September 4, 2018 2:31:50 am
The sex ratio of the tribal population in the country is higher than the national average at 990 females per 1,000 males, but the child sex ratio has declined from 972 in 2001 to 957 in 2011, the first ever report on health of tribals has revealed.
“At 990 per 1,000 males, the sex ratio among STs is much better than the All India average of 933. It is also an improvement from 978 in 2001. Tribal population in states like Goa (1,046), Kerala (1,035), Arunachal Pradesh (1,032), Odisha (1,029), Meghalaya (1,013) and Chhattisgarh (1,020) show a positive sex ratio. However, the child sex ratio among STs has declined from 972 in 2001 to 957 in 2011. While this is better than the All India average of 914, it represents a worrying trend and can be attributed to greater dispersion of tribal communities and consequently increased access to ultrasound technology,” the report prepared by an expert committee on tribal health stated.
The report titled, “Tribal health in India Bridging the Gap and a Roadmap for the Future”, revealed how manpower and infrastructure deficiencies are more acute in tribal areas. The report listed ten health challenges for tribals, including malaria and animal bites.
The committee was constituted in 2013 by the UPA government to look into the health status of the tribal population, goals of tribal healthcare and finances, governance and knowledge required for the purpose. The committee submitted its report to the Union Health Ministry last month.
The report revealed poor access to amenities, with only 52 per cent tribal (scheduled tribes) households having access to electricity and only one-third of tribal households using clean cooking fuels as compared to non-tribal households.
In Jharkhand, Rajasthan and Odisha, more than 90 per cent of the tribal population defecates in the open, and 77.3 per cent of tribal households have no facilities for drainage. The limited access to technology may have come with some devastating consequences.
The committee, headed by Dr Abhay Bang, in its report identified ten special tribal health problems — malaria control, reducing malnutrition, reducing child mortality, ensuring safe motherhood and the health of women, providing family planning services and care for infertility, de-addiction and mental health care, sickle cell disease, animal bites, providing health literacy and health of children in ashramshalas (residential schools for tribal children).
Malaria in the tribal population is an acute health issue. Tribals constitute 8 per cent of the country’s population, but account for 30 per cent of all malaria cases.
At 14.7 per cent of the total tribal population in the country, Madhya Pradesh has the highest number of tribals — more than 1.5 crore. Maharashtra has about 1 crore, Odisha and Rajasthan have 90 lakh each.
However, the concentration of tribals is the highest in the northeastern states — Mizoram, which has 94.4 per cent tribal population, Nagaland (86.5 per cent), Meghalaya (86.1 per cent) and Arunachal Pradesh (68.8 per cent).
The committee recommended appointing one ASHA (Accredited Social Health Activist) for every 50 tribal households, and opening tribal health and wellness centres — one for 3,000 people initially. Later, the number of health centres can be increased to one for every 2,000 people and technology-driven solutions like telemedicine and innovative point of care diagnosis can be adopted.
“This committee recommends that the government should focus 70 per cent of its resources for tribal health on provision of primary care in tribal areas,” the report stated.
It also says that all frontline health workers and health care institutions should be given specific coverage targets for STs and all tribals should be provided with a ST health card to help them avail health insurance and other facilities.
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