Tribal Health

Birth Waiting Room in 17 Tribal PHCs:

The Tribal Birth Waiting Room is a facility built at foothill Primary Health Centres (PHCs) where expectant Tribal mothers, along with one attendant, can stay for seven days to ensure a safe delivery. During their stay, they receive nutritious food, institutional care, and transportation support after delivery.

It was observed that admitting expectant Tribal mothers in advance, who face difficulties accessing healthcare facilities due to remote locations and geographical barriers, can significantly improve the chances of a safe delivery under institutional care, thereby helping to reduce Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR). If a referral to a Comprehensive Emergency Obstetric and Newborn Care (CEmONC) centre is necessary, it can be arranged in a timely manner.

In 2008-09, the pilot project for Birth Waiting Rooms was initiated in two Primary Health Centres (PHCs) in Dharmapuri and Krishnagiri districts. Following the positive feedback from this trial, an additional 15 BWRs were set up in tribal and foothill PHCs in Tamil Nadu. During Financial year 2023-24, a total of 2836 mothers were benefitted through the scheme.

Referral Services in Tribal Districts:

The State has a well-established emergency referral system established through National Ambulance Services (NAS). In order to reach those tribal villages which are inaccessible by regular ambulances, four-wheel drive vehicles suitably equipped as ambulances have been provided in 14 identified points in tribal / hilly areas. These vehicles ensure timely referral during emergencies to higher referral centres and prevent adverse outcomes in the tribal community.

Tribal Bed Grant Scheme

Tribal Bed Grant is a scheme exclusively for Tribal people where the tribal patient avails the services like hospitalisation, free diagnostics, Drugs for IP, Surgery and Food in hospitals run by Non-Governmental Organisations (NGOs). The scheme is being operated through 2 DARPAN registered NGOs in the Nilgiris with a MOU between the DDHS and the NGO’s.

The scheme has increased the health seeking behaviour in the tribal community, access to quality health care has reduced Out of Pocket expenditure, improvement in the maternal and child health care of the tribal community and percentage of institutional deliveries has increased.

In the financial year 2023-24, a total of 1714 tribal people were benefitted through this scheme.

Tribal Counsellors

Tribal communities in general and primitive tribal groups in particular are highly disease prone. They do not have required access to basic health facilities. Their misery is compounded by cultural shyness, lack of education/awareness, poverty, illiteracy, ignorance of cause of diseases, hostile environment, poor sanitation, lack of drinking water etc.

Tribal counsellors who belong to the tribal community, have been placed in 10 Government Hospitals in the Tribal districts. They act as a link between health systems and tribal community. They also function as health activists in the institution where they not only create awareness on health but also motivate the community towards healthy living practices.

Sickle cell anaemia programme through Non-Government Organization’s

Sickle Cell Anaemia programme is being implemented by NHM-TN through Tribal NGOs in two districts i.e. the Nilgiris (Kothagiri, Gudalur and Coonor Blocks) and Coimbatore districts (Perinayankenpalayam and Karmadai blocks).

A regular screening followed by standard treatment and marriage counselling are provided in order to ease the burden of Sickle Cell Disease from tribal communities in the catchment areas. In the financial year 2023-24, a total of 2447 people were benefitted through this scheme.

Prevention and Control of Haemoglobinopathies:

Among the South Indian States, Tamil Nadu is the first state to implement Prevention and Control of Haemoglobinopathies program for early detection of Haemoglobinopathies like Sickle Cell Anaemia, Thalassemia among the tribal population.

The screening for Haemoglobinopathies (Sickle Cell Anaemia and Thalassemia) in adolescent children studying in 10th and 12th standard and unmarried school dropouts above the age of 14 is implemented in 30 selected tribal blocks in 14 Districts since November 2017. The programme is being implemented in Dharmapuri, Salem, Krishnagiri, Namakkal, The Nilgiris, Coimbatore, Tiruvannamalai, Kallakurichi, Vellore, Tirupathur, Tiruchirappalli, Dindugal, Erode and Kanyakumari districts. Since 2017, totally 1,23,993 Children (up to July 24) have been screened for the disease with a positivity rate of 8.2%.

In addition to the school screening programme, Ante Natal Mothers are also screened for Haemoglobinopathies in 30 tribal blocks and so far, 84,263 Ante Natal Mothers have been screened for this disease (Up to July 24).

Integrated Treatment Centres for Haemophilia & Haemoglobinopathies:

To provide continuum of care and services for children/adults affected with Haemophilia and Haemoglobinopathies, comprehensive Integrated Treatment Centres has been established at 10 Government Medical Colleges at regional level namely:

• Institute of Child Health and Hospital for Children, Chennai-8 (Nodal Centre)
• Government Mohan Kumara Mangalam Medical College Hospital, Salem
• Government Dharmapuri Medical College Hospital, Dharmapuri.
• Government Rajaji Hospital, Madurai.
• Government Theni Medical College Hospital, Theni.
• Government Vellore Medical College Hospital, Vellore.
• Government Annal Mahatma Gandhi Memorial Hospital, Tiruchirappalli.
• Government Kanyakumari Medical College Hospital, Asaripallam.
• Government Coimbatore Medical College Hospital, Coimbatore.
• Government Villupuram Medical College Hospital, Villupuram.

These centres are beneficial for the children/adults requiring frequent blood/factor transfusions and providing iron chelation therapy for transfusion dependent haemoglobinopathies. Since 2018, a total of 5,230 patients have received Blood transfusion and 7,032 patients have received factor transfusion through these centres.

Tribal Mobile Medical Units:

To augment the Mobile Outreach Services in tribal and hard to reach areas, in addition to regular MMUs, 20 Tribal Mobile Medical Units are being operationalized through Non-Governmental Organizations in tribal blocks of 14 Districts.

The Tribal Mobile Medical team comprises of one Medical Officer, Staff Nurse, Lab Technician and Driver and conducts minor ailment clinic, Antenatal screening, Non-Communicable Disease screening, lab tests and distributes free drugs.

In addition to the regular health provisioning, the team screens the children (in the age group of above 14 years) of 10th & 12th Standard Tribal & non-Tribal children and dropouts for Haemoglobinopathies traits. During the year 2023-24, these 20 MMU teams have conducted 12,190 camps and treated 4,79,701 patients in tribal villages.