AMRAVATI, Dec. 7 -- Citizen participation is necessary to strengthen the healthcare system and prevent maternal and child deaths in the tribal-dominated Melghat region in Amravati district, secretary of the public health department Nipun Vinayak said on Saturday. "Along with the creation of necessary facilities to prevent maternal and child mortality, the health system needs to be strengthened at the village level, with active participation of citizens," a press release issued by the district collectorate said, quoting Vinayak's address during a review meeting comprising officials from six teams which toured different regions of Melghat on Friday. The teams visited the region to assess health infrastructure and address malnutrition, pursuant to orders issued by the Bombay High Court (HC) on November 24. But petitioners of a clutch of Public Interest Litigations (PILs), whose interventions in court led to the directive and who were present during Saturday's meeting, said the emphasis on citizen participation belied crippling problems regarding lack of inter-departmental coordination and government neglect. Saturday's review meeting was held at the district collector's office in Amravati. It began with members of the six teams that visited the region - including secretaries of the public health, tribal development and women and child welfare departments, and the Amravati zilla parishad chief executive officer - presenting their observations before divisional commissioner Shweta Singhal, district collector Ashish Sherekar, representatives of all departments of the district administration, and petitioners in HC. "Officials who toured the region said a range of problems that lay beneath recent infant deaths and malnutrition cases, such as lack of road connectivity, transport, electricity, clean water, and mobile connectivity, poor quality of construction and reluctance among tribals to seek treatment in hospitals," said a participant in the meeting who did not wish to be identified. The press release issued by the district collectorate too mentioned a similar set of problems, underlining the need to fill vacant medical posts in this region as well as enhancing community participation to solve the problem. "Cooperation of local citizens will be necessary to implement a campaign to create health awareness among tribals. Accordingly, a medium and long-term action plan will be prepared to change their mindset regarding health," Vinayak said, as quoted in the press release. Adolescents in villages would be a key target of the awareness campaign, Vinayak noted, repeating what many frontline health workers had told him during Friday's tour. All six teams that toured the region were asked to submit separate reports entailing their observations and proposed solutions. These reports would be compiled and shared with petitioners before the matter comes up for hearing in HC on December 18, Vinayak said. Bandu Sane and Ravindra Kolhe, activists and petitioners in HC, were also present at Saturday's meeting. They spoke after the officials shared their observations and stressing on the need for more resources and coordinated action. Ravindra Kolhe, who was awarded a Padma Shri in 2019 alongside his wife and activist Smita Kolhe, said it was necessary to upgrade primary health centres and rural hospitals in the region to address high rates of anemia and malnutrition and prevent child and maternal deaths, said the attendee who was quoted earlier. Sane drew attention to a clutch of reports and deliberations of various committees on addressing malnutrition in Melghat since the early 1990s, when the first of the PILs were filed in HC. All these reports and deliberations must be studied before formulating any new intervention plan, he told Hindustan Times, referencing his presentation. "The problem is, the government does not have any intent to expend any money or resources on tackling malnutrition," Sane told HT, alluding to Integrated Child Development Project Commissioner Kailash Pagare's statement in the meeting on increase of financial allocation for pregnant women, lactating mothers and infants in recent years. For reference, he said the area of the two blocks in Melghat - Chikaldhara and Dharni - was larger than 12 other rural blocks in Amravati district, and the more than 300,000 residents were dispersed in 324 small villages. "Naturally, more funds are required for people spread over such a large area - be it for healthcare, or education, or improving access to livelihood and government services," he said. Purnima Upadhyay, fellow activist with Sane in Khoj - a community-based organisation in Paratwada in the foothills of Melghat, alleged that the government was not serious about addressing malnutrition. "Seventy-five percent of Melghat is forest. Yet, neither the forest secretary nor top level forest officials were part of the team that came here. This shows they are not serious," she told HT. "That is why I did not engage with official teams yesterday or attended the meeting today even though I am a petitioner."...