommendations by government: a) Upgradation of 100 bed Dharni sub district hospital (SDH) to a 300-bed facility, b) Upgradation of Rural hospitals at Churni and Chikhaldara from 30 beds to 50 beds.

49. It is submitted that rather than addressing the issue of Tribal Health in an ad-hoc and piecemeal manner, it is proposed to draw a detailed Tribal Health Action Plan. For this, a committee had been constituted by the Public health Department The committee has recently submitted a detailed Report with Recommendations which is under examination by the Government.  (Response      of govt. health department on 9.2.26 in response to PIL _133 of 2007). Honourable High court has ordered to implement Tribal Mission. (Hon. High court order on 26.3.2026, PIL _133 of 2007)