This study has focused on Migration, Remittances, and maternity healthcare utilization ...

1. Guide: Prof. Balram Paswan
Advisory members:
Prof. Ram Babu Bhagat
Dr. Manas Ranjan Pradhan
Migration, remittances and utilization of
maternal health care services among
Oraon Tribes in rural Jharkhand
By, Jaymangal Chandra

2. Outline of the presentation
o Background
o Existing literature
o Rationale of the study
o Objectives
o Hypotheses
o Study design
o Study area
o Sampling procedure
o Target population
o Tools of data collection
o Methods of analysis
o Chapterization

3. Introduction
• India is the home to large number of indigenous people, who are still
untouched by the lifestyle of the modern world. With more than
hundred million (104.4), India has the largest population of the tribal
people in the world (RGI, 2011).
• These tribal people also known as the adivasi's are the poorest in the
country, who are still dependent on hunting, agriculture and fishing
(GOI, 2014).
• Some of the major tribal groups in India include Gonds, Oraon,
Santhals, Khasis, Angamis, Bhils, Bhutias and Great Andamanese
(GOI, 2014).

4. Cont…
• All these tribal people have their own culture, tradition, language and
lifestyle.
• As per the recent census (2011), the tribal population constitute more
than 8 percent of the total population. 89.97% of them live in rural
areas and 10.03% in urban areas.
• The decadal population growth of the tribal’s (23.7 percent) from
Census 2001 to 2011 has been more than the general population (17.7
percent).

5. The Fifth Schedule covers Tribal areas in 9 states of India
State Areas
Andhra
Pradesh
Visakhapatnam, East Godavari, West Godavari, Adilabad, Srikakulam,
Vizianagaram, Mahboobnagar, Prakasam (only some mandals are scheduled
mandals)
Jharkhand Dumka, Godda, Devgarh, Sahabgunj, Pakur, Ranchi, Singhbhum (East & West),
Gumla, Simdega, Lohardaga, Palamu, Garwa, (some districts are only partly tribal blocks)
Chhattisgarh Sarbhuja, Bastar, Raigad, Raipur, Rajnandgaon, Durg, Bilaspur, Sehdol,
Chindwada, Kanker
Himachal
Pradesh
Lahaul and Spiti districts, Kinnaur, Pangi tehsil and Bharmour sub-tehsil in
Chamba district
Madhya
Pradesh
Jhabua, Mandla, Dhar, Khargone, East Nimar (khandwa), Sailana tehsil in Ratlam district,
Betul, Seoni, Balaghat, Morena
Gujarat Surat, Bharauch, Dangs, Valsad, Panchmahl, Sadodara, Sabarkanta (parts of these
districts only)
Maharashtra Thane, Nasik, Dhule, Ahmednagar, Pune, Nanded, Amravati, Yavatmal,
Gadchiroli, Chandrapur (parts of these districts only)
Orissa Mayurbhanj, Sundargarh, Koraput (fully scheduled area in these three districts),
Raigada, Keonjhar, Sambalpur, Baudakondmals, Ganjam, Kalahandi, Bolangir,
Balasor (parts of these districts only)
Rajasthan Banswara, Dungarpur (fully tribal districts), Udaipur, Chittaurgarh, Siroi (partly
tribal areas)

6. Oraon Tribe
• The Oraon is an agricultural tribal
community (Mittal, & Srivastava, 2006)
and one of the largest tribal groups in India.
• The Oraons are a tribe of about 3.6 million
people inhabiting in the states of West
Bengal, Odisha, Chhattisgarh, Maharashtra,
Madhya Pradesh, Jharkhand and Bihar.
Linguistically, they are of Dravidian Origin
(Census, 2011).
• Oraon Tribal (1.7 Million) is the second
largest tribal community of Jharkhand after
the Santhals (Census, 2011).
Source: UNESCO, 1987

7. Oraon Tribal Population by state in India, Census-2011
0.03 0.04
0.14
0.36
0.64
0.75
1.72
0.01 0.02
0.13 0.30
0.60
0.66
1.47
0.02
0.03
0.02 0.06 0.04
0.09
0.24
Madhya
Pradesh
Maharashtra Bihar Odisha West Bengal Chhattisgarh Jharkhand
In
Million
Place of Residence
Total Rural Urban

8. Source: Census, 2011
Tribes in Jharkhand
31.86
19.86
14.22
10.74
12.08
5.60 5.64
Santal Oraon Munda, Patar Ho Tribes # Tribes * Tribes @
In
Percentage
Tribes
Note:
Tribes #: Kharwar, Lohra, Bhumij, Kharia, Dhelki Kharia, Dudh Kharia, Hill Kharia, Generic Tribes.
Tribes *: Mahli, Mal Paharia, Kumarbhag Paharia, Bedia, Chero
Tribes @: Karmali, Chik Baraik, Gond, Kol, Sauria Paharia, Kisan, Nagesia, Korwa, Kora, Mudi -Kora, Parhaiya, Asur,
Agaria, Binjhia, Birhor, Savar, Kawar, Birjia, Gorait, Baiga, Bathudi, Banjara, Khond.

9. Distribution of Oraon Tribes by Religion in Jharkhand
Religion*
1%
Hindus
12%
Christians
26%
Other
Religions and
persuasions
61%
Percentage distribution of Oraon population by
religion in Jharkhand
Religion* (0.61%)
[Religion not Stated (0.35%)
Muslims (0.20%)
Buddhists (0.04),
Sikhs (0.01) and
Jains (0.003)]

10. Socio-Demographic characteristics of Oraon Tribes, Census-2011
1018
1007 1007
993 992
955
877
ODISHA JHARKHAND CHHATTISGARH WEST BENGAL MADHYA
PRADESH
BIHAR MAHARASHTRA
Female
per
1000
males
States
Literacy level
Sex Ratio
38.34
54.96
63.52
68.28
69.77
74.20
81.26
BIHAR
WEST BENGAL
ODISHA
MAHARASHTRA
JHARKHAND
CHHATTISGARH
MADHYA PRADESH

11. Author (Year) Major findings
Lindstrom &
Munoz,
(2006)
Migration improves the material conditions of rural households and
communities through the infusion of remittances, and it can alter ideational
systems and cultural practices through the diffusion of new ideas, attitudes,
and behaviours.
Chatterjee,
(2006)
Migration has exposed individuals and groups in health risks at many
settings.
Goldman et. al.,
(2001);Brockerho
ff & Biddlecom,
(1999);Levitt,
(1998)
Relatively few studies have examined the implications of assimilation in
the context of return migration and the diffusion of new health-related
behaviours and ideas to rural areas, even though a significant proportion of
internal and international out-migrants return to their community of origin.
Ian Anderson et
al.,(2016)
Study conducted in 23 countries on 28 populations provide
evidence of poorer health and social outcomes for indigenous
peoples than for non-indigenous populations.
Existing literature

12. Author (Year) Major findings
Lusome &
Bhagat, (2006)
Industrialization and economic development has been accompanied by
large-scale movements of people from villages to towns, from towns to
other towns and from one country to another country.
NFHS-3 (2005-
06), DLHS-3
Highlights low utilization of essential maternal healthcare like antenatal
care, delivery care and post-natal care of Tribal people. It also shows a low
level of institutional delivery and high maternal mortality. This is more
noticeable in high focused states like Jharkhand.
Jan chetana
Mnach, (2009)
Evidence from Jharkhand, though sparse, suggests that rural women do not
receive quality care during pregnancy or childbirth. Most are not attended
by a ‘skilled attendant’; they do not have access to emergency obstetric care
(EMoC), or a referral system to ensure timely live saving care. In Bokaro
only 20% of rural women deliver in an institution
Jharkhand
Economic Survey
(2016);
;Hindustan Times
(Mar 10, 2016)
More than 90% expectant mothers in rural areas are unaware of health and
nutritional issues. The state has one of the country’s worst maternal
mortality rates.

13. Author (Year) Major findings
State health
department,
Jharkhand; 2015
In Jharkhand, for every 100,000 live births 208 mothers die during delivery,
compared to the national rate of 178, while the under-five mortality rate
among children is at a high 51 per thousand live births.

14. Rationale of the study
• Census doesn’t provide Tribal Specific Migration information.
• Addition to this, there is hardly any studies which scientifically assess the
utilization of remittances on the health care among tribes in India.
• Comprehensive area-specific health related studies are limited; most of the
available studies are either isolated or fragmentary and did not cover the
various dimensions of health affecting the status of tribal women.
• It has often been said that Tribal people in India have worse health
condition than other Indians (Subramanian et al., 2006).
• With this backdrop, the present study is an effort to assess the effect of
perception about migration and pregnancy on maternal healthcare
utilization among one of the most distinct and indigenous Tribe i.e. Oraon
in Jharkhand.

15. Research Questions
1. What are traditional practices and social believes with regard to maternal
healthcare among Oraon tribes in rural Jharkhand ?
2. What is the role of migration and remittances on socio-economic development and
utilization of essential maternal healthcare services ?
3. Does the general health of women have improved due to the migration of any
member in the household ?

16. Objectives
1. To examine the perception, traditional practices and social believes on the
utilization of maternal healthcare services among Oraon Tribes.
2. To study the impact of migration and remittances on socio-economic
development among Oraon Tribes.
3. To study the effects of migration and remittances on maternal healthcare
utilization among Oraon Tribes.
4. To assess the general health of women having utilized the essential maternal
healthcare services.

17. Hypotheses
1. H0: The perception and traditional believes of Oraon tribes does not have any
effect on the maternal health of women.
2. H0: Utilization of any maternal healthcare services does not vary by having a
migrant member in the household.
3. H0: General health of women does not vary by the utilization of essential maternal
healthcare services among Oraon tribes.

18. Study design
Data source:
o Primary data will be collected to fulfill the objectives of this study. In particular,
data will be collected from Oraon tribes to understand their perception on
maternal health, pattern of migration and use of remittances on maternal
healthcare utilization.
Design:
o The study will be explorative in nature. It will explore a new dimension in the
maternal health care system in Jharkhand.

19. Study area
Map of India
N

20. Operational Definition
Migration
(UN, 1993)
Migration is defined as a move from one migration defining area to
another, usually crossing administrative boundaries made during a
given migration interval and involving a change of residence.
Maternal Health
(WHO)
Maternal health refers to the health of women during pregnancy,
childbirth and the postpartum period. While motherhood is often a
positive and fulfilling experience, for too many women it is
associated with suffering, ill-health and even death.

21. Target population
• Women who had given birth in the last one year will be the target population in this
study.
Inclusion criteria
• Women aged 15-45 Years given birth in the last one year
• Women given birth both at home and health institutions will be incorporated
• Only one woman in the selected HH will be considering.
Exclusion Criteria
• Remarried women will not consider in the study.

22. Sampling Procedure
• A cross-sectional survey using multi-stage random sampling procedure will be
conducted among Oraon Tribes in Ranchi district of Jharkhand.
• 300 (150-Migrants and 150-Non migrants) women (women having at least one
child below 1 year) will be selected purposively.
• Data will be collected by face-to-face interviews with a pre-tested structured
questionnaire.

23. Sampling Framework
M: Migrant NM: Non-Migrant
Chanho Block (67 villages)
3 villages will be selected randomly
Mandar Block (69 villages)
3 villages will be selected randomly
Village-1
Ratu Lapung Burmu Namkum Ormanjhi Angara Silli
Kanke Khelari
MANDAR Itaki Rahe Bundu Sonahatu Tamar CHANHO
Nagri Bero
Jharkhand
Ranchi
25 M
HH
25 M
HH
Village-2 Village-3 Village-4 Village-1 Village-2 Village-3 Village-4
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH
25 M
HH

24. Data collection tools
o Household information: Type of family, Type of house, Family size, Sources of
income of household with household assets and facilities (water & toilet) etc.
o Women information: Age, sex, caste, religion, working status, age at marriage,
registration of pregnancy, utilization of essential maternal healthcare services,
age at first child birth, number of children by age and sex etc.
To fulfill the objectives of the present study the following household and individual
information will be collected by using structured interview schedule.

25. • After collecting the requisite information from the women, data
will be cleaned, edited and entered using advanced research
software like CsPro. Necessary statistical inferences like
bivariate and multivariate will be used using SPSS and STATA
to fulfil the objectives of the study.
Analysis Plan

26. Ethical issues
• This study is based on primary data.
• So, ethical clearance will be obtained from the Students Research
Ethics Committee (IIPS-SREC) of the institute before
undertaking the study.
• Apart from this, prior consent will be obtained from women
before collecting information from them.
• The prior consent will be acquired after presenting the utility of
the present study.
• Confidentiality of participant's identity will be maintained in the
study.

27. Utilization of
maternal healthcare
services
Migration Remittances
Programmatic Factors:
Availability of Services
Accessibility of Service
Quality of Care
Perceptions of Health
Knowledge
Awareness
Social Stigma
Socioeconomic and
demographic
characteristics
Women Education
Work status of women
Women Autonomy
Children ever born
Pregnancy outcome
Economic Status of
Household
Conceptual frame work

28. Organization of the Ph.D. thesis
The thesis will be organised in the following manner:
Chapter 1 Introduction and Literature review
Chapter 2 Data and Research methodology
Chapter 3 The perception, traditional practices and social believes on the utilization of maternal
healthcare services among Oraon Tribes.
Chapter 4 The impact of migration and remittances on socio-economic development among Oraon
Tribes.
Chapter 5 The effects of migration and remittances on maternal healthcare services utilization among
Oraon Tribes.
Chapter 6 The general health of women having utilized the essential maternal healthcare services.
Chapter 7 Summary and conclusion
Chapter 8 Policy Recommendations

29. Timeline for Ph.D. Thesis
Particular Date Status
Joining Ph.D. 22th Jan 2014 Completed
As a assignment in “IHAT” Lucknow, U.P. 11th February to 15th April 2014** Completed
Concept note Submission 10th October 2014 Completed
Received comments on Concept note 24 February 2015 Completed
Literature Review March to August 2015 Completed
Research Methodology September to November 2015 Completed
Proposal Preparation December 2015- January 2016 Completed
Proposal Presentation July 4, 2016 Scheduled
Tool Preparation August – October 2016 -
Data Collection November 2016- March 2017 -
Data Cleaning and Data Entry April 2017 -
Data Analysis Chapter Writing May - October 2017 -
Synopsis Preparation November-December 2017 -
Synopsis Presentation January-Feb. 2018 -
Submission of Ph.D. Thesis March-April 2018 -
**Assignment as a PIP Consultant in “Indian Health Action Trust (IHAT)”, Lucknow, U.P, India