For the first time in Indian history, Draupadi Murmu, a tribal woman became president of India thus representing the whole tribal population. This is a big and commendable step being taken by the Narendra Modi government. Let us explore how this symbolic gesture can be turned into a health revolution for the tribal people of India.
According to the 2011 Census, India has an 11 crores tribal population. The tribal population constitutes 8.6% of the total population in India which accounts for the 2nd largest in the whole world. Followed by Pakistan, India stands 2nd highest in Infant Mortality Rate for its tribal population according to the Lancet, titled ‘Indigenous & Tribal Peoples’ Health’ (2016).
According to the latest survey, there are some major findings regarding the tribal population of India.
- The tribal population resides in the 809 blocks of India, termed Scheduled Areas. But, in contrast, most of them live outside the outskirts of the Scheduled Areas in a scattered way. They are the most powerless coummunities.
- The health status of the tribal communities has improved during the last 25 years as the Under-five mortality rate has come down from 135 in 1988 to 57 in 2014. However, the excess of under 5 mortality among STs compared to others has widened.
- Child Malnutrition is 50% higher in tribal children as compared to others.
- Diseases like Malaria and Tuberculosis are 3 to 11 times more common among the tribals as compared to the general population. Half of the deaths from Malaria happen to the tribals in India.
- Other than these, non-communicable diseases like hypertension, diabetes, and mental health problems like depression and addiction leading to cancer and suicide are highly prominent in the tribal population.
- Public institutions like hospitals, primary health centers schools in Scheduled Areas account for a deficit of 27-40% and a deficit of 33-84% in the medical doctors for the tribal people.
- There is hardly any tribal participation at the local, state, or national level in designing and delivering healthcare to them.
According to the Tribal Sub Plan, as estimated for 2015-16, there should be an expenditure of 15,000 crores on tribal health annually. But there is no accountability for that. No separate data is there for tribal health or on money spent.
Need for a Road Map
A large number of recommendations were put forward by the committee for the future. The most important recommendations are listed below
- There is a need to launch a National Tribal Health Mission with the goal to bring the status of tribal healthcare at par with the respective State averages in the next 10 years.
- A lot of measures to address the 10 priority health problems, the health care gap, the human resource gap, and the governance problems.
- Proper allocation of additional money so that the per capita government health expenditure on tribal becomes equal to the stated goal of the National Health Policy (2017) i.e. 2.5% of the per capita GDP.
Four years have already passed since the report was put forward by the committee. The tribal people of India are still waiting for the government to keep their promises where it said that the report won’t lie on the shelf, it would certainly be implemented. The tribal healthcare system is mostly avoided and particularly very sick. Tribal people hence need more substantive solutions. We are required to move from just symbolic gestures or lip service to substantive promises, from promises to a comprehensive action plan, and from an action plan to realizing the goal of a healthy tribal population. India needs to assure the tribals that democracy assures a caring solution for their wounds.