Lok Sabha Question No. 989 (UNSTARRED), answered on 2019-11-22
Subject: Recommendation of Expert Committee on Tribal Health
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Rahul Gandhi

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

LOK SABHA UNSTARRED QUESTION NO. 989 TO BE ANSWERED ON 22 ND NOVEMBER, 2019

## RECOMMENDATION OF EX PERT COMMITTEE ON TR IBAL HEALTH

## 989. SHRI RAHUL GANDHI:

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

- (a) whether the Ministry has accepted the recommendations of the Expert Committee on Tri Health in India;
- (b) if so, the details thereof; and
- (c)  the details  of  the  measures  being  taken  to  assess  the  state  of  health  of  various communities in India, particularly in Kerala?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a) & (b):  An Expert Committee on Tribal Health was constituted jointly by the Ministry of Health & Family Welfare and the Ministry of Tribal Affairs which submitted its report t Ministry. The Report is available in public domain at https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=1110&lid=630
- (c ):    As per information received from Indian Council of Medical Research (ICMR), in or have all the Institutes / Centers working in the field of tribal health on a single platform, ICMR established  Tribal  Health  Research  Forum  (THRF)  on  9 th August  2010,  which  had  been committed to prioritize research addressing specific health needs of the tribal populati this THRF, there are 16 Institutes / Centers and major Divisions of ICMR under leadership o National Institute of Research In Tribal Health (NIRTH), Jabalpur. 10 Tribal Health Res Units (THRUs) were established by ICMR in two phases, which have also been functioning wit h  an  overall  mandate to improve tribal health through diagnosis and develop strategi management in their sub -population with emphasis on various infectious diseases as well as no -communicable diseases, apart from hemoglobinopathies, nutrition and ma ternal and child health etc.  These  units  worked  to  outline  the  health  problems  of  tribal  population  and  gen evidence for policy change. Key Contributions to the National Health Research Programme Policies by ICMR are at Annexure.

In  addition,  surv eys  like  National  Family  Health  Survey  (NFHS),  and  District  Level Household Survey (DLHS), conducted by the Ministry give estimates inter - alia for tribal health indicators.

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## Key Contributions to the National Health Research Programmes / Policies by ICMR

- Established  facilities  for  newborn  screening  for  SCD,  prenatal  diagnosis  of  β -thalassemia syndrome, sickle cell disorders and micro mapping of G6PD deficienc in  Madhya  Pradesh,  Assam  and  the  Andaman  and  Nicobar  Islands.  Established Sickle Cell diagnostic Clinics in 5 tribal districts of MP and in a remote triba Baster in CG. The same is underway in 22 tribal districts.
- Conducted regional training workshops / training of Master Trainers on diagnosi SCD  and  management - Ind ucted  in  19  States.  More  than  1.5  crore  tribal  school children screened.
- Developed evidence - based malaria intervention model (Dindori) for control of fores and  tribal  malaria.  The  model  up - scaled  to  make  a  model  in  malaria  elimination through  PPP  mode  in Mandla  district  of  MP  through  MEDP  project.  Prepared 'Tribal Malaria Action Plan' as a part of NHM -Contributed to policy formulation for Malaria - in - Pregnancy. Evaluated bivalent malaria rapid kits (RDTs) inducted int National  programme.  Monitoring  ther apeutic  efficacy  in  malaria  endemic  tribal regions of the country to support National programme.
- A  sharp  decrease  in  Malaria  incidence  has  been  shown  in  Car  Nicobar  since  t Tsunami (API decreased from 105 in 2005 to <1 in 2013). Further, repeated surve conducted in Car Nicobar showed a declining prevalence of pulmonary tuberculosi which is attributed to the better socio - economic status and housing brought about the post - tsunami  reconstruction  and  rehabilitation  initiatives.  Also,  implemente programme for elimination of lymphatic filariasis from its only focus in India v Nancowry of islands. The programme has almost achieved its objective of bringi down the mf rate <1%.
- Among Saharias (a PVTG in India), several studies identified and reporte very high TB  prevalence  (upto  3000  /  1,00,000).  Intervention  study  among  this  tri demonstrated  decline  in  TB  prevalence  and  an  intensified  TB  control  progra (Research cum Intervention study) has been launched.
- Developed universally accepted Nutrition al supplementation and safe drinking water based intervention model for fluorosis prevention & control developed and inclu in the National Program.
- Sickle cell anaemia is among over 1 lakh tribal population of Rajasthan has been studied and a prevalence of about 10% recorded.
- Kathodi - Katkari tribe in Karnataka has been successfully assessed for health st of and the report / recommendations have been submitted to Dept of Tribal Welfa and Govt .of Karnataka, Mysuru for mitigating the ailments among the tribes.
- Regular health and nutritional surveys have been carried out among the access indigenous  tribes  of  Andaman  and  Nicobar  (Onges,  Andamanese,  Shompens, Jarawas).
- A project to e liminate tuberculosis from Nicobarese of Car Nicobar and subperiodic filariasis from Nicobarese of Nancowry group of Islands are ongoing.
- Various  studies  have  been  recently  initiated  and  are  currently  being  undert which has a direct relevance for h alth of tribal communities as below :
- o New  born  screening  for  sickle  cell  anaemia  has  been  initiated  in  tri populations of 6

States.

- o Understanding tribal culture, lifestyle, animal husbandry activities and ca death in five tribes of India through establishment of tribal habitats.
- o Study on p revalence and severity of hemoglobin disorders (Hemoglobinopathies  and  G6PD  Deficiency)  and  the  measures  of  multi -morbidity and morbidity burden of selected hemoglobinopathies among tribal populations of Tamil Nadu.
- o Project to eliminate malaria from Car Nicobar.
- o Surveillance  of  long  term  sequelae  of  chronic  heptatis  B  infection  and reduction from Car Nicobar.
- o Double  fortified  salt  (DEC  +  Iodine)  as  a  supplementary  measure  to  th ongoing  MDA  for  elim inating  a  persistent  foci  of  diurnally  sub  periodi Wuchereria bancrofti in nancowry group of islands.
- o Comprehensive Health Assessment including a study of reproductive tract infecti among women of Lahaul & Spiti, Himachal Pradesh.
- o Lifestyle intervention program on health seeking behavior, malnutrition and mal prevention in Ashram school children of Dindori district in Madhya Pradesh.
- o Socio - economic  development  among  tribes  of  India:  Analysis  of  2001  &  2011 censuses.
- o Revitalizing ethnomedicine  among  Baiga  of  Madhya  Pradesh - an  exploratory research.

As regards the assessment of health of various tribal communities particularly in Kera research studies undertaken by ICMR are as follows:

- Entomological  and  Epidemiological  inv estigations  on  Leishmaniasis  among  the Kani forest Tribes in the tribal settlements of Thiruvananthapuram, Kerala;
- Studies  on  distribution  and  biological  characteristics  of  the  members  of Fluviatilis -Minimus group for effective vector control strategies i n tribal areas of India (including Kerala);
- A rapid survey on assessment of nutritional status of under - five children and women and cause of infant deaths among tribes of Attappady hills, Palakkad district, Kerala;
- Nutritional status of tribal population a nd prevalence of hypertension in various states of India including Kerala.

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