Healthcare in Tribal Areas
Key Points:
- There are various Governmental/non-government institutional mechanisms and survey agencies which generate data on tribal healthcare periodically.
- Rural Health Statistics (RHS) provides details of infrastructure & human resources in tribal areas.
- National Family Health Survey(NFHS) provides details on major health indicators about maternal and child health among schedule tribes.
- Census of India provides population and household details including Tribal areas.
- National Sample Survey provides household surveys on various socio-economic subjects.
- The expert committee on Tribal Health titled, “Tribal Health in India: Bridging the Gap & a Roadmap for the Future” came in 2018 which gives details on the status of tribal health.
- The Report of the Committee pieces together the health status of the tribal populations, did a detailed analysis of the health situation in tribal areas, maps out the disease burden, and discusses the challenges in areas of infrastructure, facilities, human resources, and financing, participation in planning etc.
- The main recommendations of the committee include-
- strengthen access to comprehensive primary health care by establishing health & wellness centres
- provide insurance for access to secondary & tertiary care;
- enhance human resources via community health officers, mid-level healthcare providers, enhancing capacities of ASHA, task sharing & shifting etc;
- community mobilization & IEC;
- use of technology to increase access to health services; strengthening school health programs;
- integration of tribal health practitioners in primary care;
- increased financing for tribal health for instance through Tribal Sub Plan(TSP).
- The NHM focuses on a universal approach & hence all the Health & Family Welfare Schemes run under the umbrella of NHM are applicable & available in all the States/UTs including Odisha.
- Under the National Health Mission(NHM), financial & technical support is provided to States/UTs to strengthen their healthcare systems including upgrading public health facilities & augmenting health human resources on a contractual basis for the provision of equitable, affordable healthcare to all its citizens particularly the poor & vulnerable population in the tribal areas based on requirements posed by the States in their Program Implementation Plans(PIPs) within their resource envelope.
Various support under NHM for better healthcare for beneficiaries in Tribal areas are as follows:
- Ayushman Bharat- Health & Wellness Centers (HWCs) are established by transforming the Sub-Health Centers(SHCs) & Primary Health Centers(PHCs), as part of the Ayushman Bharat- the flagship program of the government of India, to deliver 12 packages of Comprehensive Primary Health Care(CPHC) that includes preventive, promotive, curative, palliative, rehabilitative services which are universal, free and close to the community.
- The population norms for setting up Health Facilities in vulnerable areas are relaxed. Against the population norms of 5000, 30,000 & 1,20,000 for setting up of SHC, PHC, CHC, the norm is 3000, 20,000, 80,000 respectively in vulnerable areas like remote, tribal, desert & hard to reach areas.
- Under NHM, States/UTs were given the flexibility to deploy Mobile Medical Units(MMUs) to provide a range of health care services for the population particularly those living in remote, inaccessible, un-served areas, as per the needs identified by the respective States/UTs.
- To minimize the out-of-pocket Expenditure incurred on health services, National Free Drugs Service Initiative & National Free Diagnostic Service Initiative were rolled out.
- The ASHA program guidelines provide for recruitment of ASHA at the habitation level in hilly, tribal & difficult areas.
- Government of India is supporting states in implementing National Ambulance Services under NHM for free transportation of sick patients to the health facilities.
- States are free to place these ambulances at a lower population norm or as per time to care approach so that these ambulances are easily accessible.
- Further, all tribal majority districts whose composite health index is below the State average were identified as High Priority Districts(HPDs) & these districts receive more resources per capita under the NHM as compared to the rest of the districts in the state.
