title: Improvement in health and empowerment of families as a result of watershed management in a tribal area in India - a qualitative study.
abstract: BACKGROUND
  Tribal people in India, as in other parts of the world, reside mostly in forests and/or hilly terrains. Water scarcity and health problems related to it are their prime concern. Watershed management can contribute to resolve their health related problems and can put them on a path of socio-economic development. Integrated management of land, water and biomass resources within a watershed, i.e. in an area or a region which contributes rainfall water to a river or lake, is referred to as watershed management. Watershed management includes soil and water conservation to create water resources, management of drinking water, improving hygiene and sanitation, plantation of trees, improving agriculture, formation of self-help groups and proper utilisation and management of available natural resources. For successful implementation of such a solution, understanding of perceptions of the tribal community members with regard to public health and socioeconomic implications of watershed management is essential.
  
  
  METHODS
  A qualitative study with six focus group discussions (FGDs), three each separately for men and women, was conducted among tribal community members of the Maharashtra state of India. The data collected from the FGDs were analyzed using manifest and latent content analysis.
  
  
  RESULTS
  "Improvement in health and empowerment of families as a result of watershed management" was identified as the main theme. Participants perceived that their health problems and socio-economic development are directly and/or indirectly dependent upon water availability. They further perceived that watershed management could directly or indirectly result in reduction of their public health related challenges like waterborne diseases, seasonal migration, alcoholism, intimate partner violence, as well as drudgery of women and may enhance overall empowerment of families through agricultural development.
  
  
  CONCLUSIONS
  Tribal people perceived that water scarcity is the main reason for their physical, mental and social health problems and a major obstacle for their overall development. The perceptions of tribal participants indicate that infectious diseases, migration, alcoholism, intimate partner violence and drudgery of women are end results of water scarcity and efforts to increase water availability through watershed management may help them to achieve their right to health which is embedded in their right to access to water.
authors.affiliation: Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18 A, SE 171 77, Stockholm, Sweden. san_ner@rediffmail.com.
authors.forename: Sandeep S
authors.initials: SS
authors.lastname: Nerkar
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Tamhankar
authors.forename: Eva
authors.initials: E
authors.lastname: Johansson
authors.forename: Cecilia Stålsby
authors.initials: CS
authors.lastname: Lundborg
mesh_terms: D000293:Adolescent; D000328:Adult; D000383:Agriculture; D003247:Conservation of Natural Resources / Q000379:methods*; D003469:Culture; D005006:Ethnicity; D005260:Female; D017144:Focus Groups; D005618:Fresh Water; D006304:Health Status; D006801:Humans; D006920:Hygiene; D007194:India; D008297:Male; D008875:Middle Aged; D011209:Power, Psychological; D011634:Public Health; D036301:Qualitative Research; D012424:Rural Population; D012499:Sanitation; D012657:Self-Help Groups; D012923:Social Class; D014881:Water Supply / Q000592:standards*; D055815:Young Adult