Presenter Dr Vikas Bhatia Professor and HOD Department

Presenter – Dr. Vikas Bhatia Professor and HOD, Department of Community and Family Medicine All India Institute of Medical Sciences, Bhubaneswar 1/18

A prospective study of tribal population in ODISHA, INDIA 2/18

Outline of presentation Geographical location of Odisha & distribution of tribal population Background information of Tribals Socio-demographic characteristics of tribal population Particularly Vulnerable Tribal groups ( PVTGs) – Distribution & key features Socio-cultural distinctness of tribals in Odisha Important means of livelihood among tribal groups Health system issues Future prospects 3/18

Location of Odisha q. Odisha, being located in the eastern region of the country, hosts 4. 2 crores of people (census 2011 q. About 485 km of coastline along Bay of Bengal q 155, 707 sq km geographical area q Literacy rate: 75% with female literacy: 64% q sex ratio : 979 females/1000 males 4/18 Source Population census 2011 & Wikipedia

Distribution of tribal blocks in Odisha q 30 districts in Odisha q 13 out of 30 are tribal dominant districts, called ITDA districts q Total 314 Blocks in the state q. More than 1/3 rd of blocks (119) under ITDA (Integrated Tribal Development Agency) coverage 5/18

Background q q q *An Proportion of tribal population in Odisha - increased from 22. 1% to 22. 8% in the last decade Odisha ranks third and accounts for 9. 1% of the total tribal population in India Highest in Mayurbhanj (58. 7%) and lowest in Puri (0. 7%) Over 62 types of Tribes are in the State 13 PVTG Tribal groups- Highest in the country analysis of health status of Orissa in specific reference to health equity. Available at http: //www. nrhmorissa. gov. in/writereaddata/Upload/Documents/An%20 analysis%20 of%20 health%20 status%20 of%20 Orissa%20 in%20 spe cific%20 reference%20 to%20 health%20 equity. pdf 6/18

Background (cont’d) q q • 44. 70% of the State's geographical area - Scheduled Area- Special Tribal Development Plans are implemented. Extends over 119 out of 314 Blocks in 13 districts Further Classification of Blocks • 20 blocks (16 in tribal blocks & 4 in other blocks) - consisting of PVTG (Particularly Vulnerable Tribal Groups) • 39 blocks – consisting of mostly inaccessible and Hard to reach tribal • *An analysis of health status of blocks in Orissa specific reference to health equity. Available 7/18 at http: //www. nrhmorissa. gov. in/writereaddata/Upload/Documents/An%20 analysis%20 of%20 health%20 status%20 of%20 Orissa%20 in%20 specifi c%20 reference%20 to%20 health%20 equity. pdf

Socio-demographic characteristics – Tribal population Sex ratio of the tribals has increased from 1003 in 2001 to 1029 in 2011 Literacy rate among tribal population - 52. 24% against the overall literacy rate of 72. 87% of the State Tribal male and female literacy rates are 63. 70% and 41. 20% respectively Over the last decade - significant improvement in literacy level among the STs, from 37. 37% in 2001 to 52. 24% in 2011 *Census 2011 report. Available at http: //www. censusindia. gov. in/2011 census/PCA_Highlights/pca_highlights_file/Odisha/Executive_Summary. pdf 8/18

Socio-demographic characteristics – Tribal population ( cont’d) More than 50% of tribal population reside in 8 districts About 93. 8% of tribal population in Odisha reside in rural areas (males - 93. 6%, females - 93. 9%) Among tribal population residing in urban areas, 39. 7% households fall below the poverty line Among tribal population residing in rural areas, 63. 5% households fall below the poverty line *Census 2011 report. Available at http: //www. censusindia. gov. in/2011 census/PCA_Highlights/pca_highlights_file/Odisha/Executive_Summary. pdf 9/18

Socio-demographic characteristics – Tribal population ( cont’d) *Census 2011 report. Available at http: //www. censusindia. gov. in/2011 census/PCA_Highlights/pca_highlights_file/Odisha/Executive_Summary. pdf 10/18

Particularly Vulnerable Tribal Groups ( PVTGs) 11/18

Distribution of PVTG blocks in Odisha 12/18

Particularly Vulnerable Tribal Groups. Key Features Primitive, geographically isolated, shy educationally & economically backward and socially, Live in various ecological and geo-climatic conditions ranging from plains to forests, hills and inaccessible areas There are 75 Particularly Vulnerable Tribal Groups (PVTGs) in India, characterized by a pre-agriculture level of technology, Remote located enclaves smallness in numbers a stagnant or diminishing population trend extremely low literacy and a subsistence level of economy * Tribal Culture Heritage Foundation in India. Available at http: //www. indiantribalheritage. org/ 13/18

Particularly Vulnerable Tribal Groups. Key Features ( cont’d) Special category - Distinct social, cultural and occupational practices About 13 PVTG groups exist in Odisha- largest in the country Concentrated in the Eastern Ghats and Northern Plateau An estimated population of 83, 611 Spread over 541 villages in 12 districts Needs special focus – increasingly vulnerable *Statistical profile of Scheduled Tribes in India – 2013. Ministry of tribal affairs, Statistical division, Govt of Indi. Available at www. tribal. nic. in 14/18

Socio-cultural distinctness of Tribals Harmonious co-existence with Nature 15/18

Socio-cultural distinctness of Tribals (cont’d) Unique costumes and ornaments 16/18

Socio-cultural distinctness of Tribals (cont’d) Community living and togetherness 17/18

Socio-cultural distinctness of Tribals (cont’d) Tribal Hat ( Weekly Market) and Tribal alcohol( locally made 18/18 like Handia, Mahul, Salap prepared from flowers, rice, saps,

Socio-cultural distinctness of Tribals (cont’d) Tribal Dance and Tribal Art 19/18

Tribal livelihood- living at the margins 49. 6 % tribals live below poverty line in India Average income of a tribal household is INR 32345 against INR 72717 for general category household Mostly survive on forest and forest produce Have little access to formal markets Exploited by middle men in the market Source-Indian Human development Survey-2005 20/18

Major sources of Tribal livelihood Minor Forest Produce 21/18

Major sources of Tribal livelihood( cont’d) Forest produce-based Craft work 22/18

Tribal livelihood ( cont’d) Mid & up land Agriculture 23/18

Tribal livelihood ( cont’d) Slash& Burn ( Jhuming) cultivation 24/18

Rationale…. The tribal population, still being the under privileged section of the society, focus needs to be laid upon their prevailing health status 25/18

Health Profile of tribal population in Odisha The infant mortality (78. 7 per 1000 live births) and under five mortality (136. 3 per 1000 live births) rates among tribal population stand at an alarmingly higher rate Analysis of nutritional indicators - any anemia (80. 1%) and under nutrition (54. 4) are highly prevalent in children Perspective of maternal health – Only 17. 3% of expectant mothers were attended by a health care professional and 11. 7% delivered in a health care facility *An analysis of health status of Orissa in specific reference to health equity. Available at http: //www. nrhmorissa. gov. in/writereaddata/Upload/Documents/An%20 analysis%20 of%20 health%20 status%20 of%20 Orissa%20 in%20 specific%20 r eference%20 to%20 health%20 equity. pdf 26/18

Health system issues – tribal population Shortage of skilled human resource Inadequate infrastructure Poor logistics and supply arrangements Lack of ST specific data like disease burden, morbidity & mortality profile, etc. Absence of Private Sector Poor availability of critical emergency services Poor Monitoring & Supportive Supervision Poor Governance, High absenteeism & unresponsive health system 27/18

Future prospects…. Area sensitive and tribe specific Health planning given the fact that there about 700 tribals groups in india and about 62 in Odisha To bridge the scientific knowledge gap, health care should give paramount importance to spreading ‘ Health Literacy’ by way of mass educational methods, folk media, modern media and school curriculum More focused research should be done to identify the causative factors for meagre health indicators A focused continuum of care approach - from early childhood to reproductive age group, would bridge the gap in health status of the tribal population Strengthen community mobilization and build up the capacities of frontline workers in tribal areas to ensure effective delivery of basic health services and increased utilization by tribal communities 28/18

Thank you…. . 29/18