TRIBLE POPULATION AND THEIR HEALTH ISSUESPresentation Transcript
TRIBAL HEALTH IN INDIA
Part Of Indian Constitution
Different Types Of Tribes
Social And Cultural Issues
Example Of Maharashtra
High Disease Burden
Factors Contributing To Increased Disease Burden
Older Govt Initiatives
Additions After 9 th Five Year Plan
Obstacles In Set Up
Strategies To Improve Health Care In Tribal Areas
Tribal Health Development Organization
Ādivāsīs (Devanagri: आदिवासी , literally: old inhabitants) is a term used for all the heterogeneous set of ethnic and tribal groups believed to be the aboriginal population of India.
PART OF INDIAN CONSTITUTION
Officially recognized by the Indian government as "Scheduled Tribes" in the Fifth Schedule of the Constitution of India, they are often grouped together with scheduled castes in the category "Scheduled Castes and Tribes", which is eligible for certain affirmative action measures.
Scheduled Castes 16.2%
Scheduled Tribes 8.02%
(As per 2001 census)
Tribal peoples constitute 8.2% of the nation's total population.
In the Northeastern states of Arunachal Pradesh, Meghalaya, Mizoram, and Nagaland - 90% Tribal population.
In the remaining Northeast states of Assam, Manipur, Sikkim, and Tripura -Tribal population between 20% and 30%
Central Indian states have the country's largest tribes, and, taken as a whole, roughly 75% of the total tribal population live there.
One concentration lives in a belt along the Himalayas stretching through Jammu and Kashmir, Himachal Pradesh, and Uttarakhand in the West, to the Northeast.
Another concentration lives in the hilly areas of central India (Chhattisgarh, Madhya Pradesh, Orissa and, to a lesser extent, Andhra Pradesh)
Small numbers of tribal people in Karnataka, Tamil Nadu, and Kerala in South India.
In Western India in Gujarat and Rajasthan.
In the Union Territories of Lakshadweep and the Andaman and Nicobar Islands.
DIFFERENT TYPES OF TRIBES
Efforts to improve a tribe's educational status have had mixed results.
Recruitment of qualified teachers and determination of the appropriate language of instruction also remain troublesome.
Many tribal schools are plagued by high dropout rates.
Tribes usually remain isolated.
Majority of them have poor health status.
Inadequate health infrastructure.
Deficiency of essential components in diet leading to malnutrition, protein calorie malnutrition and micronutrient deficiencies.
Goitre of various grades is also endemic in some of the tribal areas.
Water borne and communicable diseases: Gastrointestinal disorders are very common, leading to marked morbidity and malnutrition.
Malaria and tuberculosis.
Spectrum of viral and venereal diseases.
High prevalence of genetic disorders mostly involving red blood cells: Genetically transmitted disorders like sickle cell anaemia,
Glucose 6 phosphate dehydrogenase deficiency and different forms of thalassaemia are also common.
The inadequate health infrastructure for these peculiar health needs of the tribes is also a major factor.
Lack of maternal and child health services among the hilly tribal areas.
The tribal demographic scenario is one of high fertility, high maternal and infant mortality rates.
SOCIAL AND CULTURAL ISSUES
Superstitions particularly related to health problems.
Excess consumption of alcohol.
EXAMPLE OF MAHARASHTRA 12% 86% Delivery by TBA 4.2 3.8 Family Size 40% 28% LBW babies Not available 2 Maternal mortality rate 13 7.9 Crude death rate 110 59 Infant mortality rate Tribal Situation Situation in Maharashtra Indicators
HIGH DISEASE BURDEN
Poverty and under nutrition
Poor sanitation, lack of safe drinking water
Diseases which are more prevalent in tribals
Lack of awareness about and access to health care
Social and economic barriers to utilisation
FACTORS CONTRIBUTING TO INCREASED DISEASE BURDEN
Poverty and consequent undernutrition;
Poor environmental sanitation, poor hygiene and lack of safe drinking water.
Lack of access to health care facilities resulting in increased severity and/or duration of illness;
Social barriers preventing utilization of available health care services.
Specific diseases they are prone to such as genetic diseases (G-6 PD deficiency), infections (Yaws) etc.
Till June 30, 1996 there were 20097 sub-centres functioning against a requirement of 28383 sub-centres for tribal areas.
The number of functioning PHCs were 3260 against a requirement of 4180 and functioning CHCs were 446 against a requirement of 492.
There are also 1122 Dispensaries and 120 Hospitals and 78 Mobile Clinics in Modern Medicine .
1106 Dispensaries and 24 Hospitals in Ayurveda.
251 Dispensaries and 28 Hospitals in Homeopathy.
OLDER GOVERNMENT INITIATIVES
ADDITIONS AFTER 9 TH FIVE YEAR PLAN
16,845 Sub Centres, 5987 PHCs and 373 CHCs have been established in Scheduled Caste Basties/Villages - 20% or more Scheduled Caste population.
In addition 980 Dispensaries in Modern Medicine, 1042 Ayurvedic Dispensaries, 480 Homeopathic Dispensaries, 68 Unani/Siddha.
Mobile dispensaries and camps were organised to provide health facilities wherever feasible.
OBSTACLES IN SET UP
Lack of both professional and paraprofessional manpower.
The State Governments are trying to minimize vacancies .
A Central Planning Committee has been set up to review the health care activities in 39 districts of 12 States .
STRATEGIES TO IMPROVE HEALTH CARE IN TRIBAL AREAS
Ensuring availability of adequate infrastructure and personnel.
Area specific RCH programmes.
100% central Plan funds for NMEP.
Effective implementation of the Health & Family Welfare programmes.
Close monitoring, early detection of problems in implementation and midcourse correction.
Improvement of healthcare infrastructure.
Developing a flawless referral system.
Provide diagnostic facilities for genetic defects.
Follow up of anemic and other severe patients.
Carry out population genetic survey programs.
Provide prenatal diagnosis.
TRIBAL HEALTH DEVELOPMENT ORGANIZATION
Tribal Health Initiative is a public registered charitable trust established in the small village of Sittilingi in Dharmapuri District, Tamil Nadu.
Fifteen years ago, in Sittilingi, one out of five babies died before they became a year old and many mothers died in childbirth.
The nearest hospital was 48 kilometers away and to find one with surgical facilities meant a journey of over 100 kilometers.
Today, Tribal Health Initiative runs a full-fledged 24 bed primary care hospital.
Bring all woman and children through childbirth alive and well.
Ensure children grow up well nourished.
Give easy, low cost access to good health care
Share their knowledge of health care with tribal communities so it becomes part of their wisdom and day to day experience.
To attain the highest possible level of physical, mental and social health .
To create an atmosphere highly conducive for the growth and development of local cultures and customs
Regular clinics in all villages to see all pregnant mothers and children less than five years.
Refreshing and sharing knowledge with tribal women.
Tribal girls working as Health Workers.
Postnatal checkups in all villages once a week .
Health education and discussion of social problems.
Dramas and cultural shows to spread information.
Outpatients & Inpatients seen at the Tribal Hospital.
95% of pregnant mothers undergo checkups.
7 out of every 100 children still die during the first year.
Underweight children are only 30% compared to 50% earlier.
No mothers died in childbirth last 3 years.
It is necessary to continue with primary health care educational activities, National health and tribal health programmes and other measures of providing proper nutrition and counseling and with the help from experts from multi-disciplinary fields, the health status of the tribal population can be improved.
Dr.Jayanti Roy Dutta
Dr.Manoj Kumar Sharma
Dr. Swaran Singh
Health Problems of Tribal Population Groups from the State of Maharashtra, S. L. Kate