Explaining Tribal Disparities in Infant Feeding Practices in Jharkhand: The Role of Poverty, Education and Culture - Evidence from NFHS-4, NFHS-5 and NFHS-6: A Systematic Literature Review

One of the most significant factors of infant survival, growth and development in the first two years of life is infant feeding practices. Proper breast feeding and supplementary feeding helps in alleviating malnutrition, curbing childhood morbidity and enhancing health results in the long-term. Although significant policy interventions have taken place in India, the inequality in infant feeding habits still remains, especially in Scheduled Tribe (ST) communities. One of the most tribal states in India, Jharkhand records poor child nutrition, delayed breastfeeding initiation, insufficient complementary feeding and increased under-nutrition levels. These differences are contributed by a multifaceted combination of socioeconomic disadvantage, education disparities and entrenched cultural habits. This is a systematic literature review that provides factors to explain tribal inequalities in infant feeding practices in Jharkhand focusing on poverty, maternal education and cultural factors. The review summarises the data of 15 qualitative, quantitative and mixed-method articles (2020-2026), as well as the results of National Family Health Survey (NFHS-4, NFHS-5 and new NFHS-6 evidence). The search using Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) was used to identify the studies and evaluate them with the help of the Mixed Methods Appraisal Tool (MMAT). The results show that poverty is one of the biggest structural obstacles that can restrict access to nutritious foods, healthcare services and the best practices of feeding infants. Mother education was always a very strong predictor of breastfeeding behaviour as well as complementary feeding behaviour, cultural beliefs and traditional food practices had a strong influence in the care giving decision of the tribal communities. The review also highlights existing inequalities and disparities in healthcare usage across the regions. The study conclude that the infant feeding inequities in Jharkhand can be mitigated by combining multifaceted methods to tackle the socioeconomic and social factors involved in the problem, alongside raising maternal education levels and ensuring cultural-sensitive nutrition programs to suit tribal households.