Tribals in India Still Struggle for Basic Healthcare

IndiaSpend Analysis Shows Poor Access, High Mortality, Rising Diseases

March 7, 2025

The health outcomes of India’s tribal populations lag behind the national average, according to an IndiaSpend analysis of government data. More tribal children die in early childhood, and many of those who survive suffer from malnutrition.

India’s Scheduled Tribes (STs) account for 8.6% of the country’s total population, or about 104 million people, according to the 2011 Census. The tribal population lives mostly in Madhya Pradesh, Maharashtra, Odisha, Rajasthan, Chhattisgarh, Jharkhand and in the northeastern states like Mizoram, Nagaland, Meghalaya, Arunachal Pradesh, Manipur, Assam and Tripura.

For its analysis, IndiaSpend looked at health data from the National Family Health Surveys (2015-16 and 2019-21) and found improvements but persistent disparities.

It found that registered pregnancies among tribals rose to 94.3%, surpassing the national rate, and institutional deliveries increased from 68% to 82.3%. However, fewer tribal births are attended by doctors, and antenatal care remains below national levels, it said.

Child mortality has declined but remains higher among tribals, with one in 20 dying before age five compared to one in 25 nationally, according to the data, which also showed that neonatal mortality among tribals fell from 31.3 to 28.8 deaths per 1,000 live births, yet it remained above the national average of 24.9.

Immunisation rates among tribal children have improved, reaching near parity with national figures. However, malnutrition remains a concern, with stunting among tribal children at 40.9%—higher than the national average of 35.5%.

Anaemia is also rising, according to the data, affecting 64.6% of tribal women compared to 57% nationally. Anaemia, which results from iron deficiency and other factors, leads to fatigue, weakness, and complications in pregnancy. Cultural misconceptions contribute to the problem, as many tribal women avoid taking iron supplements due to fears of side effects.

Non-communicable diseases, including hypertension and high blood sugar, are rising among tribals, said the analysis. Studies in states such as Kerala and Tamil Nadu show increasing rates of hypertension, while stroke prevalence is high in some tribal communities, it added. Dietary shifts from traditional foods to processed staples like polished rice are contributing to health problems such as obesity and diabetes, it suggested.

Healthcare in tribal regions is hindered by poor infrastructure, inadequate transport, and shortages of medical personnel. Many healthcare workers avoid tribal postings due to poor working conditions, lack of career opportunities, and weak financial incentives. Despite measures such as higher salaries and compulsory rural service bonds, the shortage of doctors and nurses in tribal areas remains unresolved.

Many tribal communities live far from healthcare facilities, with some travelling up to 80 km to reach a district health centre, according to the analysis. The national average distance to a community health centre is 13.55 km, but for tribals, it is often much higher. Poor roads, unreliable transport, and language barriers further limit access.

Inadequate healthcare staffing and poor infrastructure mean that many tribal patients receive substandard or delayed care. Reports suggest that doctors, nurses, and other health workers are often missing, ill-trained, or unwilling to work in these areas, which are seen as punishment postings.

Without urgent policy interventions, these gaps in tribal healthcare access will continue to persist, warned IndiaSpend.