The article examines the recurring issue of infant mortality and malnutrition in Attappady, Kerala, revealing how marginalization, systemic healthcare gaps, and socio-economic deprivation persist among tribal groups despite the State's broader developmental achievements. - **Particularly Vulnerable Tribal Groups (PVTGs):** Particularly Vulnerable Tribal Groups (PVTGs) are marginalized tribal communities identified by pre-agricultural technology, stagnant population growth, extremely low literacy, and subsistence economies, requiring special government protection. - **Health Department Kerala:** The administrative wing responsible for healthcare delivery, disease control, and public health infrastructure implementation across Kerala, tasked with addressing recurring health crises like malnutrition in tribal belts. - **Government of Kerala:** The elected state government of Kerala, responsible for governance, public policy, and social welfare execution within the state, including targeted interventions for tribal development and health. **Introduction** The article examines the recurring issue of infant mortality and malnutrition in Attappady, Kerala, revealing how marginalization, systemic healthcare gaps, and socio-economic deprivation persist among tribal groups despite the State's broader developmental achievements. **Core Issue and Detailed Points** - Infant deaths in Attappady, Kerala, highlight a severe, deep-rooted crisis involving healthcare failures, extreme malnutrition, and social marginalization among tribal communities. - Despite Kerala's generally high social development indices, vulnerable tribal groups (PVTGs) like the Irula, Kurumba, and Mudugar face systemic exclusions and land alienation. - The crisis underscores structural bottlenecks in public healthcare delivery at the grassroots, nutritional deficiencies, and the failure of targeted welfare interventions. - Experts call for holistic interventions integrating culturally sensitive healthcare, livelihood security, food security, and community participation to break the cycle of poverty and malnutrition. **Key Statutory Bodies, Acts & Concepts** - **Particularly Vulnerable Tribal Groups (PVTGs):** Particularly Vulnerable Tribal Groups (PVTGs) are marginalized tribal communities identified by pre-agricultural technology, stagnant population growth, extremely low literacy, and subsistence economies, requiring special government protection. - **Health Department Kerala:** The administrative wing responsible for healthcare delivery, disease control, and public health infrastructure implementation across Kerala, tasked with addressing recurring health crises like malnutrition in tribal belts. - **Government of Kerala:** The elected state government of Kerala, responsible for governance, public policy, and social welfare execution within the state, including targeted interventions for tribal development and health.