Even after 75 years of independence, the country's most underprivileged tribal population is still far from getting health benefits. Tribals in India have poor health and present a bleak picture in terms of social development metrics, especially health. From this perspective, this paper is intended to identify the problems and existing challenges faced by tribal communities in accessing health care from primary health care settings. Exploring the observations based on reviewed scholarly articles published between 2012 and 2022 from databases like PubMed and Google Scholar and in addition to several government reports and articles. These articles were selected and subsequently analyzed to extract specific outcomes. By applying the principle of the 'five A' approach, the analysis revealed a significant shortfall in the service delivery of health wellness centers. It was implicit that despite the introduction of affirmative policies by the government, gaps still existed in the healthcare system at grass root level. Major gaps are lack of human resources, staff stereotyping indigenous population, and inadequate infrastructure; and high health costs due to out of pocket expenditure and informal payments were evident. The paper recommended both individual and community-level strategies to overcome the barriers of rural health services. More decentralized planning and cultural competency training are immediate measures for the inclusion of tribal-rural people in healthcare services. Further, we proposed developing a "Mangal Health Team' which will coordinate between Health and wellness centre and villagers.
Madhya Pradesh is India's largest tribal population state, with 46 tribal groups accounting for 21.1% of the total population. While numerous studies on tribal health in general were conducted, research on the health risks coverage of adolescent girls in Madhya Pradesh was inadequate. This paper aimed to identify the current health delinquencies of tribal adolescent girls living in Madhya Pradesh. In the present study, 23 research papers published from 1st January, 2000 to 18th July, 2022 were selected for review, while another 38 papers were reviewed to understand the background of adolescent health issues. The papers for review were selected by applying certain criteria in accordance with the study objective. Google Scholar and the PubMed database were used to search for relevant research articles, and the final selection was done after an in-depth reading and suitability of the subject. Major health risks are identified as anaemia and IFA supplementation, reproductive health, malnutrition, and menstrual hygiene. High proportion of anaemia (52%-94%) was observed. Rate of underweight (20.1% to 72.7%), wasting (9% to 61.1%), and stunting (20.1% to 32.3%) indicated undernutrition among adolescence girls. Girls were infected by Human Papillomavirus and Sexually Transmitted Disease. Limited knowledge on Human Immunodeficiency Virus, contraceptive methods, and sexual routes of transmission were found among tribal girls. Low birth weight babies as a result of early marriage and stillbirth were major concerns among adolescent tribal girls. The analysis revealed that lack of information on health services, social-cultural factors and deprivation from health care access are responsible for unfortunate health situation of tribal girls. More comprehensive studies with a holistic approach on identified issues are essential for effective adolescent friendly policy implication in favour to improve prospective health. Key words: [Health Risk, Tribes, Adolescent Girls, Anaemia, Undernutrition, Madhya Pradesh]
Background The purpose of this study was to highlight the state of undernutrition among migrant/refugee children living in lower middle income countries using published evidence from the past twelve years (2010 to 2022). Methods We searched PubMed, Scopus, Science-Direct, CINAHL Plus, & Google-Scholar to identify peer reviewed evidence relevant to our objective published between January 2010 to December 2022. Two researchers independently examined the studies, retrieved the data, and evaluated the studies' quality. NIH quality assessment tool was used. A random effect meta-analysis was conducted to pull the estimates. Subgroup analysis, Meta regression and sensitivity analysis was done to explore the source of heterogeneity and the robustness of our estimates. Findings From selected 17 studies out of 1664 identified records, the pulled estimates of stunting, wasting and underweight among migrant/ refugee children in LMICs was 27.45% (Confidence Interval (CI) 18.99 to 36.82; I2 100%; p value <0.001), 13.59% (CI 8.48 to 19.67; I2 99%; P value <0.001), and 25.96 (CI 17.20 to 35.83; I2 100%; p value <0.001) respectively. Among different WHO regions all three undernutrition estimates were higher in LMICs belonging to South-east Asian region (Stunting 36.64%; wasting 13.98%, underweight 31.79%). Estimates in India was 43.55%, 18.71%, and 37.45% respectively in similar chronology. High heterogeneity was noted across all the estimates with I2 value >90%. Sensitivity analysis across indicators shown stability of our estimates. Interpretations The extent of undernutrition, particularly wasting, was significant among migrant/refugee children living in LMICs. Measures should be taken to strengthen the government-subsidized public food distribution system, increase the healthcare outreach, and ensure public health-insurance coverage among the migrant population.
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