Health parameters of tribal population have always been a concern for India’s march towards Millennium and Sustainable Development Goals. Tribal communities in India contribute to 8.6% of the total population and most of them live in forested areas. They suffer from extreme deprivation and economic underdevelopment. One of the key reasons identified for poorly designed and poorly managed health service in tribal areas, by a special committee on tribal issues constituted by GOI was “near complete absence of participation of people from the Scheduled Tribes or their representatives in shaping policies, making plans, or implementing services in the health sector”. Tribal health is further compromised by social issues such as excessive consumption of alcohol and in some areas, tobacco consumption is rapidly increasing as well. The triad of lack of health infrastructure, roads, and extreme poverty has further compelled many to ignore their health problems. Thus, understanding the dynamics of poor tribal health is
a challenge as well as a means of understanding the public health in the tribal context.
An innovative approach is required to improve tribal populations’ access to health care and raise the quality of service provided.
1. Awareness & Education
Raising awareness of health issues is the first step towards improving health outcomes. Public health programs conduct Information, Education and Communication (IEC) campaigns – such as stressing the importance of hand washing, regular ante-natal checkups, institutional deliveries, immunization etc. but they have very little impact on the tribal populations. Thus, the content and quality of health messages needs to be improved with specific target at tribal groups and delivery through the appropriate means.
2. Health Services to Remote Populations
Mobile medical camps to improve outreach in remote tribal populations would play a major role. The success of mobile clinics depends on effective management of medical personnel, as well as on the availability of drugs, diagnostic facilities and vehicles so that the delivery of services remains assured and consistent.
3. Transportation for Expectant Mothers
Tribal populations generally have to deal with lack of resources in tough terrains. Provision of emergency transportation for pregnant tribal women to health facilities for obstetric care is one of the major necessities of the tribal women.
4. Health Workers from Tribal Communities
As tribal populations find it difficult to navigate through the complexities of medical facilities, health workers from tribal communities may become the link between the healthcare facilities and tribal communities to guide patients, explain doctors’ prescriptions, help patients take advantage of welfare schemes, and counsel them on preventive and promotive health behaviors.
5. Capacity building for Healthcare Providers
To help healthcare providers deliver quality healthcare services dealing with complex healthcare scenarios of tribal regions, upgraded capacity building initiatives needs to be in place.
The acceptance and popularity of these initiatives and their impact in terms of improved health outcomes for tribal and disadvantaged populations has to be phased out in the country. The pilots are already being taken over by individual state health departments or the central government’s flagship health program. Spreading the Innovations to lead discussions about expanding mobile health services, improving targeting, enhancing drug budgets, improving their integration with medical facilities for referrals and sophisticated lab tests, and increasing allocations for overhead costs and staff salaries ix the next step. There is a significant scope to expand these initiatives to regions that continue to be underserved or require additional inputs for improving health outcomes.