Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:
(a) whether the Government has taken note of the relatively weak health indicators among the tribal communities in the country; and
(b) if so, the details thereof along with the steps being taken by the Government to address the issue?
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 to the Ministry. The Report is available in public domain at https://nhm.gov.in/New_Updates_2018/NHM_Components/Health_System_Stregthening/tribal_health/Tribal-Health-Report.pdf. The status of Tribal Health has been summarized in the report as under:
“Tribal people have the poorest health status and they carry a triple burden of disease. Moreover, despite the high reliance of the tribal people on the public health care system in Scheduled Areas, it continues to be characterized by low output, low quality and low outcome delivery system, often targeting wrong priorities.
An important reason behind this is the near complete absence of community participation in the planning, design and implementation of health services. Therefore, restructuring and strengthening of the public health care system, in accordance with the needs and aspirations of the tribal communities, and with their full participation, should be the highest priority for the Ministries of Health and Family Welfare, both at the Centre and in the states”.
Public Health & Hospitals” being a State subject, the primary responsibility of provision of healthcare to all including tribal population is that of respective State Government.
However, under the National Health Mission (NHM), financial and technical support is provided to States/UTs to strengthen their health care 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 population including tribal population based on requirements posed by the States in their Programme Implementation Plans (PIPs).
Under NHM, tribal areas already enjoy relaxed norms for setting up public health facilities including “time to care” norm for setting up sub health Centres in tribal areas within 30 minutes of walk from habitation and relaxed norm for Mobile Medical Units for tribal areas; extra one MMU if it exceeds 30 patients per day against 60 patients per day in plain areas for bringing healthcare delivery to the doorsteps of the population.
Further, all tribal majority districts whose composite health index is below the State average have been identified as High Priority Districts (HPDs) and these districts receive more resources per capita under the NHM as compared to the rest of the districts in the State. These districts receive higher per capita funding, have enhanced monitoring and focused supportive supervision and are encouraged to adopt innovative approaches to address their peculiar health challenges.
The Allocation of funds under Scheduled Tribal Sub-Plan in respect of major health schemes/ programme during 2016-17 to 2018-19 are at Annexure-I to Annexure-III.
As per Rural Health Statistics the change in health facilities in Tribal areas versus All India between 2005 and 2018 is given as below:
Facilities All India Tribal Areas
2005 2018 2005 2018
CHCs 3346 5624 643 1017
PHCs 23236 25743 2809 3971
SCs 146026 158417 16748 28091
Total 172608 189784 20200 33079
% increase 9.95 63.75