Abstract
India is home to the world’s second largest Indigenous population, comprising 8.6% of the national population. They are constitutionally recognised as ‘Scheduled Tribes’ to aid their development after centuries of oppression and socio-cultural marginalisation through the caste system. Limited disaggregated data exist on India’s Scheduled Tribe populations’ health outcomes, including for Indigenous women. Kerala, one of India’s southern states, is an intriguing case study. The State has outperformed other Indian states and South Asian countries with respect to a number of health and education indicators despite its more modest economic performance. Relatively little is known, however, about whether the State’s tribal or ‘Adivasi’ population is prospering. This article used data from a cross-sectional observational study of tribal women conducted in the Attappady area in the Palakkad district in Kerala, South India, which has a dense tribal population. The outcomes for these communities were compared with the relevant United Nations 2030 Sustainable Development Goal (SDG) indicators as well as Kerala State data to identify areas of growth and need. The findings of this case study highlight successes as well as persisting gaps in health outcomes for women and children in marginalised tribal communities. Using a strengths-based approach, we propose possible strategies to address the perceived gaps.
Highlights
Indigenous peoples are disadvantaged, even in high income countries [1]
This study examined the health status of women and children in the Indigenous tribal ‘Adivasi’ communities of Attappady in Kerala, India
In spite of Kerala’s growing enrolment of women in higher education [36], female employment has fallen in recent years [29, 37]
Summary
Indigenous peoples are disadvantaged, even in high income countries [1]. While standards of living and life expectancies have improved for most, Indigenous communities have not prospered like their non-Indigenous counterparts [2]. Sustainability is a core philosophy shared by many Indigenous communities They are custodians of centuries and in some cases, millennia of knowledge of the lands’ biodiversity and environmental adaptation. They have fallen vulnerable to physical, emotional and sexual violence, drug and alcohol misuse, incarceration and discrimination both within and outside their communities [1] Their limited health care access, educational opportunities, employment and participation in decision-making bodies further disenfranchise Indigenous women [6]. One systematic analysis reported that due to increased women’s education in the sub-Saharan region, childhood mortality did not increase as a result of the HIV epidemic [10] Drawing from this inference, a greater emphasis on improving the health and well-being of Indigenous women and their empowerment may be the key to ‘closing the gap’ and improving the prospects and survival of Indigenous communities overall.
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