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Tribal areas see increase in health infrastructure: Is it enough?

Illustration of tribal areas.
Tribal workers in Gadchiroli. Image credit: Subodhkiran [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)]
Tribal areas witnessed a 73 percent increase in the availability of healthcare facilities between 2005 and 2020, according to government data.

In 2005, the number of sub-health centres in tribal areas stood at 16,748. By 2020, this increased to 29,745 – a 78 percent increase. Primary health centres, meanwhile, increased by fifty percent from 2,809 in 2005 to 4,203 in 2020 and community health centres increased by 61 percent from 643 to 1,035. 

Countrywide, meanwhile, the number of healthcare facilities increased by ten percent in the same timeframe. The number of sub-health centres increased by nine percent, from 142,655 to 155,404. The number of primary health centres increased by eight percent, from 23,109 to 24,918. The number of community health centres increased from 3,222 in 2005 to 5,183 in 2020.

Access to healthcare for tribal areas is a long-standing issue, as is the case for many rural populations. As Health Issues India noted earlier this year, “the vast majority of India’s population reside in rural villages. As of 2018, 66 percent of India’s population are defined as living in rural communities according to the World Bank. Despite this, the vast majority of India’s healthcare infrastructure is focused within the more densely populated urban centres.” In addition, “many healthcare facilities in rural areas have simply been abandoned or repurposed, instead being used for other purposes such as cattle sheds and storage.”

Tribal populations are especially vulnerable. “India…is finding it difficult to bridge the gap that exists between tribal and non-tribal population in regards to healthcare,” a study – “Tribal population in India: A public health challenge and road to future” – published last year outlined. 

“[The] tribal population suffers [a] triple burden of disease; in fact it is quadruple, namely, communicable diseases, noncommunicable diseases, malnutrition, mental health, and addictions complicated by poor health seeking behavior…It is high time and states should act swiftly to assess the needs, priorities of their own tribal population and set goals, targets to achieve the same through proven public health strategies.” The study added that “poverty among tribal groups declined by more than a third between 1983 and 2005 and nearly half the country’s Scheduled Tribes population remains in poverty.” 

Despite the increases in the availability of healthcare facilities in tribal areas, they continue to experience a deficit of healthcare facilities as opposed to population norms. These norms recommend one sub-health centre for every 5,000 people; one primary health centre for every 30,000 people; and one community health centre for every 120,000 people. In desert and tribal areas, the ratio is one for every 3,000, 20,000, and 80,000 people respectively. 

As such, it is clear more needs to be done. Enhancing the availability of human resources in tribal areas, strengthening primary healthcare infrastructure are among the interventions needed. As “Tribal population in India: A public health challenge and road to future” concluded, “it is high time and states should act swiftly to assess the needs, priorities of their own tribal population and set goals, targets to achieve the same through proven public health strategies.” 

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