The Health of Indigenous Populations in South Asia: A Critical Review in a Critical Time

Abstract

Despite South Asia’s promising social inclusion processes, staggering social and health inequalities leave indigenous populations largely excluded. Marginalization in the South Asian polity, unequal power relations, and poor policy responses deter Adivasi populations’ rights and opportunities for health gains and dignity. The ongoing COVID-19 pandemic is likely to result in a disproportionate share of infections and deaths among the Adivasis, given poor social conditions and exclusions. Poor health of indigenous people, inequalities between indigenous and non-indigenous groups, and failures in enforcing constitutional and legal provisions to reclaim indigenous land and cultural identity herald deeper structural and political fractures. This article unravels health inequalities between the Adivasis and non-Adivasi populations in their social context based on a critical review of secondary sources. We call for intersectoral policies and integrated health care services to address systemic inequalities, discrimination, power asymmetries, and consequent poor health outcomes. The current COVID-19 pandemic should be viewed as a window to pursue real change.

Identifying non-communicable disease multimorbidity patterns and associated factors: a latent class analysis approach

“…Tribal population is considered the most disadvantaged population subgroup in India 39. They reside in remote locations, have inadequate awareness about health risks and have limited access to good quality healthcare 40 41. Another issue is the low acceptability of healthcare among this social group which is highlighted as a significant cause of low diagnoses and treatment rates.…”

Exploring the Linkages Between Non-Communicable Disease Multimorbidity, Health Care Utilization and Expenditure Among Aboriginal Older Adult Population in India

“…There is ample evidence indicating a perpetual disparity in health and nutrition outcomes among tribal population vis-à-vis their non-ST counterparts (this includes all the social caste groups other than the Scheduled Tribes) ( 5 ). Existing studies have focussed on exploring various health realms for this population, which are not limited to malnutrition ( 9 ), risky health behaviours ( 14 , 15 ), infectious ( 14 , 16 ), and non-communicable diseases burden ( 14 , 16 ).…”

“…Aiming at improved prevention, early detection, and effective management, the government initiated various NCD control programs in India ( 21 ). However, as the aboriginal population usually resides in remote locations, they have inadequate awareness of risky health behaviours and non-communicable diseases ( 4 , 14 ). Additional issues like poor health care delivery system, scepticism, and myths reducing the utilization of healthcare infrastructure, and poor affordability are major precursors to low healthcare accessibility among the aboriginal population ( 4 , 14 ).…”

“…However, as the aboriginal population usually resides in remote locations, they have inadequate awareness of risky health behaviours and non-communicable diseases ( 4 , 14 ). Additional issues like poor health care delivery system, scepticism, and myths reducing the utilization of healthcare infrastructure, and poor affordability are major precursors to low healthcare accessibility among the aboriginal population ( 4 , 14 ). These pretexts act as a catalyst in worsening the chances of universal health access.…”

Beyond behaviour as individual choice: A call to expand understandings around social science in health research

“…An approach that focuses exclusively or even predominantly on individual behavioural drivers of health considers the individual as the main site of analysis, disregarding existing knowledge of social hierarchies and power relations, and the resulting social oppressions and conflicts. The unfair accumulation of markers of poor health among historically marginalised communities has been demonstrated through many global, national, and sub-national analyses 5 .…”