An expert committee has compiled a report on the state of tribal health in India, marking the first time such an exhaustive study has been conducted. There are around 8.6% tribal people among the country’s total population, but despite forming a significant part of the population, their issues such as the state of health, education, and poverty have often been overlooked in national discussions. The committee, consisting of 12 members and led by Dr. Abhay Bang, was created by the Ministry of Health and Family Welfare and Ministry of Tribal Affairs to investigate the current condition of health and healthcare in tribal areas.
The Key Findings
The committee found child mortality rates have decreased in tribal areas—halving from 90 per 1000 in 1988 to 44 in 2014—with under-five mortality rates dropping from 135 to 57 in the same period. However, this is still higher than the rest of India, where the rate was around 39 in 2014. The report reveals that tribal communities face a triple burden of malnutrition, communicable diseases like malaria and tuberculosis, and non-communicable diseases like cancer and diabetes. Malnutrition among Scheduled Tribe (ST) children has decreased from 54% in 2005-06 to around 40% in 2015-16. Yet, they account for 30% of India’s total malaria cases, tuberculosis rates three times higher than the rest of the country, and one in four tribal adults diagnosed with hypertension.
Ongoing Problems
The report also highlighted the issue of health care infrastructure, noting serious shortages of allopathic doctors and specialists in primary healthcare centers in tribal regions. It also pointed out issues of lack of data at the local level and community involvement in agenda setting. The committee identified ten key issues impeding tribal health in India, including communicable and non-communicable diseases, malnutrition, socio-economic determinants like housing, education, sanitation, geographic terrains, quality and appropriateness of healthcare services, health human resource availability, fund utilization, data gaps, political dis-empowerment of tribal people, and a lack of community participation.
Recommendations
The committee recommended a raft of measures to improve the situation. It argued for the implementation of the Universal Health Assurance under National Health Policy (2017), starting with tribal areas, primary care management by Aarogya Mitra trained local tribal youth and ASHA supported by gram sabha, financial protection for tribals through government medical insurance, the introduction of a Tribal Malaria Action Plan, strengthening home-based newborn and child care, ensuring food security, spreading awareness against addictive substances, and offering provisions for de-addiction and mental health services.
Proposed Solutions
The report also suggested providing a tribal health index to capture the state of tribal health, conducting national surveys to estimate health parameters in tribal areas, and responsive and focused governance structures for tribal health. Such structures would involve a National Tribal Health Council, Tribal Health Directorate, and Tribal Health Research Cell at both central and state levels. The report also recommended creating a Prime Minister Tribal Health Fellow (PMTHF) role as District Tribal Health Officer and prescribed that the funds allocated for health in tribal areas should be proportional to their population. According to the report, the Ministry of Tribal Affairs should spend nearly 15% of district allocations on health. Lastly, the committee suggested the necessity for all tribals, whether living within or outside tribal areas, to be covered under a health insurance scheme.
Last Modified: February 2, 2024