Anthropology 2024
Batch 1 - #071
Here are some solutions to address
health challenges faced by tribal
communities
Skilling and support to nurses and midwives will help in ensuring the provision
of a responsive healthcare
In India, 8.6 per cent of the total population, or 104 million people, belong to tribal
communities. The tribal communities are primarily settled in rural and remote areas and are
among the most vulnerable and marginalised groups.
They disproportionately suffer from ill health and malnutrition. For instance, the prevalence
of tuberculosis (TB) among them is almost three times higher than the national average — 703
per 100,000 compared to the national average of 256 per 100,000.
Malaria and malnutrition are other scourges that disproportionately affect the tribal
communities. In recent decades, increasing stress levels, as well as changing food patterns,
are also leading to an increase in non-communicable diseases that are often referred to as
lifestyle diseases.
Tribal populations have predisposition to a few specific afflictions such as sickle cell anaemia
which is hereditary in nature but other diseases like malnutrition and respiratory disorders
are largely attributable to their living and working conditions.
Moreover, limited access to nutritious food and healthcare, coupled with heavy and hazardous
work, put them at high risk of early death, disability and malnutrition.
Dwindling forests, declining water tables and rising food costs make it difficult for them to
access affordable, nutritious food. A study conducted among tribal communities of southern
Rajasthan showed that the consumption of proteins and oils by children from tribal families is
much below the levels required to stay nourished.
When a person from the tribal population falls ill, it is difficult to access healthcare since
healthcare facilities are far away and understaffed. For example, 84 per cent of positions of
specialist doctors and 33 per cent of graduate doctors are vacant in 10 states with a sizable
tribal population.
Interestingly, however, there is a surplus of Auxiliary Nurse Midwife (ANM) — 64 per cent more
ANMs are posted than sanctioned. Existing healthcare providers are also often not sensitive
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1
Anthropology 2024
Batch 1 - #071
to the needs of the tribal population, nor are they well versed with their regional dialects,
limiting their ability to communicate with the tribal populations and build trust.
A large proportion of tribal families, especially young men, migrate to cities and work as
manual labourers, where the hazardous living and working conditions make them vulnerable
to diseases such as TB. The city health system is also often not friendly to the needs of the
migrant populations.
The Government of India constituted an expert committee on tribal health, which
recommended that the government's per capita expenditure on tribal health should be
substantially enhanced. It recommended that 70 per cent of this should be spent on primary
health care.
This recommendation should be immediately implemented. Such increased outlays should be
used for expanding easy-to-access primary healthcare centres (PHC), which are managed by
healthcare providers from tribal communities.
Greater autonomy, skilling and support to nurses and sourcing of ANMs posted in these PHCs
from the tribal communities will help in ensuring the provision of responsive healthcare.
AMRIT Clinics, managed by Basic Health Care Services, nurse-led primary healthcare services
in tribal Rajasthan is one such example.
When complemented with greater skilling and autonomy for community health workers, such
as Arogya Mitras promoted by the SEARCH foundation, a non-profit) at Gadchiroli, the dream
of responsive and comprehensive healthcare for tribal populations can become a reality.
For those requiring emergency referrals, a referral transport system having a fleet of vehicles
which can navigate the hilly terrains should be deployed at suitable locations for the timely
transfer of patients to higher-level hospitals.
Currently, only 108 ambulances are in place and they cannot typically withstand the road
conditions in the tribal terrain.
For specialised non-emergency care, PHCs in these areas could be equipped with
telemedicine but with expertise from specialists who understand the tribal milieu as well as
epidemiology.
Improving access to healthcare should be supplemented with efforts to improve nutrition, one
of the most critical determinants of health in these populations.
Setting up day-care-centres for young children, like Phulwaris run by several NGOs across
tribal areas, including pulses and oil in the Public Distribution System as being done in
Chhattisgarh and promoting the growth of nutritious food, such as millets, locally are some
ways by which nutrition security and outcomes could be improved.
Finally, we need to invest in making living and working spaces safe for vulnerable migrant
workers in cities, a large proportion of whom are tribals. Affordable and safe housing and
enforcement of safety standards will go a long way in promoting the health of some of the
most vulnerable tribals and their families.
Forum Learning Centre: Delhi - 2nd Floor, IAPL House, 19 Pusa Road, Karol Bagh, New Delhi - 110005 | Patna - 2nd floor, AG Palace, E Boring Canal Road,
Patna, Bihar 800001 | Hyderabad - 1st & 2nd Floor, SM Plaza, RTC X Rd, Indira Park Road, Jawahar Nagar, Hyderabad, Telangana 500020
9311740400, 9311740900 | https://academy.forumias.com | [email protected] | [email protected]
