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Launch a national Tribal health mission

  • Published
    19th Aug, 2022
Context

The health of the Tribal in India is in a dismal state. On the occasion of International Day of the World’s Indigenous Peoples, let us explore the need of a tribal health mission to bring revolution for the tribal people of India.

As per the Lancet, “Indigenous and Tribal Peoples’ Health” (2016), India has the second highest infant mortality rate for the tribal people, next only to Pakistan.

About

Health status of Tribals in India

  • Tribal people are concentrated in 809 blocks in India. Such areas are designated as the Scheduled Areas.
  • Half of India’s tribal population, nearly five and a half crore, live outside the Scheduled Areas, as a scattered and marginalised minority.
  • They are the most powerless.
  • The health status of tribal people has certainly improved during the last 25 years as seen in the decline in the under-five child mortality rate from 135 in 1988 in the National Family Health Survey (NFHS)-1 to 57 in 2014 (NFHS-4).
  • However, the percentage of excess of under-five morality among STs compared to others has widened.

What threatens the health and survival of tribal adults?

  • Child malnutrition is 50% higher in tribal children: 42% compared to 28% in others.
  • Malaria and tuberculosis are three to 11 times more common among the tribal people.
  • Though the tribal people constitute only 8.6% of the national population, half of the total malaria deaths in India occur among them.
  • While malnutrition, malaria and mortality continue to plague tribal people, gradually, the more difficult to treat non-communicable diseases such as hypertension and diabetes, and worse, mental health problems such as depression and addiction leading to cancer and suicide are increasing.

Challenges

  • Lack of health facilities: Tribal people heavily depend on government-run public health care institutions; there is a 27% to 40% deficit in the number of such facilities, and 33% to 84% deficit in medical doctors in tribal areas.
  • “Public Health and Hospital” is a state subject.
  • The primary responsibility of ensuring availability of healthcare facilities including access to healthcare facilities in tribal dominated areas lies with the respective State Governments.
  • However, Ministry of Health and Family Welfare, Government of India provides technical and financial support to the States/UTs to strengthen the public healthcare facilities through National Health Mission (NHM).
  • Lack of involvement: There is hardly any participation of the tribal people – locally or at the State or national level – in designing, planning or delivering health care to them.
  • Lack of data: There is hardly any segregated national data on tribal health.

Required measures

  • Health plan: 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 gap in health sector: Address 10 priority health problems, the health care gap, the human resource gap and the governance problems.
  • Adequate funding: 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.
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