MUMBAI: Despite significant improvements in tribal health indicators, a state-level committee has warned that Maharashtra’s tribal communities continue to lag behind the state’s overall population on key health outcomes. Gaps in last-mile delivery, healthcare personnel, data, nutrition, and access to emergency care require a fundamental overhaul.
The ‘State Committee Report on Strengthening Tribal Health in Maharashtra’, submitted to the state health department, recommends that the state create a separate tribal health system for these communities.
The committee has called for anaemia to be tackled through a broader nutrition strategy rather than iron supplementation alone. The centres would integrate information across health programmes and track patients through referrals instead of leaving families to navigate the system themselves. The committee notes that while pregnancies are registered, high-risk cases may not be consistently followed up and referrals may not be completed. The report recommends ‘health enabling infrastructure’ be improved in tribal areas, which are often remote. This includes the construction of all‐weather roads, footbridges over rivers, and mobile network expansion. A major recommendation is to create a Tribal Disaggregated Public Health Dataset that tracks health indicators down to the block, village and pada levels. It has proposed that the Tribal Health Cell publish the state’s first comprehensive Tribal Health Report within one year and progressively digitise antenatal, postnatal, child-health and disease-surveillance records with tribal identifiers. The proposed Tribal Health Dashboard would allow frontline workers to identify children due for vaccination, pregnant women nearing delivery, adolescents flagged for anaemia and families returning from seasonal migration. At the state level, the system could also be used to detect emerging disease risks, including potential malaria outbreaks.
The committee has proposed Health Action Centres to tackle a critical weakness in the existing system—poor follow-up of high-risk pregnancies and children, while referring to district‐level NFHS‐5 data shows that tribal‐dominant districts in Maharashtra consistently report poorer perinatal outcomes. The committee recommends a substantial increase in health’s share of the Tribal Sub-Plan, recommending that 12-15% of TSP resources be earmarked for health. In 2018-19, the state health department received only 3% of the ₹ 255 crore under the Tribal Sub-Plan. It has proposed a 12-15% allocation, which would translate into ₹ 1,100-1,500 crore annually based on current TSP outlays.
It says no village should be unreachable. The committee says district-level averages can mask severe disparities in mixed-population districts.
It also recommends point-of-care haemoglobin testing to enable earlier detection and treatment closer to tribal communities.
