Madankar Minal, Kakade Narendra, Basa Lohitha, Sabri Bushra
Tata Institute of Social Sciences, Mumbai, India.
School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Glob J Health Sci. 2024;16(2):31-47. doi: 10.5539/gjhs.v16n2p31. Epub 2024 Jan 4.
India experiences high rates of maternal and infant mortality and morbidity, with tribal communities disproportionately affected. Tribal populations frequently live in unfavorable socio-economic conditions and deficient social health indicators, culminating in adverse health consequences. Using a life course perspective, this qualitative study explored risks over the life course that contribute to maternal and child health problems among tribal populations in India. Additionally, the study examined barriers to utilization of healthcare services during the pregnancy and postpartum periods. Data collection occurred between 2017 and 2019 through participant observation, key informant interviews ( = 7) and in-depth interviews ( = 68) and a focus group ( = 7) with tribal women from the Madia-Gond tribe in the Indian state of Maharashtra. Additionally, verbal autopsies were conducted with relatives of three deceased women and five infants from the tribe. Multiple risk factors operating at different socio-ecological levels and developmental stages of life were associated with maternal and child health problems among the tribe. These included adherence to traditional harmful practices, limited access to nutritional diet, women's health neglected due to the double burden of domestic and professional labor, and a lack of accessible and well-equipped medical facilities. Inaccesibility stemmed from factors including extreme poverty, geographical isolation, and suboptimal healthcare infrastructure. There is need for provisions to promote access to care and to promote education and awareness centered on evidence-supported healthcare, particularly targeted towards expectant mothers. The implementation of nutritional support programs may help mitigate high maternal and child mortality and morbidity rates prevalent among tribal populations.
印度的孕产妇和婴儿死亡率及发病率很高，部落社区受到的影响尤为严重。部落人口经常生活在不利的社会经济条件下，社会健康指标不佳，最终导致不良的健康后果。本定性研究从生命历程的角度探讨了印度部落人口中导致孕产妇和儿童健康问题的生命历程风险。此外，该研究还调查了孕期和产后利用医疗服务的障碍。2017年至2019年期间，通过参与观察、关键 informant访谈（=7）、深入访谈（=68）以及与印度马哈拉施特拉邦马迪亚-贡德部落的部落妇女进行焦点小组访谈（=7）收集数据。此外，还对该部落三名已故妇女和五名婴儿的亲属进行了口头尸检。在部落中，不同社会生态层面和生命发展阶段存在的多种风险因素与孕产妇和儿童健康问题相关。这些因素包括坚持传统有害做法、获得营养饮食的机会有限、由于家庭和职业劳动的双重负担而忽视妇女健康，以及缺乏可及且设备完善的医疗设施。难以获得医疗服务源于极端贫困、地理隔离和医疗基础设施欠佳等因素。需要采取措施促进获得医疗服务，并促进以循证医疗为中心的教育和认识，特别是针对准妈妈。实施营养支持计划可能有助于降低部落人口中普遍存在的高孕产妇和儿童死亡率及发病率。
