Annals of Community Health (ISSN 2347-5455, eISSN 2347-5714), Peer Reviewed, Indexed Journal focusing exclusively on Community Medicine and Public Health

Tribal Health

  • Introduction
  • Geographical distribution of tribes
  • Health problems of tribal population.
  • RCH Programme – Tribal Health

Tribal communities of India cannot be clubbed together as one homogeneous group. They belong to different ethno-lingual groups, having diverse faith and are at varied /different levels of development - economically, educationally and culturally.

An endogamous group with an ethnic identity; who have retained their traditional & cultural identity; who have distinctive language or dialect of their own; they are economically backward and live in seclusion governed by their own social norm and largely having a self contained economy”

The essential characteristics of these communities are:-

  • Primitive Traits
  • Geographical isolation
  • Distinct culture
  • Shy of contact with community at large.
  • Economically backward

India - 84.33 million tribal's. It accounts to 8.2% of population. 9 states (A.P. Assam, Jharkhand, Gujarat, Chattisgarh, Maharashtra, Orissa, Rajasthan and West Bengal) where majority of Schedules Tribes (ST) population lives.

Classification of Tribals

  • Food gatherers and hunters. Eg: Jenukurubas of Karnataka, Rajis of Uttar Pradesh, Chenchus of Hyderabad, Kadars of Cochi, Jarwa and the Andamanese of Andaman islands.
  • Shifting cultivators. Eg: Nagas of Assam, Khasis of Meghalaya, Korwa of Bihar, Saora of Orissa.
  • Settled agriculturists. Eg: Mundas
  • Artisans . Eg: Kota of Nilgiri hills
  • Pastoralists and cattle herders. Eg:Todas of Nilgiris, Bakerwal and Gaddi in Himachal Pradesh.
  • Folk artists. Eg : Pradhans of Madhya pradesh
  • Wage labourer. Eg: Santhals of Bihar
  • Acculturated layer: They have travelled farthest from their original habitat (civilised). Eg : Minas
  • Settled schedule tribe agriculturists: They have come quite some way from their original habitat. Eg: Santal
  • Third category: Those who have hardly shifted from their original habitat. Eg: Khasis
  • Fourth category: Those encysted in their original habitat. Eg: Kadars

Tribes in Karnataka

  • Soligas - Chamarajnagar
  • Jenu kuruba - Chamarajnagar
  • Kadu Kuruba - Nagarhole
  • Koraga –Udupi district
  • Siddis – Karwar
  • Todas –Nilgiri plateau
  • Betta Kurubas – Chamarajnagar
  • Gollas – Tumkur, Chitradutga
  • Lambanis – North Karnataka

The health problems of the tribals arise from

  • Socio-cultural (The widely prevalent ancient health practices, use of indigenous herbal medicines, taboos & superstition).
  • Genetic attributes .
  • Environmental conditions (Forest indwelling) - Vector borne diseases.
  • Poor maternal & child health services .
  • Poor nutrition/ Malnutrition - Nutritional problems.
  • Other factors: In accessability to safe drinking water & sanitation - Gastrointestinal disorders.

Tribal development strategy of Government of India

  • Health sector – The National Population Policy 2000 places RCH at the centre stage and the immediate objective is to address the unmet needs of health infrastructure, train health care personnel and promotion of contraception.

RCH progamme

Goal

To improve the health status of the tribal community

Objectives

  • Assess the unmet needs of RCH services in different tribal areas and different tribes.
  • Improve service coverage, accessibility, acceptability and its utilization
  • Promote community participation and inter-sectoral coordination.
  • Develop a sufficient number of first referral institutions capable of tackling emergencies including obstetric emergencies.
  • Provide associated supplies, management and information

Rationale for Tribal health component under RCH

Tribals have poor access to health services and there is also under utilization of health services owing to social, cultural and economic factors:

  • Poorly located subcentres, CHC’s and PHC’s: Difficult terrain and sparsely distributed tribal population in forests and hilly regions.
  • Non availability of service providers due to vacant posts and lack of residential facilities.
  • Services not being client friendly in terms of timing, cultural barriers inhibiting utilization. Non involvement of the local traditional faith healers.
  • Lack of suitable transport facilities
  • Lack of appropriate HRD policies
  • Inadequate mobilization of NGO’s
  • Lack of integration with other health programs and other development sectors.
  • IEC activities not tuned to the tribal beliefs and practices
  • Weak monitoring and supervision systems

Magnitude of Health problems in tribal areas

  • Decadal Growth rate is higher than that of the total population.
  • Girls marrying below 18 years is up to 60%.
  • 43% of tribal pregnant women do not receive any antenatal check up, 38% do not receive any Tetanus toxoid injections and only 51% do not receive Iron and Folic acid tablets.
  • 81% tribal pregnant women deliver at home, 44% of all deliveries are attended by TBA and 32% by other untrained persons. Only 5% are attended by health care professionals.
  • Unmet need for family planning 15.4%
  • 42% of currently married women have any reproductive health problem
  • Only 26% of children receive all vaccines.

Strategies to improve health care

  • Identifying the objectives
  • Strengthen the health infrastructure
  • Promote community participation
  • Involvement of NGO’s
  • Development of human resource

Special schemes to tribal population

  • The Navsanjivani scheme is being implemented in all tribal areas.
  • Special schemes are prepared for tribal areas:
    1. Matrutva Anudan Yojana
    2. Pada Volunteer Scheme
    3. Mobile Medical Squad
    4. Compensation for loss of daily wages
    5. Water Quality Monitoring

Ministry of Tribal Affairs

  • Constituted in October 1999
  • Objective : providing more focused attention on the integrated socio-economic development of the most under-privileged sections of the Indian society namely, the Scheduled Tribes (STs), in a coordinated and planned manner.
  • The Ministry of Tribal Affairs is the nodal Ministry for the overall policy, planning and coordination of programmes for development of STs.
  • Union Minister : Shri V. Kishore Chandra Deo,
  • Minister of State: Shri. Mahadeo Singh Khandela
  • Secretary: Shri. Arvind Kumar Chugh

Programmes for development of STs

  1. Social security and social insurance to the Scheduled Tribes.
  2. Tribal Welfare: Tribal welfare planning, project formulation, research, evaluation, statistics and training.
  3. Promotion and development of voluntary efforts on tribal welfare
  4. Scheduled Tribes, including scholarship to students belonging to such tribes
  5. Development of Scheduled Tribes 5(a) All matters including legislation relating to the rights of forest dwelling Scheduled Tribes on forest lands

National Commission for Scheduled Tribes

The statutory National Commission for Scheduled Castes and Scheduled Tribes came into being consequent upon passing of the Constitution (65th Amendment) Act, 1990.

  1. Health guide should be made available for each village
  2. Providing incentives to doctors and paramedical staff
  3. Provision of safe drinking water.
  4. Creation of awareness regarding family planning.
  5. Provision of accommodation in subcentres for health worker.
  6. Provision of basic laboratory facility in subcentre
  7. Training of local ST girls and boys as MPHW.
  8. CHC’should be equipped with operation theatres
  9. Arrangement for at least one ambulance in CHC’s
  10. Anti-snake venom and antirabies vaccine

Role of NGO's

The National Health Policy emphasised the role of NGOs in two vital areas of tribal health i.e.,

  • Primary health care
  • Population stabilization

NGOs have done some remarkable work in these two fields. These are funded by the government under the grants-in aid provision.

NGO’s in India

  • Bharatiya Adimjati Sewak Sangh
  • Indian Council for Child Welfare
  • Central Social Welfare board

NGO's in Karnataka

  • Nagarahole Tribal Rights Restoration Committee of Hunsur and Kodagu
  • Vanavasi Girijana Mahila Sangha
  • Development Through Education (DEED)
  • Nisarga of H.D. Kote
  • Coorg Organisation for Rural Development
  • Samruddhi
  • Tribal Joint Action Committee.
  • Vivekananda Girijana Kalyana Kendra (VGKK)


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