The Tribal Health Initiative model for healthcare delivery: a clinical and epidemiological approach.
BACKGROUND
Tribal populations generally have poor health outcomes, often because of a healthcare delivery system that does not cater to their needs. This study evaluates a current healthcare model for tribals, and explores it in combination with the health status of the target population, placing emphasis on the long term sustainability and cross-implementation of the model.


METHODS
We examined the health system from the perspective of the base hospital, by concentrating on mortality patterns, inpatient incidence of selected infectious and non-infectious illnesses, and the preventive and curative health services administered by the hospital to the community.


RESULTS
Gender susceptibility patterns revealed disparities in anaemia and tuberculosis besides fluctuations in gastrointestinal disorders, tuberculosis and typhoid. A combination of gender- and age-susceptibility patterns revealed specific age intervals for mental health-related disorders. Mortality patterns indicated an Increase in youth deaths and suicide, with an overall reduction in infant mortality. However, an increased tribal confidence in allopathic medicine was noted after implementation of the health system.


CONCLUSIONS
The base tribal hospital is important in administering primary and secondary healthcare, health education, disease surveillance, community outreach and for continued confidence in allopathic medicine. Diet-based morbidities may be combated via organic farming and banning local alcohol production, while anaemia may be combated through continued iron, salt and folic acid supplementation to women. The formulation of mental health programmes and long term educational initiatives at the village level are critical to reducing suicide and infant mortality. Further epidemiological studies are required to gain a complete picture of health within the population, and successful implementation of the model elsewhere must factor in sociocultural disparities among tribes.
Prabhakar
Hari
H
Department of Public Health, The Johns Hopkins University, Baltimore, Maryland 21218, USA. Hari.Prabhakar@jhu.edu
Manoharan
Ravikumar
R
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000208:ethnology; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007226:Infant Mortality; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational