In the wake of the ongoing pandemic, a polluted planet, an increasing incidence of infectious diseases and over-burdened health systems—the factors place an enormous pressure on the limited resources that we have.
‘Our Planet, Our Health’ is therefore an apt theme for this year’s World Health Day 2022.
This thematic call from the international community, puts the health of individuals and the planet at the centre of discussions, actions; fosters a movement to create communities that focus on well-being, and presents a unique opportunity for a green and healthy recovery from the Covid-19 pandemic. This also calls for a time to pay attention to tribal people, a social sub-group that embodies a true connect between our planet and our health.
The 104 million tribal people of India predominantly live in hilly, forested rural areas that are hard to reach. With the lowest Human Development Index, the health and nutrition status of tribal people is worse than other population sub-groups. Several persistent barriers have led to consistently poorer health outcomes among the tribals. In the past, we have written about these barriers, about whether India’s health care goals are inclusive of tribals as well as about how India can lead the way in improving their lives. In this article we provide a road map to transform the health of tribal peoples and end preventable deaths.
The complexity and magnitude of the problem necessitates collaborative action. For all stakeholders working in public health, including the government and the tribal communities, to align their resources, organisational agendas and intellectual capacities and jointly address the health needs of tribal people. This collaborative action aimed at ensuring quality health services at scale, must not merely be satisfied with making health care accessible, but needs to be welcoming of tribal communities. For this joint action to work, we recommend three key strategies that leverage the resources, experience, and expertise of all partners.
A process of institutionalising and scaling up of community-led action for health, communitisation will ensure that the voice of the community adequately and appropriately informs the design and deployment of healthcare services. Coordinated efforts of a critical mass of community leaders from tribal communities, will promote health as a priority agenda from within and among the community. These community leaders will help organise and magnify community voice to inform, strengthen, and contextualise public health services, and push for delivery of services designed by tribal peoples themselves. Leaders could be tribal youth, students, self-help group members, panchayat or traditional government members or tribal healers as well as other local tribal influencers.
2) Robust public health system
We are urging for reimagining the public health system; one that is driven by a critical mass of health leaders who cause change from within and transform delivery of health services. Leaders at state, district and block level tasked with delivery of health services, sensitive to the needs of tribal peoples, will be guided by a mid- to long- term vision of transforming the healthcare system, not merely delivering immediate outputs. We envision building a community of health leaders who understand the local context, can establish a culture of empowerment, transparency, and accountability among themselves and the people they lead. By encouraging the government health-ecosystem to work closely with the community and civil society, they will contribute to a collective ownership of public health. This will build institutional capacity, strengthen service delivery, and facilitate digital transformation and establish a more efficient health ecosystem that is empathetic towards and inclusive of the tribal peoples.
3) Development and dissemination of knowledge
It is a well-known fact that there is a paucity of knowledge about tribal health and practices. There is also a need to document the medicinal and healing knowledge that resides inherently within tribal communities and with tribal healers. It is therefore critical to develop and disseminate knowledge that will inform and prioritise tribal health agenda. Doing so will create an enabling environment for informing and implementation of policy at regional and national level. The knowledge piece will comprise of curating, conducting and commissioning research, capturing and documenting existing knowledge and engaging with policymakers and influencers.
We firmly believe that this potent combination of community-led action for health, government leaders motivated to lead change and availability of knowledge and research can be a game changer in transforming the health and nutrition status of tribal peoples. In line with this approach, we launched Anamaya-The Tribal Health Collaborative, to end preventable deaths among tribal peoples across India. Anamaya brings together several like-minded organisations such as the Piramal Foundation, Bill and Melinda Gates Foundation, United States Agency for International Development, Ekjut India, Center for Policy Research to work together with the government and the tribal communities.
‘Our Planet, Our Health’ is a wake-up call for India to put the health of tribal populations at the centre of actions, commit ourselves to ending preventable deaths among tribal communities, and enable them contribute to a thriving India.
Dr Piramal is vice-chairperson, Piramal Group.
Dr Hegde is senior vice president, public health innovations at Piramal Swasthya.
The thoughts and opinions shared here are of the author.
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