A comprehensive assessment of health indicators among tribal populations in Odisha, India (Odisha Tribal Family Health Survey): a community-based, cross-sectional study

Abstract

Background: Indigenous tribal communities in the state of Odisha, eastern India, face persistent health disparities driven by socio-economic marginalisation, geographical isolation, and limited healthcare access. The Odisha Tribal Family Health Survey (OTFHS) aimed to comprehensively assess the health status, socio-demographic characteristics, and healthcare utilisation patterns of Odisha's tribal populations.

Methods: A community-based survey was conducted between July 2022 and July 2023, covering 9711 households across 389 clusters in 14 tribal-dominated districts in Odisha. The study included 30,292 participants from 53 notified tribal groups. The study included participants of all age groups (from neonates to the elderly, aged 0 years and above), with 56% of the sample comprising females. Individuals belonging to one of the notified tribes who were permanent residents and provided written consent were included, while bedridden individuals and those with recognisable cognitive impairments were excluded. Data collection involved the use of structured tools at the household and individual levels, anthropometric measurements, point-of-care tests (including blood pressure, random blood glucose, and haemoglobin levels, as well as haemoglobinopathy screening), and laboratory analyses of blood serum samples (for liver function, kidney function, and lipid and iron profiles).

Findings: OTFHS revealed that 88.0% of children aged 12-23 months were fully vaccinated and over 40% of children younger than five years were stunted or underweight. Anaemia affected 71.3% of children aged 6-59 months, with prevalence remaining high among adolescents (76.1% of females, 56.9% of males) and adults (77.5% of women, 42.1% of men). 93.0% of women had bank accounts and 91.4% of births occurred in healthcare facilities. Gaps persisted in antenatal care (40.3% completed four or more visits) and hygienic menstrual practices (35.8% of women).

Interpretation: OTFHS offers crucial disaggregated data, guiding targeted health improvements and policy reforms essential for bridging health equity gaps. The specific focus on Indigenous populations and a broader look at the social determinants alongside health indicators reflect the multi-dimensional nature of healthcare interventions needed for vulnerable groups.

Funding: Scheduled Castes and Scheduled Tribes Research and Training Institute (SCSTRTI), Odisha, India.

Keywords: Anaemia; Chronic diseases; Indigenous health; Malnutrition; OTFHS; Odisha; Odisha Tribal Family Health Survey; Public healthcare; Scheduled tribes; Women’s empowerment.

Fig. 1

Study flow diagram for participant recruitment.

Fig. 2

Village and household-level access to health and social services among Indigenous tribes of Odisha.

Fig. 3

Nutritional profile of the 53 Indigenous tribes in Odisha.

Fig. 4

Average self-rated health among 53 Indigenous tribes in Odisha.