This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Prashanth N Srinivas
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0968-0826
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The data available for the health of Scheduled Tribes (ST) in India are often coarse-scale snapshots of health status and healthcare access showing poorer indicators when compared to others but do not allow fine-scale analysis. In this paper, we examined health inequalities between ST and non-ST populations in two forested sites and compare healthcare parameters for ST populations across three forested sites in India.
Methods
We conducted a cross-sectional household survey in sites in and around Biligiri Ranganathaswamy Temple (BRT), Kanha and Pakke tiger reserves in the south, central and northeast regions of India respectively. In each site, multi-stage sampling and cluster analysis provided a representative sample of households across villages of 859 ST and non-ST households. We examined sociodemographic and health-related information including self-reported illnesses and healthcare utilisation; from these we explored within-site health inequality patterns for two sites and inter-site differences among ST households in the three sites.
Results
In BRT, ST-non-ST differences favoured the latter for socio-economic characteristics with no difference in self-reported illness/injuries or healthcare utilisation. In Kanha, both groups were similar for socio-economic characteristics and healthcare utilisation. Pakke ST households reported highest healthcare utilisation, while Kanha ST households reported lowest care seeking at hospitals and relied on home networks and health workers. High tobacco consumption prevalence was noted among ST households in all sites.
Conclusions
ST-non-ST inequality patterns at a fine-scale were different between BRT and Kanha. Absence of health inequalities between both groups in Kanha indicates uniform socio-geographical disadvantage while poor healthcare utilisation by ST in BRT indicates health inequities within the state. Pakke ST households reported highest utilisation while Kanha reported the lowest. Thus, programmes addressing health inequalities of STs need to consider site-specific assessments in socio-geographical and health system factors.
Keywords
Forests, health inequalities, healthcare access, tribal health, indigenous health, tiger reserves, India
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Prashanth N Srinivas
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0968-0826
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 27 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The data available for the health of Scheduled Tribes (ST) in India are often coarse-scale snapshots of health status and healthcare access showing poorer indicators when compared to others but do not allow fine-scale analysis. In this paper, we examined health inequalities between ST and non-ST populations in two forested sites and compare healthcare parameters for ST populations across three forested sites in India.
Methods
We conducted a cross-sectional household survey in sites in and around Biligiri Ranganathaswamy Temple (BRT), Kanha and Pakke tiger reserves in the south, central and northeast regions of India respectively. In each site, multi-stage sampling and cluster analysis provided a representative sample of households across villages of 859 ST and non-ST households. We examined sociodemographic and health-related information including self-reported illnesses and healthcare utilisation; from these we explored within-site health inequality patterns for two sites and inter-site differences among ST households in the three sites.
Results
In BRT, ST-non-ST differences favoured the latter for socio-economic characteristics with no difference in self-reported illness/injuries or healthcare utilisation. In Kanha, both groups were similar for socio-economic characteristics and healthcare utilisation. Pakke ST households reported highest healthcare utilisation, while Kanha ST households reported lowest care seeking at hospitals and relied on home networks and health workers. High tobacco consumption prevalence was noted among ST households in all sites.
Conclusions
ST-non-ST inequality patterns at a fine-scale were different between BRT and Kanha. Absence of health inequalities between both groups in Kanha indicates uniform socio-geographical disadvantage while poor healthcare utilisation by ST in BRT indicates health inequities within the state. Pakke ST households reported highest utilisation while Kanha reported the lowest. Thus, programmes addressing health inequalities of STs need to consider site-specific assessments in socio-geographical and health system factors.
Figure 1
Figure 3
Figure 6
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