Tribal Areas Research Articles

Does Implementation of ’Citizen’s Charter Make Any Difference in Service Delivery? Comparing the Performance of Local Councils between Plain and Hilly Areas—A Case of Bangladesh

This paper compares the impact of citizen’s charters in delivering services by Union Parishads in Bangladesh in Bengali-majority and tribal areas. Using a qualitative research method, the case study was used to look at CC implementation in a comprehensive and in-depth way. Interview and observation methods were employed to collect data. One hundred interviewees from each union, including service providers, service users, and LG officials, were consulted in equal numbers from May to July 2019. The findings of this study reveal that, although Union Parishads of both areas are implementing charters, their performance differs. Subjects of performance variation are timeliness of service delivery, cost of services and responsiveness of the service providers. Performance variation results from varying degrees of implementation of the citizen’s charter, attributable to several factors that include citizens’ awareness, knowledge and skills, implementation willingness, and performance monitoring of the local officials.

IJCM_30A: A mixed methods study to assess the contributory factors to anaemia among adolescent girls studying in tribal schools in a rural area of Maharashtra

Background: Anaemia is prevalent globally, notably in marginalized adolescent girls. NFHS-5 reports 59.1% anaemia in Indian adolescent girls. Tribal communities face unique health challenges due to their sociocultural dynamics. The national program for anaemia addresses this, but its implementation in contexts like tribal areas is unexplored. This study integrates quantitative and qualitative data for a thorough understanding of anaemia and its control in tribal settings. Objectives: 1. To estimate the prevalence of anaemia in tribal adolescent girls 2. To explore the awareness of anaemia in tribal adolescent girls 3. To understand the challenges in the implementation of an anaemia control program in a tribal setting Methodology: This 6-month mixed methods study assessed anaemia prevalence among adolescent girls in tribal schools. Using complete enumeration, a 200-sample size was determined, with obtained informed consent and assent. Adolescent girls were administered a questionnaire in their local language to collect information on their socio-demographic status and anaemia-related habits like diet and handwashing among others. Haemoglobin levels were measured using a digital haemoglobinometer. Focus Group Discussions with willing girls explored their understanding of anaemia, its causes and complications. Forced field analysis for ASHA and Anganwadi workers and certain Key Informant Interviews were conducted. Data was collected until saturation. Ethical approval with confidentiality was ensured. Results: The prevalence of anaemia was 70%, indicating a severe public health concern. Among these, 57.1% had mild, 34.3% had moderate, and 8.6% had severe anaemia. Anaemia in girls was statistically associated with specific food groups and habits. Low awareness of anaemia and operational issues in the control program were also identified. Conclusion: To enhance adolescent awareness of anaemia, efforts to improve their understanding of the condition and its impact are necessary. This research is vital for informing policymakers and health practitioners in refining interventions for this specific demographic in Maharashtra.

IJCM_73A: Knowledge, attitude, practice, and perception of women regarding breastfeeding- A mixed method study conducted in the tribal areas of Koraput, India.

Background: Breastfeeding is one of the most effective ways to ensure a child’s health and survival. Contrary to WHO recommendations, fewer than half of infants under 6 months old are exclusively breastfed. Although we know about breastfeeding practices in urban and rural populations, very little knowledge is available about breastfeeding practices and their correlates among the tribal population. Objectives: 1. To assess the knowledge, attitude and practices prevailing among tribal women about breastfeeding 2. To explore the facilitators and barriers to infant breastfeeding practices amongst women in tribal areas. Methodology: Study design- Mixed method study. Study period- May, 2023 to July, 2023 Study population- tribal women of Koraput district. Study setting- villages in Koraput Inclusion criteria- 1. Women belonging to Scheduled Tribe communities. 2. Having at least one living issue. 3. Residing in their respective villages during the study period. Exclusion criteria- 1. Those who did not consent to the study. 2. Not residing in their respective villages. Sampling- Multistage sampling. Sample size- 500. Results: 78.6% of mothers belong to the age group 21-30 years, 93.4% were literate whereas 6.6% were illeterate, 88% were housewives with 78.8% belonging from joint family. Majority of them had good knowledge regarding breastfeeding, though they lacked clarity on the concept of exclusive breastfeeding. Majority of their knowledge about breastfeeding was from relatives or neighbours and healthcare workers. having multiple children in quick succession serves as a major barrier to exclusive breastfeeding. Conclusion: The findings can form targeted interventions and policy initiatives to reduce the barriers and promote the facilitating factors for optimal breastfeeding practices within this unique cultural setting, ultimately contributing to improved maternal and child health outcomes.

Regional Disparity and Determinants of Body Mass Index Status among Tribal Women in Eastern India.

The body mass index (BMI) is a commonly employed metric for determining the nutritional status and health risks associated with weight. Tribal women in India face neglect and discrimination in terms of livelihood, nutrition, education, wealth, and health-care access. The study examined 18,697 tribal women from Bihar, West Bengal, Jharkhand, and Odisha, using data from the National Family Health Survey-5. Multinomial logistic regression has been used to determine how the multiple background factors are associated with the BMI of tribal women. The study found that the prevalence of underweight and overweight was 28.5% and 7.6% among tribal women, respectively. Rural tribal women had a higher likelihood of being underweight, whereas urban women were more likely to be overweight. Odisha had a higher prevalence of underweight tribal women, whereas the prevalence is lower in Bihar. The higher prevalence of underweight among tribal women is alarming and necessitates a reconsideration of health infrastructure in the tribal areas.

Health of Tribal Population in India: A Glimpse of the Current Scenario

Abstract Article 366(25) of the Indian constitution refers to indigenous people as “scheduled tribes,” which constitute 8.6% of the country’s population. For decades, the health of the tribal people had remained neglected and incorporated in rural health care because of incorrect assumptions of their similar health needs to that of the rural population. An expert committee coordinating with the Ministry of Health and Family Welfare and the Ministry of Tribal Affairs provided a detailed report on the current scenario and recommendations related to tribal health in India. They considered the health-care needs of the tribal population, highlighted their specific health problems, and gave a roadmap of best approaches. The tribal population has a unique and higher burden of health problems than the mainstream population, influenced by their health-seeking behavior, lack of awareness and education, sociocultural and magico-religious beliefs, customs, and practices. The current health-care system incorporates their health needs with approaches such as differing population norms in tribal areas, nonmonetary incentives to staff, mobile medical units, identification of high-priority districts, and the emergence of the “Swasthya” portal. However, tribal health is transitioning as with the rest of the population. Moreover, the present health-care services are unable to address this. Legal recognition of indigenous peoples’ rights to self-determination, their land, natural resources, and their knowledge is a need of the hour.

Prevalence and Pattern of Morbidity, Febrile Illness, and Treatment-Seeking Behavior in a Tribal-Dominated District in Odisha, India: An Observational Study.

Background Tribal populations constitute a major portion of India's total population, especially in the eastern and northeastern states. We lack comprehensive information on the community burden of general morbidity and febrile illness in tribal population-dominated areas, which is quite essential for the microplanning of healthcare expenditure and implementation. This study aimed to provide evidence on the prevalence and pattern of general morbidity and febrile illness at the community level as well as the treatment-seeking behaviour in a tribal-dominated area. Methods The study was undertaken as an observational study in the community setting; looking into seasonal cross-sectional evidence on period prevalence (two weeks) of morbidity and qualitative/semiquantitative information on treatment-seeking behaviour of the selected community during 2012 and 2013. Result This study involved 5541, 5482, and 5638 individuals during the rainy season 2012,winter 2012-13, and rainy season 2013 seasons, respectively, from 25 tribal villages of Odisha, India. A period prevalence (two weeks) of overall morbidities was shown to be 27.28% and 28.9% during the rainy seasons of 2012 and 2013, respectively, of which 13% and 11.5%, respectively, were febrile, with low prevalence(6.44% overall morbidity and 1.81% febrile illness) in the winter of 2012-13. It indicated inadequacy in skills of the village-level health staff, monitoring of supplies/logistics, and population awareness for early reporting of fever to healthcare providers at the community level. Conclusion The evidence provided by the study would be helpful in making public health plans in tribal settings and also highlighted the opportunity to improve tribal health status through community awareness, especially in areas and populations with limited health access.

Quality Assessment of Interactive Mobile Application - Maternal and Infant Care for Tribal Birth Attendants.

Digital health interventions can overcome geographical barriers and prepare health-care providers for better health outcomes in rural and remote tribal areas, however, it has not been explored among traditional birth attendants (TBAs). A mobile application, "maternal and infant care" (MAI) for capacity building of tribal birth attendants was developed and its quality was evaluated using the Mobile Application Rating Scale for user's interest in and satisfaction with the esthetics, information, and functionality. Thirteen Android user TBAs with the MAI application were piloted with the MARS checklist. Engagement, functionality, esthetics, and information quality; and one subjective quality scale having 29 items were used. The application was found to be entertaining excellent rating (mean score ± standard deviation) (4.00 ± 0.58), and scored high on performance (3.77 ± 0.93); layout design (3.85 ± 0.90); subjective quality (4.23 ± 0.93), however, scored minimum on interest; gestural design; visual appeal, etc. MAI is a user-friendly, culturally acceptable Android app that can be used for the capacity building of frontline workers.

IJCM_60A: Menstrual hygiene management practices in tribal areas of Mysore district: A cross-sectional study

Background: Menstrual Health Management is defined as women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of menstruation period, using soap and water for washing the body as required and having access to facilities to dispose of menstrual management materials. Since considerable amount of tribal population belong to Mysore district it is important to study the practices among the most vulnerable population. Objectives: 1. To estimate the knowledge on menstrual hygiene among the study population. 2. To measure the impact of socio-demographic and cultural determinants on menstrual hygiene management practices among the study population. Methodology: A community based cross-sectional study on menstruating women residing in tribal areas of Mysuru district was conducted from July to September 2023. Sample size was calculated using single proportion formula and it was estimated to be 130. All menstruating women/girls who were present during the time of visit were included in the study after getting their consent/ ascent. Multistage sampling was adopted to select the study participants. A validated semi-structured questionnaire was used for collection of data. Data was entered in MS Excel and analysed using SPSS v29 trial version. Results: 99% of the study population knew that menstruation is a physiological process and poor menstrual hygiene causes urinary and reproductive tract infections. More than 80% of the study population have access to sanitary napkins for managing their menstrual cycles. Conclusion: Majority of the study participants are aware about menstruation as a physiological process and have access to sanitary napkins for management. But the disposal of sanitary waste and cultural barriers that persists in the society are still existing as a roadblock for improving reproductive health.

Terrorism and Insurgency in the Tribal Areas: Investigating the Historical Roots and Dynamics of Terrorism and Insurgency in Pakistan's Tribal Regions

This research delves deeply into the origins and evolving dynamics of various regions in Pakistan, presenting a nuanced and intricate image shaped by diverse elements and social intricacies. The interplay between global developments and inherent complexities has given rise to a milieu fraught with persistent challenges. These regions, steeped in historical tribal traditions, have experienced pronounced instability, exacerbated by pivotal events such as the Soviet-Afghan War. The study systematically investigates the transformative journey of terrorism and insurgency, scrutinizing the contributing variables. The primary objective of this paper is to furnish readers with a comprehensive understanding of the factors underpinning terrorism and insurgency in Pakistan's tribal areas. It accomplishes this by delving into historical events, cultural components, and geopolitical influences that have intricately woven the tumultuous past of the region.

Post-Merger Political and Social Dynamics: Fata's Shifting Paradigm in Pakistan

This research analyzes the perceptions and experiences of individuals from the Federally Administered Tribal Areas (FATA) following its merger with Khyber Pakhtunkhwa (KP). The study employs a mixed approach, collecting primary data through random sampling from various districts of FATA, including students, teachers, social activists, politicians, and government servants. The analysis reveals a divided sentiment regarding the merger, with nearly half of the respondents expressing dissatisfaction. Major concerns include the lack of improvement in governance, ineffective law enforcement, and worsening security conditions. The traditional Jirga system is still preferred over the new judicial framework by a majority, highlighting cultural and practical considerations. Findings indicate that the merger has not achieved its desired outcomes, with the Deputy Commissioners operating similarly to the previous Political Agents, and the former Levies and Khasadars remaining ineffective as a police force. Policy recommendations emphasize the need for honoring merger-related promises and improving peace and security.

Zero Budget Natural Farming Impact on Tribal Rabi Rice Farming: Economic Analysis

This study examines the economic viability of implementing Zero Budget Natural Farming (ZBNF) interventions in rabi rice cultivation, focusing on cost-effectiveness and productivity outcomes. Data collected before (2014-15) and after (2018-19) ZBNF adoption in a selected tribal area of Visakhapatnam district of Andhra Pradesh, India were analysed. Results reveal a reduction in total variable costs by 10.20 per cent, primarily attributed to decreases in weeding and nutrient supply expenses. Despite a slight increase in operational costs, ZBNF led to a significant drop (51.30 per cent) in input expenditures. Yield experienced a notable 10.25 per cent increase, resulting in a decrease in production costs from ₹1161.23 to ₹934.34 per quintal. The calculated cost-to-benefit ratio of -1:1.17 demonstrates favourable economic outcomes, highlighting the potential of ZBNF to enhance economic viability and sustainability in rabi rice cultivation among tribal farmers.

A STUDY ON THE CAUSES OF SEPARATE STATE DEMAND IN NORTH EAST INDIAN STATE OF TRIPURA

This article explores the socio-political dynamics and historical context leading to the demand for a separate state of Tipraland within Tripura, India, focusing on the indigenous Tiprasa peoples' aspirations for autonomy and cultural preservation. Originating from the establishment of the Indigenous People's Front of Twipra (IPFT) in 2009, the demand for Tipraland reflects a culmination of historical grievances, including the failure of the Tripura Tribal Areas Autonomous District Council (TTAADC) to meet the indigenous community's needs, demographic shifts due to refugee influx from neighboring Bangladesh, and the erosion of indigenous cultural and linguistic identity. The article analyzes how these factors have contributed to a sense of alienation and marginalization among the Tiprasa people, further fueled by land alienation, linguistic hegemony, and political underrepresentation. It discusses the recent political developments under the leadership of Bubagra Prodyot Kishore Manikya and the formation of the TIPRA Motha party, highlighting their significant role in revitalizing the demand for a more inclusive Greater Tipraland. The study concludes with recommendations for the Government of India to address the complex interplay of refugee integration, indigenous rights, and regional autonomy to ensure the socio-political and economic wellbeing of the indigenous populations within a cohesive national framework. Through this analysis, the article contributes to the broader discourse on indigenous rights, migration, and state formation in northeast India, emphasizing the need for inclusive policies that recognize the unique challenges and aspirations of indigenous communities.

Barriers and Enablers of Postnatal Care by Accredited Social Health Activist (ASHA) Workers: A Community-Based Qualitative Study From Tribal Gujarat.

Background The care provided to the mother and child from delivery to six weeks after is defined as postnatal care. The postnatal period is both a happy and critical phase for the mother and the newborn. However, the provision of high-quality care services is often ignored during this time. The objective of this study was to assess postnatal care services quality by Accredited Social Health Activist (ASHA) workers and associated factors such as newborn care in rural tribal areas of Gujarat, India. Methodology An ethnographic approach was adopted. Four primary health centers (PHCs) were selected purposively from Sankheda Block, Chhotaudepur, a tribal district in the eastern part of Gujarat. Information on obstacles and facilitators of postnatal care services was collected using in-depth interviews (IDIs) with a purposive sample of 22 ASHAs working in selected PHCs. Qualitative data were analyzed using thematic analysis. Results The median age of the ASHA workers was 39 years and ranged from 30 to 51 years (N = 22). Most ASHAs encountered logistical challenges when offering postnatal care services (e.g., they struggled to care for the mother and her babies because they were missing essential equipment, such as a thermometer and a salter-type baby weighing machine, or they had broken equipment). The two main issues facing ASHAs were incentives and timely payments. There were concerns about their safety and physical security during fieldwork. The majority of ASHA workers had good experiences during postnatal home visits, and they received support from other healthcare workers. There were many misconceptions and false assumptions in the community regarding breastfeeding, prelacteal feeding, family planning, and contraception methods. ASHAs wanted to become long-term government employees and believed they were entitled to sufficient training, assistance, recognition, and remuneration for the duties they performed. Conclusions Postnatal mothers receive considerably less attention than antenatal mothers because it mostly depends on ASHA workers and field staff. ASHA workers are doing their best regarding postnatal care. This study revealed some issues ASHAs face, including logistic issues, transportation issues, regular and timely payment issues, and local-level acceptance issues.

Neglected Millets, Crop Diversity and Nutritional Security: Paradox of Millets in India

Crop diversity, millet crops and their erosion are matters of rising concern. Millets are known in several ways to various stakeholders. Some people consider millets as climate-resilient, climate-smart, eco-friendly, contingency and future crops; as nutri-cereals, nutraceuticals, smart and future foods. For some people, millets are ‘neglected millets’, ‘underutilized millets’, neglected and under-utilized crops/species; they are often undervalued as ‘minor millets’, minor crops and coarse grains. For some other, millets are stigmatized as ‘marginalized grains’, ‘marginalized millets’, ‘marginalized crops’ and crops for the poor. At the empirical dimension, on one hand, the traditional producers and consumers of millets from tribal and rural areas are losing and lacking interest in such cultivation and consumption. On the other hand, there is a reinvention of tradition, as nutritional values and health benefits of millets are realized by the urbanites and educated sections. Thus, I see a paradox of millets. Therefore, the present article studies the status of traditional and ‘neglected’ millets and also the trends of their cultivation and consumption. It identifies the opportunities, constraints and challenges for millets use for achieving sustainable food security and nutritional security and towards the Sustainable Development Goal 2.

“Word”, “Honour” , and Forced Marriages: Depiction of Matrimonial Custom of Pakistani Tribals in Bapsi Sidhwa’s The Bride

This discussion aims to investigate how tribal woman is maltreated in the name of “word” and “honour” depicted in Bapsi Sidhwa’s The Bride. It explains how the words, “word” and “honour” are given connotation to exploit the freedom and the basic rights of women in tribal areas of Pakistan. Further, the objective of this study is to highlight the peculiar traditional customs rampant in the tribal areas of Pakistan which results in early marriages, child marriages, as well as forced marriages. Living under patriarchal norms the tribal woman is leading a lifeof slavery. Either a tribal woman is forced to marry a person who is three times older than sheor even sometimes she is forced to marry a person who has not yet reached the age of puberty. Majority of the tribal women accept their lot stoically but those who nourish the feelings of rebellion in their minds, they face gruesome consequences. The tribal don’t follow the constitution of the country, rather, they follow the man-made laws devised by their elders. In order to strengthen the discussion, on the one side, the textual fabrics of the novel will be untangled, on the other hand, the views of those researchers will be considered into account who have carried out their research on the tribal matrimonial traditions.

The puzzle of public health expenditure and healthcare infrastructure in India: An empirical investigation

This study examines the temporal pattern of healthcare infrastructure and manpower indicators across Indian states and regions between 2006–2020 using a composite index and data from various published sources. The study also investigates the monetary factors determining the quality and provision of healthcare infrastructure and manpower for India as a whole as well as for rural and tribal areas discretely, using a panel regression model and the generalized method of moments. The results show that economically advanced states, like Haryana and Maharashtra, do not rank highly on the index based on the healthcare infrastructure and manpower indicators; rural states with smaller populations enjoy better healthcare services. Inadequate public health expenditure results in a low ranking on the composite index and is reflected in the high infant mortality rates in Bihar, Uttar Pradesh, and Madhya Pradesh, though the situation is reversed in Kerala. The panel regression model reveals that increased per capita public health expenditure has not translated into improved healthcare infrastructure and manpower in Indian states or tribal regions within those states. The public health expenditure to gross state domestic product ratio is a positively significant predictor of healthcare infrastructure and manpower in rural areas. The panel generalized method of moments results confirm that developing targeted healthcare infrastructure and manpower in India as a whole, as well as for rural and tribal areas in the short term, has been poorly realized.

Colonial policing and police administration in erstwhile Northwest Frontier Province and tribal areas of British India

Colonial policing and police administration in erstwhile Northwest Frontier Province and tribal areas of British India

Prevalence of anaemia among adolescent girls (10-19 years) in India: A systematic review and meta-analysis.

Background Anaemia is a serious public health problem. It is the second-commonest contributing factor to years lost by adolescents to disability and death. Targeting adolescent girls will allow a window of opportunity to correct their nutritional health and improve their obstetric outcomes. Studies in India have reported varying prevalence rates of anaemia among adolescent girls. Hence, we did a systematic review and meta-analysis of community-based studies to obtain a comprehensive pooled estimate of the prevalence of anaemia among adolescent girls in India. Methods We did a systematic electronic search in PubMed, Embase, Cochrane Library and Google scholar to retrieve community-based studies that reported the prevalence of anaemia among adolescent girls (10-19 years) in India, without any date or language restriction. To estimate the pooled prevalence and heterogeneity, the random-effects model and I2 statistical methods were used. We did subgroup analyses based on geographical region, study setting, method used to measure haemoglobin concentration, and year of publication. Results We included 35 studies in this meta-analysis comprising 152 640 participants. The pooled prevalence of anaemia among adolescent girls was 65.7% (95% CI 59.3%- 71.9%). There was significant heterogeneity between the studies (I2 99.6%; p<0.001). Conclusion There is a high prevalence of anaemia among adolescent girls in India. While all regions of the country have a high prevalence, tribal areas need special attention. Targeted actions need to focus on the identification of determinants of anaemia apart from iron supplementation.

Environmental Detection of Parasites in the Marginalized Paiute Reservations Compared to a Nearby Area.

The amounts of parasite DNA in soil samples from different playgrounds and other public areas can help identify areas of possible microbe transmission and give indications of the possible occurrence of parasite infection in nearby communities. We collected 207 soil samples from parks in Paiute indigenous tribal areas in southwestern Utah and from the higher income city of St. George, Utah, and tested them for 11 parasites that can cause human disease. Molecular tests revealed an elevated odds ratio (OR) of 3.072 (range, 1.114-8.065) for detecting the helminth Trichuris trichiura and an elevated OR of 3.036 (range, 1.101-7.966) for any protozoa (not including Acanthamoeba) in the tribal land playgrounds compared with St. George parks. These findings support previous studies showing that areas in lower socioeconomic communities, especially marginalized communities, tend to have more parasites in the soil, which may lead to higher disease prevalence rates.

Going the extra mile: Developing an interactive mobile application for maternal and infant care for tribal birth attendants.

Mobile health applications are an established tool for healthcare management, patient education, and even capacity building for healthcare providers. However, its use among traditional birth attendants (TBAs) is limited. The aim of this study is to explore the needs and bottlenecks of developing an interactive mobile application for maternal and infant care (MAI) of TBAs. It is a qualitative study having in-depth interviews (face-to-face approach) conducted among the seekers of MAI services. Setting: This study is conducted in tribal and rural locations in the district Sirohi, Rajasthan. Participants: TBAs and tribal females of reproductive age in tribal-dominated areas have participated. The development of an interactive mobile application MAI has three phases: (1) a need-based approach to identify the needs on the ground; (2) identifying intervention bottlenecks and possible solutions; (3) design and development of the mobile application. Ninety-six tribal females of reproductive age participated in the needs assessment. Eighty percent of them were ≤ 30 years of age and 40% of them were uneducated. Most participants informed that lack of information (culturally/locally appropriate content), peer advocacy, affordability, lack of transportation, and the influence of TBAs are the significant factors for less uptake of maternity and child health services in the tribal and rural areas. The MAI app has culturally/locally appropriate content and is prepared by the local TBAs and Accredited Social Health Activists, with full local character and clothing. MAI app has videos and audio in the local language (Marwari) with pictorial quizzes. Using the MAI app, TBAs may self-educate and guide tribal pregnant women about maternal hygiene and infant healthcare as needed at various stages of pregnancy and childbirth.