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Tribal communities lag behind the national average on several vital public health indicators, with women and children being the most vulnerable. Dasra’s report, To The Very Last Mile, discusses the challenges faced by tribal communities in their journey for adequate and accessible maternal and child healthcare, and presents solutions to overcoming these challenges.
There are 700 tribal communities in India whose women and children lag behind the national population on measures of economic standing, health and education due to decades of discrimination and violation of rights. More than half of all maternal deaths in India occur in tribal communities. Similarly, the Infant Mortality Rate (IMR) among tribal children is 30% higher than the national average and 61% higher for tribal children under-five. Disproportionate health outcomes are a result of three systemic factors that enhance the vulnerability of Scheduled Tribes: inadequate and ill-trained healthcare workforce, poor service delivery, and insufficient health financing.
Dasra’s report highlights interventions that have the potential to safeguard maternal and child health in tribal communities. First, it recommends taking strides to improve nutrition of women and children. It also outlines how decades of discrimination have made tribal communities wary of outsiders, and that as a consequence, the most successful and sustainable health programs are those that are community-led. These are the programs that should be promoted, and local community workers are pivotal to bridging gaps in public healthcare provision. Finally, while the government has designed several schemes to enhance maternal and child health outcomes, they are poorly implemented and benefits rarely reach those for whom they are intended. Therefore it is crucial to strengthen the implementation of existing government schemes and services, which are especially poor in tribal areas.