IMPACT ON HEALTH SEEKING BEHAVIOUR OF TRIBAL WOMEN IN VILLUPURAM DISTRICT, TAMILNADU J. Jayaprakash* Ph. D research scholar Department of Economics, Annamalai University, Annamalai Nagar, Tamil Nadu. Dr. R. Saravanan** Assistant Professor Department of Economics, Annamalai University, Annamalai Nagar, Tamil Nadu. ABSTRACT Status of women is generally measured using three indicators education, employment and introhousehold decision-making power. Health status of tribal women in India very poor, deficient in sanitary conditions, personal hygiene, health education. Tribal mothers have high rate of anemia and inadequate food intake. The study aims to explore the knowledge, practices and attitudes of the tribal concerning their health and examine the availability of services of health care services. Methodology, totally respondents will be selected from the 6 villages in villupuram district. The sampling of the study is said to be stratified random sampling. The study highlighted the need to improve the status of tribal women. Lack of knowledge regarding the tribal women problems or morbidities and fear to express them is a major cause of high prevalence. The use of modern allopathic treatment was also resorted to and the tribal women were not averse to it. Key words: tribal women, Health care services, hygiene practice, www.apjor.com Page 19
Introduction Tribal populations in particular, have their own beliefs and practices regarding health. Some tribal groups still believe that a disease is always caused by hostile spirits or by the breach of some taboo. They therefore seek remedies through magic & religious practices. On the other hand, some rural people have continued to follow rich, undocumented, traditional medicine systems, in addition to the recognized cultural systems of medicine such ayurveda, unani, siddha and naturopathy to maintain positive health and to prevent disease. However the socioeconomic, cultural and political onslaughts, arising partly from the erratic exploitation of human and material resources, have endangered the naturally healthy environment (e.g. access to healthy and nutritious food, clean air and water, nutritious vegetation, healthy life styles, and advantageous value systems and community harmony). The basic nature of rural health problems is attributed also to lack of health literature and health consciousness, poor maternal and child health services and occupational hazards. In tribal societies, the system of cure is not only based on magico-religious means but also on treatment with different herbs and plants. Tribal societies have developed their own medicine system and some rudimentary knowledge base of medical techniques including the diagnosis of the disease at individual level. Both these techniques i.e. magico-religious and herbal medicine are used to cure the sick either together or separately. People have knowledge about the plants in their surroundings and also attribute cultural beliefs and practices to the plants. The tribal women constitute like any other social group, about half of the total population. However the health of tribal women is more important because tribal women work harder and family economy and management depends on them. The health status of the tribal population in general are also applicable to tribal women more so. The health of scheduled tribes populations continue to carry high burdens of diseases of the poor, namely under nutritions and infections diseases. High levels of chronic under nutrition have been observed among child and women populations. Micronutrient malnutrition is also a major problem among tribal women including anaemia and iodine deficiency disorders. Tribals face a number of risks of illhealth including high rates of poverty, illiteracy, harsh living environments, high rates of smoking and alcohol use and poor access to health care. The tribal areas of concentration in India are traditionally isolated, underdeveloped and are increasingly affected by development processes (Ahmed, 1985). There is a general agreement that the health status of the tribal women in India is very poor, deficient in sanitary conditions, personal hygiene, and health education (Basu, 1994). Tribal communities in general and primitive tribal groups in particular are highly disease prone. Also they do not have required access to basic health facilities. Health status of tribal mothers have high rates of anemia, and girl children receive less than the desired nutritional intake. All told, the whole tribal community is deficient in adequate food intake. Health seeking behaviour refers to any action that has significant impact on health. Therefore, any action taken by an ill individual that is intended to change or improve the healthy condition is considered a health seeking behavior. (Ahmed, Adms, chowdhury and Bhhuiya,2003). The health culture of tribal women belonging to the poorest strata of society is highly desirable and essential to determine their access to different health services available in a social set up. Health care is one of the most important of all human endeavors to improve the quality of life especially of the tribal people (Balgir 2005). It implies the provision of conditions for normal, physical and mental development and functioning of human being individually as well as in a group. The extent of knowledge and practice of family planning was also found to be low among the Scheduled Tribes (Kanitkar and Sinha, 1988). There is a need for proper understanding of the different health aspects of tribal women and their specific health needs so that relevant health measures can be prepared and implemented. Anthropologists indicate that traditional medicines do exist and persist even though the health consumer has now access to western medicine. There is a need to scientifically study the traditional tribal www.apjor.com Page 20
medicine and healing systems and combine them with modern allopathic system so as to make it available and affordable for the poor tribal population. Objective 1. To find out the knowledge, practices and attitudes of the tribal women concerning their health. 2. To study the availability of health care services. Methodology The collection of primary data from the selected tribal women in villupuram district, Tamilnadu structured interview schedule was used. From each village 20 respondents will be selected as sample. Totally respondents will be selected from the 6 villages in villupuram district. Thus the sampling of the study is said to be stratified random sampling. Sl.No Table-1.1 Distribution of causes of morbidity among the tribal women Morbidity pattern 1. dizziness 2. Scabies 3. Light headless 4. Thyroid disorder 5. Tuberculosis 6. Gastroenteritis 7. 8. Respirator infection Whooping cough 9 Goiter 10 Anaemia 11. Weakness due to sterilization Never Rare Occasionally Regular Constant Total 26 (21.7) 28 (23.3) 45 (37.5) 36 (30) 40 (33.3) 18 (15) 37 (30.8) 26 (21.7) 36 (30) 22 (18.3) 20 (.7) 13 (10.8) 28 (23.3) 32 (26.7) 32 (26.7) 34 (28.3) 30 (25) 30 (25) 29 (24.2) 46 (38.3) 30 (25) 22 (18.3) 25 (20.8) 20 (.7) 44 (36.6) 31 (25.8) 21 (17.5) 28 (23.3) Source: Computed from primary data Note: Figures in the parentheses are percentage Columns total. 27 (22.5) 23 (19.2) 18 (15) 17 (14.2) 15 (.5) 18 (15) 23 (19.2) 13 (10.8) 33 (27.5) 20 (.7) 22 (18.3) 19 (15.8) 31 (25.8) 8 (6.7) 10 (8.3) 23 (19.2) 5 (4.2) 38 (31.7) The table 1.1 shows that indicates the morbidity pattern wise respondent. It could be noted that out of the total respondent. Dizziness rare level 30 percent respondents and dizziness never 13.3 percent low level respondents. High level Scabies of occasionally 24.2 percent and low level scabies of constant 13.3 percent of respondents. High level Light headless occasionally 38.3 percent and 10 percent level never low level light headless respondents. Thyroid disorder high level respondent constant 25.8 percent and 10.8 percent thyroid disorder low level rare respondents and tuberculosis high level respondents 37.5 percent never and 6.7 www.apjor.com Page 21
percent respondent tuberculosis constant of respondents. High level Gastroenteritis 30 percent respondent never and low level gastroenteritis 10 percent respondents constant. Respirator infection high level respondent 33.3 percent never and respirator infection low level respondent 8.3 percent constant. High level whooping cough morbidity pattern for 36.7 percent occasionally status and low level whooping cough morbidity pattern of 10 percent rare respondents and goiter of high level respondents never 30.8 percent and low level goiter 4.2 percent respondents constant. Anaemia high level respondents 31.7 percent constant and low level anaemia status of never 10 percent respondents and weakness due to sterilization of rare level respondents 30 percent and 13.3 percent of weakness due to sterilization respondents constant. Table 1.2. Domestic sanitation practices and environmental sanitation practices of respondents Sl. No Domestic sanitation practices Yes No Total 1. Cleaning latrines and using 44 76 sanitary latrines (36.7) (63.3) 2. Safe disposal of infant excreta 79 41 (65.8) (34.2) 3. Proper washing and protection of 68 52 utensils (56.7) (43.3) 4. Proper leaning of house floor and 62 58 wall (51.7) (48.3) 5. Proper washing rooms and home 67 53 environment (55.8) (44.2) 6. Proper removal of dust and debris 68 52 from the household (56.7) (43.3) Environmental sanitation practices 1. Compost pit to remove cow dung 72 48 (60) (40) 2. Household keeping drains clean 56 64 (46.7) (53.3) 3. Water logging around the 64 56 household (53.3) (46.7) 4. Proper disposal of soild waste 59 61 from the street (49.2) (50.8) 5. Proper disposal of polluted water 83 37 around houshold (69.2) (30.8) Source: Computed from primary data Note: Figures in the parentheses are percentage Columns total. Table 1.2. shows that Indicate the respondents domestic sanitation practices. It could be noted that majority of the tribal women respondents 63.3 percent stated that they domestic sanitation practices of do not have following cleaning latrines and using sanitary latrines 36.7 percent of using cleaning latrines and using sanitary latrines and majority of the tribal women 65.8 percent stated that they domestic sanitation practices of following safe disposal of infant excreta and 34.2 percent of among the tribal women respondents following do not have following safe disposal of infant excreta. Almost 56.7 percent of the tribal women respondents have following proper washing and protection of utensils and 43.3 percent among the respondent tribal women respondent in not have following proper washing and protection of utensils in domestic sanitation practices. It could be noted that of the respondents majority of the 51.7 per cent respondent tribal www.apjor.com Page 22
women respondent have following proper cleaning of house floor and wall domestic sanitation practices and 48.3 percent among the tribal women respondent not have following proper cleaning of house floor and wall in primary level educated tribal women in study area. Almost 55.8 percent of tribal women respondents have following proper washing rooms and home environment in domestic sanitation practices and 44.2 percent among the tribal women respondent do not have following proper washing rooms and home environment in domestic sanitation practices. It could be noted that 43.3 percent tribal women respondents domestic sanitation practices of do not have following proper removal of dust and debris from the household and 56.7 per cent of the tribal women respondents have following proper removal of dust and debris from the household. It could be noted that out of the total respondents majority of the tribal women 60 percent stated that they environmental sanitation practices of following compost pit to remove cow dung and 40 percent of among the tribal women respondents following do not have following compost pit to remove cow dung. The majority of the 53.3 per cent among the tribal women respondents environmental sanitation practices have following household keeping drains clean and 46.7 percent do not have following household keeping drains clean in tribal women respondents. Almost 46.7 percent among the tribal women respondent not have following water logging around the household and 53.3 percent tribal women respondents do not have following water logging around the household in environmental sanitation practices. The majority of the tribal women 50.8 per cent stated that have following proper disposal of soild waste from the street and 49.2 per cent tribal women respondent do not have following proper disposal of soild waste from the street in study area. It could be noted that 69.2 percent of tribal women have following proper disposal of polluted water around household and remaining 30.8 per cent tribal women respondent do not have following proper disposal of polluted water around household in environmental sanitation practices. Sl. NO 1. Table -1.3. Distribution of place of treatment Treatment of Place Government Hospital Health care your places Respond entsl.no. Percentage 22 18.3 2. PHC 43 35.8 3 Private Hospital 13 10.8 4. Ayurvedic 11 9.2 5. Siddha 15.5 6. Reliable practices 9 7.5 7. Any other specify 7 5.8 Total 100 Source: Computed from primary data Note: Figures in the parentheses are percentage Columns total. The table 1.3 shows that the distribution of place of treatment of sample respondent. Among the total respondents 18.3 percent of respondents belong to the government hospital and 35.8 percent of respondents belong to the PHC distribution of place of treatment. Private hospital belong to the 10.8 percent of respondent www.apjor.com Page 23
and 9.2 percent of respondents belong to the ayurvedic health care services and.5 percent of respondents belong to the siddha medicine health care services and 7.5 percent of respondents belong to the reliable practices of health care services methods and the lost any other specify 5.8 percent of respondents health care services. Findings Distribution of morbidity among the tribal women tuberculosis morbidity patter 37.5 percent never position highest tuberculosis and dizziness morbidity pattern 30 percent rare position highest dizziness and light headless and whooping cough morbidity patter 38.3 percent and 36.7 percent occasionally position highest. Anemia morbidity pattern 27.5 percent regular position highest anemia and constant position highest thyroid disorder morbidity patter 25.8 percent. Domestic sanitation practices methods using highest respondent following for 65.8 percent of safe disposal of infant excreta domestic sanitation practices methods and domestic sanitation practices methods do not have using for 63.3 percent cleaning latrines. Environmental sanitation practices method for highest respondent using for 69.2 percent proper disposal of polluted water around household and household keeping drains clean environmental sanitation practices methods do not have using highest for 53.3 percent. Distribution of place of respondents treatment of tribal women high level using for health care services in places of PHC 35.8 percent and low level using for health care services in places of respondent any other specify 5.8 percent. Conclusion It is clear that there should be an urgency to improve the health care services a well health providers for better treatment and accessibility in the remote areas of the country. Lack of knowledge regarding the tribal women problems or morbidities and fear to express them is a major cause of high prevalence. The use of modern allopathic treatment was also resorted to and the tribal women were not averse to it. However, it is found that in the tribal society whatever are the shortcomings of the medication. References 1. Balgir RS. (2004) Dimensions of rural tribal health nutritional status of kondh tribe and tribal welfare in Orissa: a bitotechnological approach. Proceedings of the UGC sponsored conference on human and Nutrition: A biotechnological approach, pp.47-57. 2. Balgir RS. 2000a. Human genetics, health and tribal development in Orissa. In: P Dash Sharma (Ed.). Environment, Health and Development: An Anthropological Perspective. Ranchi: S.C.Roy Institute of Anthropological Studies. pp. 87-104. 3. Balgir RS. 2004a. Dimensions of rural tribal health, nutritional status of Kondh tribe and tribal welfare in Orissa: a biotechnological approach. Proceedings of the UGC Sponsored National Conference on Human Health and Nutrition: A Biotechnological Approach (Lead Lecture), -13th December 2004. Thane. pp. 47-57. 4. Basu and Kshatriya (1993). Demographic features and health care practices in Dudh Kharia Tribal population of Sundergarth district Orissa. 5. Basu, S.K. (1992) Health and culture among the underprivileged groups in India (In) State of India'a Health (ed. Alok Mukhopadhyay). Voluntary Health Association of India pp. 175-186. www.apjor.com Page 24
6. Basu, S.K. (1994)A health profile of tribal India, Health For The Millions. April 2(2):-4. 7. Chaudhuri, Buddhadeb (1 990). Social and environmental dimensions of tribal health (In) Cultural and environmental dimensions of health (ed. by B. Chaudhuri. Inter-India Publications). 8. Christman. N.J. (1980) the health seeking process: An approach to the natural history of illness. Culture, medicine and psychiatry, 1(4):351-377. 9. Gangadharan. K,Vinesh Kumar.K.V. (2015) Reproductive health complications among tribal women and their health seeking behavior Kerala perspectives International Journal of Contemporary Research in Social Science,Vol. 1, Issue.4. 10. Kanitkar T and R. K. Sinha. (1988). A Report on Demographic Study of Tribal Population in Santhal Pargana in Bihar and Phulbani and Kalahandi Districts in Orissa, Bombay. India, Mumbai: International Institute for Population Sciences. PP.37-46. 11. Mahapatro.M and Kalla A.K. (2000) Heallth seeking behaviour in a tribal setting health and population 23(4):0-9.. Sadiq.H and Muynck. A. (2001) Health care seeking behavior of pulmonary tuberculosis patients visiting TB center rawlpindii Journal Pakistan medical association, 51(1):10-. 13. Syed Azizur rahman, Tara kielmann, Barbara Mcpake, Charies Normand (20) Health care seeking behaviour among the tribal people of banglades can the current health sutem really meet their needs Journal health population Nutrition, 30(3),pp.353-365. www.apjor.com Page 25