RESUMO
India is home to the largest population of indigenous tribes in the world. Despite initiative of the National Rural Health Mission, now National Health Mission (NHM) and various tribal development programmes since India’s Independence, disparity in healthcare for Scheduled Tribes (STs) prevails. The constitution of Village Health Sanitation and Nutrition Committees (VHSNCs) in 2007 by the NHM is a step towards decentralized planning and community engagement to improve health, nutrition and sanitation services. VHSNCs are now present in almost all States of the country. However, several reports including the 12th Common Review Mission report have highlighted that these committees are not uniformly following guidelines and lack clarity about their mandates, with no clear visibility of their functioning in tribal areas. Therefore, this review was conducted to assess the participation of the VHSNCs in tribal dominated States in order to know in detail about their functioning and gaps if any that require intervention. Several deviations from the existing guidelines of NHM were identified and we concluded that in order to sustain and perform well, VHSNCs not only require, mobilization and strict monitoring but also motivation and willingness of its members to bring in a radical change at the grassroot level. With continuous supervision and support from both the Government and various non- governmental organizations, handholding, strategic deployment of workforce, community participation and sustained financial support, VHSNCs would be able to facilitate delivery of better healthcare to the indigenous population
RESUMO
Knowledge and understanding of the epidemiological profile is an essential pre-requisite to assess and address public health needs in the country and to enable efficient programme planning and management. The need for adequate and accurate health information and data to undertake such an exercise cannot be over-emphasized. The present effort is a modest attempt to critically analyse the epidemiological profile of India from the historical and contemporary perspective. In order to assess the successes achieved as well caution against the daunting challenges awaiting the country, parameters such as disease burden and health status indicators, are increasingly being used. Changes in the population age structure, improvements in the nation's economic status, altered life-styles of people and duality of disease burden testify to the demographic, development and health transition occurring in the country. Population stabilization, poverty alleviation, life-style modification, surveillance and control of communicable and non-communicable diseases constitute the major challenges demanding urgent attention in the future.