Launch a national tribal health mission

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Last Updated10/08/2022

On this International Day of the World’s Indigenous Peoples, the symbolic gesture of having the first tribal President, can be turned into a health revolution for the tribal people of India.

11 crore tribal people (enumerated as Scheduled Tribes or ST) in the Census of India (2011) live in India. They constitute 8.6% of India’s population, the second largest number of tribal people in any country in the world.
A study published in The Lancet, titled ‘Indigenous and Tribal Peoples’ Health’ (2016), found that India held the inglorious distinction of having the second highest infant mortality rate (IMR) for the tribal people, next only to Pakistan. This is not an honourable position.

On this day, in 2018, the first national report on the state of India’s tribal people’s health was submitted to the Government of India by the Expert Committee on Tribal Health. It found-

Tribal people are concentrated in 809 blocks (Scheduled Areas)in India. Half of India's tribal population live outside the Scheduled Areas, as a scattered and marginalised minority. They are the most powerless.

The health status of tribal people has certainly improved during the last 25 years as seen in the decline in the under five child mortality rate (U5MR) from 135 in 1988 in the National Family Health Survey (NFHS-1) to 57 in 2014 (NFHS4). However, the percentage of excess of under five mortality among STs com- pared to others has widened.

Child malnutrition is 50% higher in tribal children: 42% compared to 28% in others.

Malaria and tuberculosis are 3 to 11 times more common among the tribal people. Though the tribal people constitute only 8.6% of the national population, half of the total malaria deaths in India occur among them.

While malnutrition, malaria and mortality continue to plague tribal people, gradually, the more difficult to treat NCDs such as hypertension and diabetes, and worse, mental health problems such as depression and addiction leading to cancer and suicide, are increasing.

Tribal people heavily depend on government run public health care institutions, but there is a 27% to 40% deficit in the number of such facilities, and 33% to 84% deficit in medical doctors in tribal areas.
Government health care for the tribal people is starved of funds as well as of Human Resources.

There is hardly any participation of the tribal people – locally or at the State or national level – in designing, planning or delivering health care to them.

The Abhay Bang committee gave following 3 major recommendations:
Launch a National Tribal Health Action Plan with a goal to bring the status of health and healthcare at par with the respective State averages in the next 10 years.
The Bang committee suggested nearly 80 measures to address the 10 priority health problems, the health care gap, the human resource gap and the governance problems.
Allocation of additional money so that the per capita government health expenditure on tribal people becomes equal to the stated goal of the National Health Policy (2017), i.e. 2.5% of the per capita GDP.

The need of the hour is to incorporate these recommendations into a holistic mission for tribals like NTHM.
NTHM would aim to improve among the tribal pockets of India the following health parameters:
Hunger and malnutrition, infant and maternal mortality rates, communicable and non-communicable diseases prevention, access to public healthcare etc.

We need to move from symbolic gestures to substantive promises, from promises to a comprehensive action plan, and from an action plan to realising the goal of a healthy tribal people.
If actualised, the Tribal Health Mission can be the path to a peaceful health revolution for the 11 crore tribal people. India needs to demonstrate to them that democracy offers acaring solution to their wounds.