ABSTRACT
Dare AJ, Ng-Kamstra JS, Patra J, Fu SH, Rodriguez PS, Hsiao M, Jha P, Jotkar RM, Thakur JS, Sheth J. (Centre for Global Health Research, St Michael’s Hospital and University of Toronto, Toronto, ON, Canada; National Rural Health Mission, Government of Maharashtra, Mumbai; School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh; and Department of Preventative and Social Medicine, NHL Municipal Medical College, Ahmedabad, India.) Deaths from acute abdominal conditions and geographical access to surgical care in India: A nationally representative spatial analysis. Lancet Global Health 2015;3: e646–53. Published Online 14 August 2015, http:// dx.doi.org/10.1016/S2214-109X(15)00079-0.
ABSTRACT
Tribals are the most marginalised social category in the country and there is little and scattered information on the actual burden and pattern of illnesses they suffer from. This study provides information on burden and pattern of diseases among tribals, and whether these can be linked to their nutritional status, especially in particularly vulnerable tribal groups (PVTG) seen at a community health programme being run in the tribal areas of chhattisgarh and Madhya Pradesh States of India. This community based programme, known as Jan Swasthya Sahyog (JSS) has been serving people in over 2500 villages in rural central India. It was found that the tribals had significantly higher proportion of all tuberculosis, sputum positive tuberculosis, severe hypertension, illnesses that require major surgery as a primary therapeutic intervention and cancers than non tribals. The proportions of people with rheumatic heart disease, sickle cell disease and epilepsy were not significantly different between different social groups. Nutritional levels of tribals were poor. Tribals in central India suffer a disproportionate burden of both communicable and non communicable diseases amidst worrisome levels of undernutrition. There is a need for universal health coverage with preferential care for the tribals, especially those belonging to the PVTG. Further, the high level of undernutrition demands a more augmented and universal Public Distribution System.