Determinants of nutritional status among adolescent tribal girls in Jharkhand: A grounded theory approach

Purpose: Adolescence is a critical period of rapid growth where nutritional needs are heightened by biological and social factors. Tribal adolescent girls in rural India experience a disproportionate burden of undernutrition despite the presence of multiple government nutrition programmes. Existing research is largely quantitative and inadequately explains the social and institutional processes sustaining malnutrition. So this grounded theory explaining the determinants of nutritional status among adolescent tribal girls. Methods: This qualitative study used a constructivist grounded theory design conducted among ten government school teachers. Data was collected by in-depth face-to-face interviews in the month of April 2025. Collected data were analysed by using Open Code version 4.03, using constant comparison, memo writing, and theoretical integration following Charmaz's grounded theory approach. Results: . Four interrelated processes shaped this outcome: reproducing nutritional deprivation through gendered household practices; prioritising household survival over nutritional continuity; failing to translate institutional nutrition intentions into household practice; and adapting to nutritional deprivation through constrained agency and health avoidance. Together, these processes rendered undernutrition an ordinary and socially legitimate condition rather than a health crisis. Conclusion: Undernutrition among tribal adolescent girls is sustained through everyday adaptations shaped by poverty, gender norms, and weak institutional mediation. Addressing adolescent malnutrition requires interventions that break the social normalisation of deprivation, strengthen culturally relatable programme delivery, and engage household survival rationalities beyond expanding nutritional coverage alone.