The total tribal populace expands to 104 million out 1.2 billion of the overall population. The tribal population is excessively marginalized and discriminated as spoken by the facts published in many magazines and newspapers. This sidelining is not the only problem that has been encountered by these people. In fact, another major threat that has emerged in the tribe people is the malaria outbreak which causes 50% of the total death toll in tribal population alone.
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The tribal community has been facing a drastic amount of economic downfall which has imbarred towards the back class of the society. Tribal people always face troubles in competing with mainstream society in terms of development, technology and majorly in case of health security.
To address this, The Expert Committee on Tribal Health, headed by Dr. Abhay Bang, was created. This led to the examination of how tribal people in India suffer from inequity in health, and how this gap can be bridged.
Over four years, the committee studied the health issues, the culture around health, and health care infrastructure present in tribal areas, and sought potential ways forward through a consultative process with researchers, representatives of tribal people, and other experts. The result? This report—”Tribal Health in India—Bridging the Gap and a Roadmap for the Future—the first of its kind in India.”
The report lays out nine recommendations for the future. The overarching goal, according to the committee, should be to bridge the gap in health care for tribal communities and to bring health coverage and indicators at par with the state average by at least 2027.
To do so, a functioning, sustainable system of health care should be in place by 2022. The focus needs to be turned to comprehensive primary health care, local participation, and human resources, and health education and research.
The Committee Emphasizes the Following;
1. An annual budget equal to 2.5% GDP per capita basis must be allocated and spent on tribal health care (this comes to approximately Rs2,500 per tribal in 2015-16).
2. New entities—a Tribal Health Council and Directorate for Tribal Health—must be established at both state and union levels to focus solely on tribal health including generating data, reviewing finances, and monitoring programmes.
3. Service delivery needs to be restructured so that the government focuses 70% of its resources for tribal health on primary care, and makes the basket of health care services larger.
The Human Resource Problem
A significant gap highlighted in the report is the lack of healthcare professionals that are available to work with tribal communities. Healthcare professionals view postings in tribal areas as a punishment of sorts and are hesitant to go, much less stay, there.
With this in mind, the report emphasizes the need for a significant mindset change, but more importantly, points to the opportunity that lies in motivating and training tribal people themselves to join the health force. “If we work with the communities, we will find that tribal youth are an excellent resource, and inducting them into healthcare will be a more feasible, sustainable, long-term solution.”
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The report also states that traditional healers within tribal communities should be recognized and utilized. There is no dearth of health-related folklore in tribal communities, and tribal people rely heavily on naturopathy, using medicinal leaves, roots, fruits, and seeds from their surrounding ecosystems. The lack of spirituality and emotionality in the modern healthcare system is a factor that sometimes keeps people away from public health systems; including traditional healers in healthcare, programmes could begin to address this issue.
It is important to look at tribal health problems as separate and distinct, and clubbing them together with the issues faced in general by rural populations negates the vastly different context within which tribal communities exist.
The committee identified 10 health issues that affect tribal people disproportionately. These are Malaria, malnutrition, child mortality, maternal health problems, family planning and infertility, addiction and mental health issues, sickle cell disease, animal bites and accidents, low health literacy, and poor health of tribal children in Ashramsalas.
These problems are specific to tribal communities, should be recognized as such, and then be addressed with the community in mind. As mentioned earlier, there is a dearth of data available on tribal health indicators, and so moving forward, the committee outlines four principals that must underpin all research.
- Respect for tribal culture,
- Relevance to tribal communities,
- Reciprocity through a two-way exchange of learning, and
- Responsibility to ensure that the research being done has no adverse effects on the communities.
- The report is a resource and guide for anyone interested in tribal health, rights, and policy making. The recommendations for improving the state of tribal health provide an in-depth understanding of the systemic changes, as well as the mindset changes required for tribal healthcare to advance.
The bottom line is that there is a dearth of data that depicts the poor health condition of the tribal community in India. Hence, the government health initiatives must begin to focus on improving the health system and support for the people living in the tribal region.
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