1. Tribal Health Status in India
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2. Introduction
 Being among the poorest and most marginalised groups in India, tribals experience extreme levels of health deprivation.
The tribal community lags behind the national average on several vital public health indicators, with women and children being the most vulnerable
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3. Definition
A tribe is a distinct people, dependent on their land for their livelihood, who are largely self-sufficient, and not integrated into the national society
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4. PART OF INDIAN CONSTITUTION
According to Article 342 of the Constitution, Officially recognized by the Indian government as "Scheduled Tribes" in the Fifth Schedule of the Constitution of India, eligible for certain affirmative action measures. The community should be declared as TRIBES by the President through a public notification

7. Tribal constitute 8.61% of the total population (2011 Census) and cover about 15% of the country’s area.
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8. Tribal Communities 705 Tribal communities in India
75 Primitive tribal communities
Not found in Punjab and Haryana

9. Andaman Primitive Tribal Communities
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10. The uncontacted tribes
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11. AERIAL FOOTAGE OF UNCONTACTED TRIBES
 Mere contact with outsiders was often sufficient to set off deadly epidemics 
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12. The Andamanese Tribes Great Andamanese, estimated 53
Jarawa now estimated 250 to 300
Jangil -90 to100
Onge, now fewer than 100
Sentinelese, now estimated to be 39
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13. Extinction
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14. Sentinelese Tribes the most isolated people
39 individuals-21 males and 18 females
In 2006, Sentinelese archers killed two fishermen who were fishing illegally within range of the island

15. Jarawa Tribes 250–300 Healthiest Optimal Nutritional Status
( when they felt the earthquake, they are said to have stuck their bows and arrows in the ground in an effort to reduce the intensity)
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16. Time ticking for India's Jarawa tribe
"There are instances of Measles and Malaria outbreak among the Jarawa as a result of frequent contact with outsiders and it could well be the beginning of the end for the tribe,“
According to experts, one of the key reasons for the changes in Jarawa lifestyle has been the construction of the ATR
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17.   Andaman Trunk Road
In 2002, the supreme court ordered the closure of the road , but the authorities have defied this, not only keeping the road open but actually widening it
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18. Extinction of Bo Community
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19. POPULATION DISTRIBUTION
Central Indian states have the country's largest tribes, and, taken as a whole, roughly 75% of the total tribal population live there.

20. Indian Tribal Belt India Tribal Belt stretches from
Gujarat in the west up to Assam in the east across the states of Madhya Pradesh, Chhattisgarh and Jharkhand.
It is among the poorest regions of the country.
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21. Distribution of Scheduled Tribe Population by States - 2011

23. Tribal population of Tamilnadu
Tribal population:1% of total
male: total:4,01,068
Rural :3,33,178
Urban:67890
Female:total:3,93,629
Rural:3,27,102
Urban:66527
In accordance with The Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1976:
36 tribal communities
Sex ratio per thousand
Total:981
Rural:982
Urban:980

24. Primitive tribes in tamilnadu
Kattu Nayakans
. Kotas
. Kurumbas
. Irulas
. Paniyans
. Todas (polyandry)
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25. DIFFERENT TYPES OF TRIBES

26. Tribal classification
Agriculturists
Cattle herder
Folk artisans
Labourers
Food gatherers and hunters

27. Key Indicators

28. Key health indicators

29. Sex Ratio & Child Sex Ratio (Females per 1000 males) INDIA
Indicator
Sex Ratio
Child Sex Ratio
2001
2011
Total Population
Total
933
943
927
919
Rural
946
949
934
923
Urban
900
929
907
905
Scheduled Castes
936
945
938
939
941
924
922
Scheduled Tribes
978
990
973
957
981
991
974
959
944
980
951
940
Source: Primary Census Abstract for Total population, Scheduled Castes and Scheduled Tribes, 2011
Office of the Registrar General & Census Commissioner, India

30. Effective Literacy Rate
Literates & Literacy Rate (Persons)
INDIA
Indicator
Literates
Effective Literacy Rate
2001
2011
Total Population
Total
56,06,87,797
76,34,98,517
64.8
73.0
Rural
36,17,36,601
48,26,53,540
58.7
67.8
Urban
19,89,51,196
28,08,44,977
79.9
84.1
Scheduled Castes
7,53,18,285
11,37,59,907
54.7
66.1
5,58,06,266
8,20,20,232
51.2
62.8
1,95,12,019
3,17,39,675
68.1
76.2
Scheduled Tribes
3,23,86,821
5,16,35,423
47.1
59.0
2,82,94,749
4,46,31,645
45.0
56.9
40,92,072
70,03,778
69.1
76.8
Source: Primary Census Abstract for Total population, Scheduled Castes and Scheduled Tribes, 2011
Office of the Registrar General & Census Commissioner, India

31. State/ Union Territory #
Literacy Rate (Persons)
INDIA
State/ Union Territory #
Literacy rate
Top 5
Bottom 5
Scheduled Castes
Daman & Diu #
92.6
Bihar
48.6
Mizoram
92.4
Jharkhand
55.9
Tripura
89.4
Rajasthan
59.7
D & N Haveli #
Uttar Pradesh
60.9
Kerala
88.7
Andhra Pradesh
62.3
Scheduled Tribes
Lakshadweep #
91.7
49.2
91.5
Jammu & Kashmir
50.6
Nagaland
80.0
Madhya Pradesh
Sikkim
79.7
51.1
79.1
Odisha
52.2
Source: Primary Census Abstract for Total population, Scheduled Castes and Scheduled Tribes, 2011
Office of the Registrar General & Census Commissioner, India

32. LR
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33. Nutritional Status Nutritional Status:
46.6% ST women have BMI below 18.5, indicating a high prevalence of nutritional deficiency.
68.5 % (55%)of women and 39.6 % (25%) of men are anemic – highest among all social groups
 Only 21% of ST children age months received vitamin A supplements
 Among children age 6-59 months, the figure drops further to only 14.6%.
76.8% of ST children are anaemic % mild, 47.2 % moderate & 3.3 % severe
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37. Diseases Encountered
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38. COMMUNICABLE DISEASES
Water borne and communicable diseases:
Gastrointestinal disorders are very common, leading to marked morbidity and malnutrition.
Malaria and tuberculosis.
Spectrum of viral and venereal diseases.

39. GENETIC DISORDERS
High prevalence of genetic disorders mostly involving red blood cells: Genetically transmitted disorders like sickle cell anaemia.
G6PD deficiency and different forms of Thalassaemia are also common.

40. Sickle cell Disease > 19% Sickle cell disease in 35 Tribal groups
>40% Sickle Cell trait
Irula ,Paniyan of Nilgiri Hills
Adiyan of Kerala
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41. G6PD Deficiency 13 lakh Tribal Population
> 15 % among tribal population in TamilNadu, Orissa,Maharastra,Madhyapradesh
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42. Mental Health Issues 20/1000 (73) 11/1000 Depression (20)
20/ (73)
11/1000 Depression
(20)
3/1000 Hysteria
2/1000 Phobia
1/ Schizophrenia (1.5)
0.4/1000 Mania
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43. AIDS 2.9/1000 per among tribes (2.8) Heterosexual transmission
Blood and Blood related products
Homosexual Transmission
Vertical Transmission
Needle stick Injuries
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44. Malaria in Madyapradesh
30% of Malaria Cases
60% of Falciparam cases
50% of Malaria Death
(According to the report, malaria control in Madhya Pradesh is complex because of vast tracts of forest with tribal settlement)
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45. IMPROPER NUTRITION
Deficiency of essential components in diet leading to malnutrition, protein calorie malnutrition and micronutrient deficiencies.
Goitre of various grades is also endemic in some of the tribal areas.

49. Long way to go?

50. WAYS
Regular clinics in all villages to see all pregnant mothers and children less than five years.
Refreshing and sharing knowledge with tribal women.
Tribal girls working as Health Workers.
Postnatal checkups in all villages once a week .
Health education and discussion of social problems.
Dramas and cultural shows to spread information.
Outpatients & Inpatients seen at the Tribal Hospital.

51. Ensuring availability of adequate infrastructure and personnel.
Area specific RCH programmes.
Effective implementation of the Health & Family Welfare programmes.
Close monitoring, early detection of problems in implementation and midcourse correction.

52. Incentives
Almost every State in the country is facing tough challenge to retain doctors in remote tribal pockets
In Chhattisgarh, specialists are being offered up to Rs. 1 lakh
In Madhya Pradesh, doctors in difficult areas get double the salary of those in normal areas
 Under outreach referral services in Gujarat, paediatricians and gynaecologists are being paid Rs. 2,500 to Rs. 3,000 per visit to difficult areas as against Rs. 1,500 for normal areas.
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53. TRIBALS PERSPECTIVES Establish a NGO including tribal representatives.
Establish especially a higher educational institution in tribal area
Conduct seminars and conferences in tribal areas
Appropriate findings should be presented that address limitations also
Eliminate “mediators” who absorb all benefits which are the rights of tribes
Do not close down primary schools even if there are just 1 or 2 students
Design & develop flexible & contextual education curriculum (local dialect).
Design community schools with seasonal flexibility
Family centred education.
Inadequate and forceful resettlement policies and lack of rehabilitation
Urging researchers to help the tribes give them their rights

54. WHAT CAN RESEARCHERS DO?
Gather empirical evidence of effectiveness of the programs such as
Integrated Tribal Development Programme.
Present evidence to government for further appropriate action
Gather qualitative aspects which bring to light the real causes of situations like
school drop outs, education etc.
Explore how technology and social media can alleviate various problems
Design and evaluate if schools like Navodaya Model School can be started in all tribal settings.
Emphasis on tribal medicine research

55. GOVERNMENT INITIATIVES
Till June 30, 2006 there were sub-centres functioning against a requirement of sub-centres for tribal areas.
The number of functioning PHCs were 3260 against a requirement of 4180 and functioning CHCs were 446 against a requirement of 492.
There are also 1122 Dispensaries and 120 Hospitals and 78 Mobile Clinics in Modern Medicine .
1106 Dispensaries and 24 Hospitals in Ayurveda.
251 Dispensaries and 28 Hospitals in Homeopathy.

56. Eklavya Ekalavya Model Residential School (EMRS)
the government gives one time Rs 30 lakh grant for establishing the school, thereafter up to Rs. 30 lakh per school annually.
Additional cost is borne by state governments.
By 2007, 72 Eklavya Model Residential Schools (EMRS) were established in tribal areas across India, including highest 10 in Orissa, followed by 8 each in Andhra Pradesh, Gujarat, Madhya Pradesh and Chhattisgarh states
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57. Mobile Medical Unit
The mobile medical unit comprises a doctor, lab technician, nurse, auxiliary mid wife and driver. The vehicle is fitted with all necessary equipment, including, microscope and a mini-lab.
Doctors will screen tribal people for diabetes, cardiac diseases, hypertension, symptoms of tuberculosis
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58. Goal Improvement of healthcare infrastructure.
Developing a flawless referral system.
Provide diagnostic facilities for genetic defects.
Follow up of anemic and other severe patients.
Carry out population genetic survey programs.
Health education.
Genetic counseling.
Marriage counseling.
Provide prenatal diagnosis.

59. Tribal welfare programmes/schemes in India
1. Integrated Tribal Development Project
2. Nursery-cum-Women Welfare Centres
3. Mid Day Meal Scheme
4. Janshala Programme
5. Tribal Alternate Education Programme
6. Scheme of strengthening education among scheduled tribe girls in low
literacy districts
7. Incentives for education
8. Ashram schools
9. Pre matric hostels
10. Post matric hostels
11. Grant in aid schemes for welfare of scheduled tribes
12. Scholarships
13. Tribes India
14. National Overseas Scholarships
15. Book Bank Scheme
16. Central Sector Scheme for up gradation of merit of SC/ST students
17. Tribal research centre

60. Role of NGOs
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61.  Tribes do not believe NGOs role in their development
 High exploitation of tribes by NGOs
 The funds availed from governments by NGOs for the betterment of tribes not
reaching the main beneficiary..
 Empty promises and innumerable surveys for data without any benefits or
improvement in the status of the tribal participants

62. NGOs in India % Fraud
The Delhi high court has called for toughening of licensing norms for NGOs observing that 99% of them are "fraud" and "merely money making devices".
"Most private run so called philanthropic organizations do not understand their social responsibilities.
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63. Tribal Health Initiative
a non profit organisation located in the Sittilingi valley in Dharmapuri district, Tamil Nadu

64. Tribal Health Initiative
It works for the welfare of the local people who are predominantly Malavasi tribals.
As of 2010 it has grown to include a 24-bed hospital with a labour room, neonatal unit, operation theatre, diagnostic laboratory and imaging facilities, a community health outreach programme
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65. Achievement Imr =147/1000 in 1992 Imr=20/1000 in 2012
The proportion of pregnant mothers coming for AN check-ups has increased from 11 per cent to 90 per cent 
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66. THI
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67.
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68. Eshop.Tribesindia.com -Ministry of Tribal Affairs
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69. Minister OF Tribal Affairs
Jual Oram – 27 May 2014

70. Tribal Minister Of Tamilnadu
Thiru N.Subramanian
Adi Dravidar Welfare and Welfare of Hill Tribes and  Bonded Labour
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71. Survival International- an NGO
A human rights organisation formed in 1969 that campaigns for the rights of tribal people
guided by the principle that tribal ways of living are not deficient, but in fact are desirable and should be maintained
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72. Quotes of Survival International
Tribal people are not ‘backward’, they haven’t been ‘left behind’. They choose to live on their land, in their own ways.
PROUD, NOT PRIMITIVE. .’
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73. Proud not primitive Eat vegetables- they do it
Drink pure and clean water-they do it
Walk a lot-they do it
Live amidst nature-they do it
Don’t destroy forest to reduce pollution-they do it
Avoid stress-they do it

74. SI – Campaign
1. use multiple media. 2.writing letters to governments, 3. spreading the word through sponsorships, 4. leaflets 5.demonstrations 6.film shows, and 7.collecting money from a variety of events
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75. Latest Battle
Vedanta Resources, a British company, lost a battle to dig an open-pit bauxite mine on Niyamgiri mountain in India.
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76. ILO 169
The only international law that can secure tribal peoples’ land rights
 ILO 169 recognizes and protects tribal peoples’ land ownership rights, and sets a series of minimum UN standards regarding consultation and consent.
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77. International Day –August 9
observed on August 9 each year to promote and protect the rights of the world’s indigenous population.
The theme of this year’s International Day of the World’s Indigenous Peoples was “Bridging the gap — implementing the rights of indigenous people.”
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78. Conclusion
Tribals’ right to good healthcare must be addressed using modern technology and innovative approaches involving the community.
 Health is intimately linked to inclusive development with food and nutrition security, safe housing and availability of sanitation and clean drinking water.
There are many successful examples of good healthcare delivery in remote tribal areas in our country
These models need to be scaled up in order to improve the lives of the most vulnerable and marginalised citizens of our country.
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