One hundred and four million tribal people, accounting for 8.6 percent of India's population, are heavily marginalized and discriminated against. Not only are tribal communities socio-economically othered by the mainstream Indian populace, but they also face a host of structural inequalities, with access to healthcare being one of the biggest.
While there seems to be a vague consensus among policymakers that tribal communities have poor health and restricted access to healthcare, there are still no policies that meet this need, and no reliable data about the state of tribal health.
Tribal healthcare in India usually falls within the ambit of rural healthcare. The assumption that the problems and needs of tribal people are the same as that of rural populations is incorrect; The difference in terrain, environment, social systems and culture, all lead to tribal communities having their unique set of healthcare needs.
Tribal communities face the "triple burden" of disease. Apart from high rates of malnutrition and communicable diseases, the advent of rapid urbanization, and changing lifestyles and environment, has led to a rise in non-communicable diseases as well. These are both in addition to the burden of mental illness and subsequent addiction.
What can be done to improve the state of tribal healthcare?
The report lays out nine recommendations for the future. The overarching goal, according to the committee, should be to bridge the gap in healthcare for tribal communities, and to bring health coverage and indicators at par with the state average by at least 2027.
By ensuring that adequate attention and diligence is paid to tribal healthcare, and structural changes are implemented to incorporate tribal health needs, the state of tribal healthcare can improve.
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 feasible, sustainable, long-term solution."
The report also states that traditional healers within tribal communities should be recognized and used. 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 programs could begin to address this issue.
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.