SCHEDULED TRIBES AND HEALTH ISSUES – POLITY

News: STs trail non-STs in 81 health measures: 2021 study | Data

 

What's in the news?

       A recent study in ‘The Lancet Regional Health — Southeast Asia’ has analyzed health, nutrition, and population trends among Scheduled Tribes (STs) in India from 2016 to 2021 using data from National Family Health Surveys.

 

Key findings of the study:

1. Scheduled Tribes (STs) Population:

       According to the 2011 Census, there are over 104 million STs spread across 705 recognised ethnic groups. They make up 8.6% of India’s population.

2. Challenges faced by STs over non-STs:

       In 2021, the non-ST population outperformed the ST population in 81 out of 129 indicators. STs continued to face challenges, particularly concerning women’s status and major public health issues such as child malnutrition, anaemia, insufficient vaccination coverage and disparities in fertility and mortality rates.

3. Child Mortality:

       The child mortality rate for STs was alarmingly high, with 50 out of every 1,000 children not surviving to their fifth birthday.

4. Child Malnutrition:

       Child malnutrition was a significant issue, with over 40% of ST children under five being stunted and underweight.

5. High Blood Pressure:

       Between 2016 and 2021, there was a notable increase in high blood pressure levels among ST men and women aged 15–49 with increases of 7.5% and 8.9%, respectively.

6. Indicators in which STs outperformed non-STs:

       STs surpassed non-STs in indicators such as gender balance, gender balance at birth, use of family planning methods, consistent treatment during pregnancy and adherence to recommended breastfeeding practices.

       Moreover, STs showed a reduced occurrence of diabetes and hypertension compared to non-STs.

7. Improvements made by STs between 2016 to 2021:

During this period, STs made progress in indicators such as:

       Sanitation Facilities: Access to improved sanitation facilities improved significantly, with a 30.4 percentage point increase from 2015–2016 to 2019–2021.

       Skilled Birth Attendance: More births were attended by skilled health personnel, increasing by 13 percentage points.

       Full Vaccination Coverage: Coverage for full vaccination among children aged 12–23 months increased by 18.6 points.

       Civil Birth Registration: Civil registration of births among STs also rose from 76% in 2016 to 88% in 2021, indicating better documentation and recognition of births within the community.

 

Challenges in Tribal Health:

1. Lack of Infrastructure:

       Inadequate healthcare facilities and infrastructure in tribal areas.

       Insufficient access to clean water and sanitation facilities.

2. Shortage of Medical Professionals:

       Limited presence of doctors, nurses and healthcare professionals in tribal regions.

       Difficulty in attracting and retaining skilled healthcare personnel in remote areas.

       Imbalance in the distribution of healthcare professionals with a concentration in urban areas.

3. Connectivity and Geographic Barriers:

       Remote locations and difficult terrain hinder access to healthcare services.

       Lack of proper roads, transportation facilities and communication networks.

       Challenges in reaching tribal communities during emergencies and providing timely medical assistance.

4. Affordability and Financial Constraints:

       Limited financial resources and low-income levels among tribal communities.

       Inability to afford healthcare expenses, including medical treatments, medicines and diagnostics.

       Lack of awareness about available healthcare schemes and insurance options.

5. Cultural Sensitivities and Language Barriers:

       Unique cultural practices and beliefs that impact healthcare-seeking behaviour.

       Language barriers between healthcare providers and tribal communities, leading to miscommunication and inadequate care.

       Lack of culturally sensitive healthcare services that respect tribal customs and traditions.

6. Limited Access to Essential Services:

       Insufficient availability of essential healthcare services such as maternal and child health, immunization and preventive care.

       Inadequate access to specialized care, diagnostic facilities and emergency medical services.

       Limited awareness about health issues, preventive measures and healthcare rights among tribal communities.

7. Inadequate Funding and Resource Allocation:

       Limited allocation of funds for healthcare in tribal areas.

       Insufficient investment in healthcare infrastructure, equipment and technology.

       Lack of dedicated funding for addressing tribal health challenges and implementing targeted interventions.

 

WAY FORWARD:

       Launch a National Tribal Health Action Plan to bring the status of health and healthcare at par with the respective State averages in the next 10 years.

       Address 10 priority health problems, the health care gap, the human resource gap and the governance problems.

       Allocation of additional money so that the per capita government health expenditure on tribal people becomes equal to the stated goal of the National Health Policy (2017), i.e., 2.5% of the per capita GDP.

       Mission mode implementation: The Health Minister and the 10 States with a sizable tribal population should take the initiative.

       Eliminate the manpower shortage: Harness the potential of community health providers and ASHA workers for basic diagnostics and essential primary medical care. Incentives to doctors to work in remote areas.

 

The tribal healthcare system is sick, and tribal people need more substantive solutions. We need to move from symbolic gestures to substantive promises, from promises to a comprehensive action plan, and from an action plan to realizing the goal of a healthy tribal people. If actualised, the Tribal Health Mission can be the path to a peaceful health revolution for the 11 crore tribal people.