Health Status of Tribal Women in Rural India and Health Consciousness: Present Perspectives

The Position of Indian Women is a paradox right from the Vedic period to modern times. In the present male-dominated society, women are shown in a passive role of a mother, wife, daughter and sister. The status of women has improved to a certain extent, especially, in urban areas. The literacy rate of women has increased. The abuse of women in the households by male has declined. Women are holding top positions in several sectors including education, business, politics etc.However, not much has changed for the majority of women, especially in rural areas. They are considered as second-grade citizens. They are given secondary status in household, workplaces, social and public places. Women are exploited and harassed in the most of the states of India, except a few states where the literacy rate is high both of males as well as females.

Almost 8% of the total population in India is constituted by the tribal people, which come to about 23.58 million. It is said that this strength is more than that of an individual country’s population in the European continent. Despite this huge strength, the tribal people in India have not received the attention they deserve, when it comes to their welfare and development. The programmes, schemes and projects of the governmental and non-governmental organisation, aimed at the development of tribes have not achieved their set objectives although it is more than sixty-five years that we have been administering our own people. A case in point is the health status of the tribal people. There have been very few studies on the health condition of the tribal population. Based on a few crucial parameters of health gleaned from these studies, especially on morbidity, mortality and nutritional status, an attempt has been made to depict the present scenario of tribal health in India.

In most of the communities in India, the male members of a family are given priorities in respect of education, food, social celebration, religious practices and so on. The priority treatment for males is followed not only in poor and illiterate families but also in rich and educated families. Education can play an important role in changing the attitudes of the people towards family, marriage and birth of a child.Therefore, education should receive top priority in India. In India, there is low health consciousness. Women are reluctant to avail of medical health until the sickness aggravates.

Health is an important aspect of human development.

The efficiency and creativity of human resources is influenced to a great extent by health standards. The health standards have improved since independence. A large number of hospitals and nursing centres have been set up both at the government level and at the private level. Due to better medical facilities, the life expectancy rate has improved over the years from 32 years in 1951 to 65 years in 2001.There has been some improvement in hygienic standards such as the supply of safe drinking water and provision of drainage system etc.This has resulted in improved health of the women, as many of the waterborne diseases are on the decline. The lower death rate is also due to proper diet between the middle class and upper class in India. Education between the middle class and upper class is also responsible for proper food habits. There has been a marked expansion of health infrastructure in India. The number of hospitals and dispensaries, hospital beds, doctors and other health related facilities has been increased considerably over the years

The high growth of population is one of the major factors for slow development in India. Due to high growth in population among the poor; there are inequalities in income and wealth. The poor women become poor and rich become richer. There may be shortages of food items in the country. Therefore the government may have to import certain food items such as edible oils. The imports result in an outflow of foreign exchange and as such the economic development of the country gets affected.

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In India, there is a high incidence of poverty among the weaker sections of the society. The landless women labourers and women belonging to backward castes are poorer than others in the society. The poor women can not afford to meet the minimum requirement of food intake. They often survive on the poor quality of food items. Some of poor tribal live on roots and such other forest stuff. There are several cases of hunger deaths in the country. The tribal women in India live in utter hopeless conditions. They live in highly unhygienic conditions. Quite often, the poor women are deprived of proper sanitation facilities. The overall standard of living of the poor women is so bad, marginalised that at times, animals may be in a better position. Due to the poverty, the poor women marginalised. They continue to live in social backwardness.Thus; they do not become part of the mainstream in the society.

The government has introduced several regulations in respect of health and safety. For instance, the prevention of Food Adulteration Act has been passed. Those found guilty under the Act are punishable. Therefore the traders may not unduly get involved in adulteration of food products. This indirectly affects the health of people in rural area positively. The government of India has initiated several measures to eradicate poverty. The major poverty alleviation and employment generation programmes currently being implemented.

Annapurna Scheme was launched in April 2000. It was a 100% centrally sponsored scheme. It aims at providing food security to meet the requirement of those senior citizens who are eligible but not getting the pension, under the National Old Age Pension Scheme.10 kgs of foodgrains per person per month are supplied free of cost. This scheme has been transferred to the state plan from 2002-2003.

Antyodaya Anna Yojana was launched in Dec 2000 at present June 2005, 2 crores poorest families out of the BPL families covered under the Targeted Public Distribution System are benefited.35 kgs of food grains per month were made available to each eligible family at a highly subsidised rate.

National Food for Work Programme was launched on Nov.14 2004 in 150 most backwards districts of the country. The main objective is to generate supplementary wage employment. This programme is open to all rural poor women /men who are in need of wage employment and desire to do manual unskilled work. It is 100% centrally sponsored scheme. The food grains are provided to the states, free of cost.

In India, Women are given secondary status in the household. In many communities, women are not literate. Therefore when the mother is not literate, others in the family, especially the girls remain illiterate. Therefore the government of India introduced the Mid –day Meal Programme to improve literacy. Under this scheme, free mid-day meals are provided to the school children in government aided schools. This scheme has attracted a large number of poor children to enrol in schools.

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There is the problem of malnutrition in India. The bottom 20% of the population does not get proper nutrition. They continue to eat roots, stale food, leaves, mango kernels and so. In India, there is the paradox of plenty and hunger. On one side, huge stocks of food grains are locked in government godowns, yet a good number of people suffer from hunger and malnutrition. This may be due to lack of health consciousness or may be due to the poverty of the poor women.

Technological advances in the field of medicine and health infrastructure have resulted in the decline of mortality rates.

Combined efforts on the part of the government to control diseases like malaria, leprosy, tuberculosis etc.have met with good success. Epidemics like smallpox and cholera have been controlled through vaccination programmes. The National Health Policy 2002 aims at eradicating or eliminating several diseases like leprosy, polio by the year 2005 and some other diseases a little later.

National health programmes are implemented to control communicable and noncommunicable diseases like malaria, leprosy, tuberculosis, blindness, AIDS, cancer etc.Peak annual incidence of 6.47 million malaria cases in 1976, declined to about 2 million by 1985.It was contained at the level 2 to 3 million in spite of increasing population. It has declined further since 1997.The prevalence rate of leprosy has reduced from 24 per 10000 in 1992 to 3.36 per 10000 populations in September 2002.Under the revised National TB control Programme (RNTCP), the cure rate has improved to 8 out of 10 patients from about 4 out of 10 in the earlier programmes.

Many studies in India have shown how morbidity condition and prevalence of high rate of illness have caused a significant loss of working days particularly for female workers. Communicable diseases continue to be the leading cause of morbidity and mortality. Malaria and tuberculosis continue to be a major health problem in India. Leprosy continues to be very high in Bihar, Jharkhand, UP, Orissa, West Bengal. MP and Chhatisgarh. AIDs have now emerged as one of the most serious public healthy problems in the country.

In human resource development strategy, the more enduring policy is preventive rather than curative approach. This is primarily because of the low consciousness of health care. It has led to overlooking morbidity and slow weakening ailments which are caused largely by low nutritional status, low sanitation and inadequate clean water supply.

Although the country has been able to eliminate nutritional deficiency syndrome like pellagra, beriberi etc. yet chronic energy deficiency among adults, under-nutrition among children and macronutrient deficiencies such as goitre, blindness due to vitamin- A deficiency and anaemia are still prevalent across all section of the population. According to Economic Survey 2003-03, one half of the children under the age of 5 years in India are moderately of severely malnourished, 30 percent of women are anaemic.

The people of India had suffered from infectious diseases, such as plague, dengue fever etc. in different parts of the country during the year 1996. For expensive hospital treatment, a “National Illness Assistance Found” is being established at the Centre as well as at the State levels for the people living below poverty line. Morbid conditions and prevalence of high rate of illness force workers, in 50 to 55 age group in particularly female labour, to remain absent at their workplace. It means that substantial amount of earnings is foregone at the stage of life, which is the significant period of financial responsibility to the family.

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It is not only the labour, that suffers the loss of earnings but, at the same time, there is an output loss to the economy of our country especially due to pollution-induced diseases like bronchitis, tuberculosis, pneumonia, and other respiratory diseases. According to P. R. Panchamukhi, the total output loss in 1978 in the city of Bombay, due to these diseases, was estimated at Rs. 49.1 crores to Rs. 124.7 crores. The cost of treatment of the diseases added to it would amount to Rs. 54 crores to Rs. 130 crores as the total output loss to the Indian economy only in the city of Bombay in 1978. If it is considered on an all India basis, the output loss due to ill-health would present an alarming figure. Thus, health-care plays a very significant role in human resource development in our country.

India presents a highly disappointing nutritional scene due to the prevalence of low consciousness of health care overlooking morbidity and slow weakening ailments among the masses. The degree of undernutrition and malnutrition is very great, especially in children. Malnutrition is found higher among females than among males, who carry it to the next generation. The pregnant women aged 15 to 49 suffer from anaemia causing a very high rate of infant mortality. The sanitation and water supply conditions are equally poor. An outlay of Rs. 1727 crores were earmarked in 1998-99 budgets for rural water supply and sanitation. Moreover, the process of urbanisation has given rise to special health problems, connected with slums, pollution, stress and strain, etc. A combination of vehicular and industrial emissions causes pollution in big cities like Mumbai, Delhi, Bangalore, and Chennai. etc.

The provision of safe drinking water supply and sanitation facilities is a basic necessity of life and a crucial input in achieving the goal of “health for all”. The sanitation and water supply conditions are far from satisfactory in the country. According to the census of India 1991, only 62 per cent of households in India has access to safe drinking water, comprising over 81 per cent of urban households and around 56 per cent of rural households. Similarly, only less than one-fourth of households in the country had toilet facilities within the premises, the proportion being less than 10 percent for rural and around 64 percent of urban households.

It is normally believed that the increasing trend of urbanisation observed in the country would automatically take care of the health problems. The Bombay metropolitan study of ill- health, has shown that incidence of mortality due to pollution-related diseases is, in particular, depressingly high at the peak of working life. Urban air quality has deteriorated in all Indian cities.

Progress made by India is a modest one in comparison to its requirement.In spite of the Five Year Plans and numerous projects, the positive effects are much below the targets thanks to the poor implementation and widespread corruption.We require a rapid development to bring a qualitative change in the life of our people which in turn would enhance the quality of human resource as an agent of production. In spite of the progress in human development, India still ranks low in the ranking of Human Development of Index (HDI).Since independence life expectancy at birth has nearly doubled, the literacy rate of the population above the age of five years has tripled and per capita availability of the food and clothing have increased significantly. But these achievements have been modest, not only in comparison with the goals and aspirations of the people but even more so in comparison with many other developing countries of Asia and some of the states such as Kerala in education, health and life expectancy compare favorably with those countries with much higher levels of income brings out the failure of other states and the country as a whole.