Lok Sabha Question No. 5027 (UNSTARRED), answered on 2016-12-16
Subject: Tribal Healthcare
Ministry: HEALTH AND FAMILY WELFARE
Asked by: DHANANJAY BHIMRAO MAHADIK

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 5027 TO BE ANSWERED ON 16 TH DECEMBER , 2016

## TRIBAL HEALTHCARE

## 5027. SHRI DHANANJAY MAHADIK:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the Government has undertaken any study regarding health indicators of tribals and the status of the tribal healthcare in the country;

- (b) if so, the details thereof;

(c) whether lack of healthcare infrastructure, shortage of doctors and paramedical personnel are the reasons due to which tribals exhibit signs of poor nutritional status, higher levels of morbidity and mortality and reduced utilization of ante - natal and post - natal services and if so, t he details thereof and the reaction of the Government thereto; and

(d) the remedial measures taken by the Government in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

(a) & (b): No specific survey/ study was conducted by the Ministry for getting tribal h indicators.  However  surveys  like National  Family  Health  Survey  (NFHS), and District  Level Household Survey (DLHS), conducted by the Ministry give estimates inter - alia fo  tri bal health indicators.

(c) & (d): There could be multiple reasons including social determinants of health for health  and  nutritional  status  of  tribals. The  information  regarding  some  health  indicators including nutrition and utilisation of ante - natal and post - natal services by sche duled tribes are at Annexure-I and Annexure -IIrespectively.

Public  Health  being  a  State  subject,  the  primary  responsibility  to  provide accessible, affordable and  quality health care services to the people including tribal population lies with State/UT  Governments.  However,  under  the  National  Health  Mission  (NHM),  support  is provided  to  States/UTs  to  strengthen  their  health  systems  including  for setting  up/upgrading public health facilities, augmenting health human resource on contractual basis for provision of equitable, affordable healthcare to all its citizens particularly the poor and vulnerable including  tribal  population  based  on  requirements  posed  by  the  States  in  their  Prog Implementation Plans. Under NHM, all tribal majority districts whose composite health index i below the State average have been identified as High Priority Districts (HPDs) and these are to receive more resources per capita under the NHM as compared to the rest of the dist ricts in the State. These districts also receive focused attention and supportive supervision. N infrastructure, Human resource, ASHAs, MMUs etc. under NHM are relaxed for tribal and hil areas.

Annexure - I

## Information regarding Various Health Indicators of Scheduled Tribes

(I)  Proportion of children 12 - 23 months receiving full immunization

|                        |   Total |   ST |
|------------------------|---------|------|
| NFHS - III (2005 - 06) |    43.5 | 31.3 |
| DLHS - III(2007 - 08)  |    53.5 | 45.5 |
| CES (2009)             |    61   | 49.8 |

(II)  Proportion of 12 - 23 months old children immunised against measles

|                        |   Total |   ST |
|------------------------|---------|------|
| NFHS - III (2005 - 06) |    58.8 | 46.1 |
| DLHS - III(2007 - 08)  |    69.1 | 65   |
| CES (2009)             |    74.1 | 67   |

(III)  Proportion of delivery attended by skilled health personnel

|                        |   Total |   ST |
|------------------------|---------|------|
| NFHS - III (2005 - 06) |    46.6 | 25.4 |
| DLHS - III(2007 - 08)  |    52.3 | 37.6 |
| CES (2009)             |    76.2 | 61.3 |

(IV)  Proportion of  institutional deliveries

|                        |   Total |   ST |
|------------------------|---------|------|
| NFHS - III (2005 - 06) |    38.7 | 17.7 |
| DLHS - III(2007 - 08)  |    46.9 | 32.5 |
| CES (2009)             |    72.9 | 57   |

| NFHS -III (2005 - 06)      | Total   | ST   |
|----------------------------|---------|------|
| InfantMortality Rate       | 57.0    | 62.1 |
| Under 5 Mortality Rate     | 74.3    | 95.7 |
| DLHS - III (2007 - 08)     | Total   | ST   |
| Any ante- natal check - up | 75.1    | 65.9 |
| Number of ANC visits (3+)  | 49.7    | 42.2 |

| Nutritional Status, prevalence of anaemia mong children and women, place and during delivery and post - natal Care-India and ST   | Nutritional Status, prevalence of anaemia mong children and women, place and during delivery and post - natal Care-India and ST   | Nutritional Status, prevalence of anaemia mong children and women, place and during delivery and post - natal Care-India and ST   | Nutritional Status, prevalence of anaemia mong children and women, place and during delivery and post - natal Care-India and ST   |
|-----------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------|
| (I) Nutritional Status of Children                                                                                                | (I) Nutritional Status of Children                                                                                                | India                                                                                                                             | ST                                                                                                                                |
|                                                                                                                                   | Prevalence of stunting in children (5) years of age (%)                                                                           | under 48.0                                                                                                                        | 53.9                                                                                                                              |
|                                                                                                                                   | Prevalence of wasted children under (5) years of age (%)                                                                          | 19.8                                                                                                                              | 27.6                                                                                                                              |
|                                                                                                                                   | Prevalence of underweight children under (5) years of age (%)                                                                     | 42.5                                                                                                                              | 54.5                                                                                                                              |
| (II) Nutritional Status of Women                                                                                                  | (II) Nutritional Status of Women                                                                                                  |                                                                                                                                   |                                                                                                                                   |
|                                                                                                                                   | Percentage of women age 15 - 49 below 145 cm whose "Body Mass Index (BMI) si below 18.5 (total thin)                              | 35.6                                                                                                                              | 46.6                                                                                                                              |
| (III) Prevalence of anaemia among children and women                                                                              | (III) Prevalence of anaemia among children and women                                                                              |                                                                                                                                   |                                                                                                                                   |
|                                                                                                                                   | Percentage of children age 6 - 59 months having any anaemia (<11.0 g/dl)                                                          | 69.5                                                                                                                              | 76.8                                                                                                                              |
|                                                                                                                                   | Percentage of women age 15 - 49 having any anaemia (<12.0 g/dl)                                                                   | 56.2                                                                                                                              | 68.5                                                                                                                              |
| (IV) Place and assistance during delivery                                                                                         | (IV) Place and assistance during delivery                                                                                         | (IV) Place and assistance during delivery                                                                                         | (IV) Place and assistance during delivery                                                                                         |
| (a)                                                                                                                               | Proportion of delivery attended by skilled health personnel,                                                                      |                                                                                                                                   |                                                                                                                                   |
|                                                                                                                                   | NFHS - III (2005 - 06)                                                                                                            | 46.6                                                                                                                              | 25.4                                                                                                                              |
| (b)                                                                                                                               | Proportion of institutional deliveries                                                                                            |                                                                                                                                   |                                                                                                                                   |
|                                                                                                                                   | NFHS - III (2005 - 06)                                                                                                            | 38.7                                                                                                                              | 17.7                                                                                                                              |
| (V) Mother's first postnatal check- up                                                                                            |                                                                                                                                   |                                                                                                                                   |                                                                                                                                   |
| (c)                                                                                                                               | Percent distribution of women giving birth in the five years preceding survey received post - natal check - up                    | the                                                                                                                               |                                                                                                                                   |
|                                                                                                                                   | NFHS - III (2005 - 06) (first postnatal - up within 2 days                                                                        | check 37.3                                                                                                                        | 23.0                                                                                                                              |
|                                                                                                                                   | Source:National Family Health Survey, 2005- 06                                                                                    |                                                                                                                                   |                                                                                                                                   |