Tribal Health

Background & objectives: Tribal people often depend on herbal medicines and the traditional knowledge practitioners (TKPs) serve as their healthcare service providers. This study was an attempt to document the use of medicinal plants by the Nicobarese of Nancowry group of Islands.
Methods: Field survey was conducted in all the five inhabited Islands of the Nancowry group of Islands. All the TKPs were interviewed with a questionnaire-guided ethnomedicinal survey protocol. Voucher specimens of all the cited plants (botanic species) were collected and a community biodiversity register of Nicobarese of Nancowry was prepared.
Results: A total of 77 TKPs were identified, who together were using 132 medicinal plant species belonging to 113 genera and 62 families. The TKPs were treating a total of 43 ailments. Seven endemic and three rare plant species were recorded. The most common plant part used was leaves. Remedies were usually prepared using water as the excipient. Routes for administration of medicinal plant preparations were oral, topical and others. The information collected from the TKPs were collated in the form of Community Biodiversity Registers.
Interpretation & conclusions: The present survey shows that the medicinal plants play a pivotal role in the healthcare of the Nicobarese tribe of Nancowry group of Islands. Efforts to document the medicinal plant species and the formulations used by them are necessary to prevent the loss of this precious knowledge.

The tribal communities face disregard for their values and culture, breach of protective legislations, serious material and social deprivation, and aggressive resource alienation. Hence, the solution to these issues should enable the tribals to protect their own interests.
Protecting the land and forest rights of tribal communities is equivalent to protecting their livelihoods, life and liberty. This remains one of the critical necessities of a welfare State. Therefore, laws protecting tribal land from alienation must be upheld at all costs;
The right to natural resources in tribal lands has to be protected. They should only be accessed with the consent of the Gram Sabhas of the villages (both directly affected and in the zone of influence);
While tribal lands hold much of the natural and mineral wealth of the nation, these resources cannot be alienated against their will. Moreover, communities who part with their lands have the right to share in the wealth and income so generated from its resources. 
Hence, a reasonable share of the wealth generated by the resources in their homelands must accrue to them by law, and  the right to preservation of their language, culture and traditions, and to
protect themselves against the loss of identity, must be recognized, protected, documented and allowed to thrive as a dynamic living culture.

Health defined as a state of ‘well being’ is understood from a functionalist perspective among tribes – a perspective which considers a person as afflicted by disease often only when one’s capability to perform one’s expected roles in life is impeded either partially or completely. When such situation arises they seek health services from various health care systems influenced by socio-cultural factors where one lives in. Often one finds them shifting between health care systems or using more than one health care system at the same time. This study brings out concept of health as conceptualization by the tribal communities in India, their health issues and status, and health seeking behaviour from socio-cultural perspective. The study is based on review of secondary literature and attempt made to develop a model of health seeking behaviour among the tribes.

World Health Organization (WHO), has defined health in a more holistic approach, which reflects the relationship with a variety of factors such as the individual's physical, social, psychological, emotional; environmental and cultural factors. The health of indigenous or tribal people is the perceptions and conceptions in their own cultural system, based on external stimuli emanating from astrological influences, witchcraft and evil spirits in the etiology of disease, with less awareness of the modern health-care and health services for Health-seeking behavior. They have the various procedures of treatment viz. folk treatment, religious or preventive procedure, magical or curative procedures and modern medical system. Tribal communities in general and Primarily Vulnerable Tribal Groups (from now PVTG, erstwhile primitive tribal groups) in particular are highly disease prone. Also they do not have required access to basic health facilities. They are most exploited, neglected, and highly vulnerable to diseases with high degree of malnutrition, morbidity and mortality. Their misery is compounded by poverty, illiteracy, ignorance of causes of diseases, hostile environment, poor sanitation, lack of safe drinking water and blind beliefs, etc.The paper aims to discuss the health and nutritional status of PVTGs in Madhya Pradesh, analyzing the disease intensities and causes and etiology of disease and also to identify major problems and issues with some suggestions to upgrade the health status of the Primitive Tribal Groups of Madhya Pradesh.

The current study reveals the documentation of traditional use and ethno-entomological value of Red weaver ant in Mayurbhanj district with special reference to tribal health and safety prospective. The traditional information are collected through questionnaires in six selected zones of Mayurbhanj district. The resident tribes of this district commonly use this species as a delicious food and traditional medicine to treat different aliment in their daily life. The brood of this arboreal species is mostly found in tropical fruit plants. This species is mostly consumed in the form of a Chutney in daily diet. The tribes use this species as medicine in different disease like common cold, fever, Jaundice, enteric problems, Whooping cough and to increase the hungriness. The Rairangpur has the maximum dietary value, ecological value and economic use i.e. 83.54%, 68.99% and 79.11% respectively and highly defensive in nature. In Udala area 79.19% people are mostly use this species as medicine in traditional treatment and 67.79% informants are having cultural beliefs towards this species. The tribes in Baripada, Rairangpur, Jashipur, Betanati and Idala are harvesting these species for commercial use and sell in local markets @ Rs.10/100gm of pouch. The dietary use and medicinal claims suggests that Red weaver ant could be an alternative source of nutrition and medicine for human society. Similar studies should be conducted to find out more edible insects of human interest. The Indigenous techniques of utilizing edible insects should be conserved before vanishing from different tribal culture and the scientific evaluation of these species can direct to build a new era of healthy and prosperous life.

Basic facilities such as food, water, shelter, sanitation, health and employment are the fundamental elements required for survival of human beings. Although national and state governments incur 85 per cent of the expenditure on these services, 2010 data from the United Nations Development Programme (UNDP) estimated that 37.2% of Indians live below the country’s national poverty line. Poverty is an undesirable state which deprives part of the human population their ability to fulfill basic needs. Through poverty alleviation policies and programmes every nation strives to improve the quality of life of the poor and the marginalized in the society. In this context, to determine the effect of poverty alleviation interventions, accessibility and utilization of these facilities by these sections become significant.

The modern healthcare system often experiences difficulties in understanding and providing care to indigenous communities. This is mainly because of the cultural distance between mainstream healing methods and indigenous health belief systems. The Lancet series (2006) on indigenous health discussed the integration of Western and traditional health practices and identified the importance of this integration for betterment of the human world. To understand what health and health care signify to tribal communities in India, it is necessary to examine the whole social system and the beliefs and behaviours related to their culture that provides meaning to people. This study examines the traditional medicinal practices and socio-cultural healthcare beliefs and behaviours of diplaced tribal communities in Odisha and Chattisgarh. The current study has used the health belief model (HBM) to examine the perceived susceptibility and severity of diseases among tribal communities, pertaining to their reproductive healthcare beliefs and practices.

Background: WHO declared COVID-19 as a pandemic on 11th March 2020. As the COVID-19 pandemic
unfolded, the lockdown was implemented as the main preventive measure to contain the spread of the virus
across the world. India also went to one of the most stringent nationwide lockdowns on March 24, 2020,
which affected the informal sector worker the most. This study aims to explore the impact of COVID-19 and
lockdown on the livelihood of street vendors in the Maharashtra state of India.
Methods: Telephonic in-depth interviews were conducted from 16th May to 1st June 2020 with 20 street
vendors who sell perishable goods for their livelihood. Interviews were transcribed and thematic analysis was
used in analyzing the data.
Results: Lockdown affected street vendors multidimensionally. Many street vendors stopped working and
many had to change their profession to selling fruits and vegetables within a limited time zone which had its
repercussions. Some participants have shared experiences of being helped in the form of free rations by the
government. Along with bearing monetary loss, street vendors also had to undergo mental stress due to
restrictions imposed by the local authorities. Participants expressed their expectations of receiving aid in the
form of direct nancial aid and protective equipment to practice their work safely.
Conclusion: India went for one of the most stringent lockdowns with wider socio-economic repercussions,
and street vendors were one of the most affected occupational groups. Since they are one most vulnerable
sections of society it is a crucial responsibility of the government to aim for their overall welfare.

Background: In India, more than 90% of the workforce is engaged in the informal sector for their livelihoods. About 2-2.5% of the total urban population is involved in street vending, and out of the total urban population in the informal sector 14% is constituted of street vending. Unlike legalization, economic and working conditions of street vendors, there are little studies conducted to understand the health problems faced by them. Authors sought to study the common health problems and utilization of health care services among street vendors of Chandrapur district.
Methods: It was a cross-sectional quantitative study. A total of 200 street vendors were purposively selected from four tehsils of the Chandrapur district and face to face interviews were conducted.
Results: The common health problems among street vendors observed under this study were respiratory tract infections (32%), musculoskeletal problems (54.4%), gastrointestinal problems (18%), generalized weakness (12.7%), non-communicable diseases including hypertension, diabetes (26.6%). Among those who had suffered from these health problems, the majority (68%) utilized private healthcare facilities and 21% utilized public healthcare facilities.
Conclusions: Though street vendors earn on daily basis, they seek healthcare services mostly from the private providers. This results in out-of-pocket expenditure for them. Therefore, it is essential to improve the overall quality of public healthcare facilities for curtailing the out of pocket expenditure. The study findings can be utilized to draw the attention of policymakers, in strategic planning the health care services for such low-income group.
Keywords: Common health problems, Public healthcare facility, Private healthcare facility, Street vendors, Utilization of health care facilities

Right to health is considered as the important element in the life of human beings, irrespective of the socioeconomic and cultural conditions of the people. But many a times the notion of right to health is questioned or denied for the most disadvantaged sections in the society, especially the people belonged to the tribal or aboriginal communities. The women group in the aboriginal communities is considered as the 'disadvantaged among the disadvantaged'. A desired reproductive health status of the women determines the better health status of the upcoming generation, and that contributes to the well being of the communities and the nation. The present paper is an attempt to describe the reproductive health disadvantages of the women belongs to the aboriginal communities in India. The paper also explains how 'Life Cycle Approach' can be used for studying the same for improving the reproductive health conditions of aboriginal women.

Issues related to health and health care system and ground realities are vibrant, alarming and eye-catching in the tribal areas of Chhattisgarh and Madhya Pradesh. This paper emphasizes on traditional healers and healing practices prevalent among the Dhurwa tribe of Kanger Valley region of Bastar, Chhattisgarh, especially near Tirathagarh. The modern medicinal facilities are not easily approachable by the tribals and they mostly depend upon the traditional medicare and healing systems prevalent in their areas. The tribals are neither educated about the modern system of medical treatment nor provided with the required facilities in their residential areas. The local medicine-man or healer treats the ailing persons in their own houses or seats of the village deities. Illiteracy, unawareness, unfamiliarity and uneasiness sometimes stop them to go to the local dispensaries and health centers. Sometimes, they also easily fall prey of the exorcists and quacks in the area instead of good real traditionally trained healers. Though, various institutions are now concerned with the traditional health care system and means of traditional treatment, the tribal people are the real custodians of the medicinal plants spread in local forest area. Younger generation loosing interest in the traditional methods must also be made aware to protect effective traditional healing practices and valuable herbal plants before they get lost due to impact of modernization, urbanization and deforestation. Correct, collaborative and effective implementation of traditional medicinal practices along with proper co-ordination with the modern medicinal practices can prove more fruitful in this perspective.

Malayalis are constitutionally categorized as a tribe in Tamil Nadu. This community had undergone a lot of changes since 1960, which are reflected in the family structure, marriage systems, juridical conventions, dress code, life style, religious practices, rituals and community customs. This paper presents how the contingent social and cultural features that originally differentiated them from those of the mainstream have impaired them considerably in various institutional respects. For instance, the practice of cross-cousin marriage and the traditional 'trial' marriage system have almost disappeared. The negotiation pattern of acquiring the spouse has changed in tune with the practice of the mainstream communities. Similarly, the ritual autonomy of the community has impaired as is evident from the growing practice of hiring Brahmins for officiating their marriage related rituals. In short, though it is considered as a homogeneous community, it is understood that the Malayalis are a stratified society with economic differentiation. The notion of hierarchy is well established but hardly articulated explicitly in the secular social space. It is implicitly expressed through various socio-cultural practices of rituals and religious rights that enable some groups to exercise control over the rest of the community in a very subtle manner. The paper also describes their traditional healthcare practices including their beliefs on causation of illnesses, health seeking behaviour, role of traditional healers, public health measures, etc. It also highlights the continued existence of traditional health practices against the modem health systems. The final section of the paper critically examines the existing policies concerning the tribal population which are broad disempowering.