A study of the health status needs and access of the nomadic tribes of Jammu and Kashmir

While tribal communities, in general, are widely disadvantaged in terms of health status and access, nomadic tribal communities face special problems in accessing healthcare because of their mobility or transhumance. They also have highly constrained healthcare access because of the severe remoteness of the locations they migrate to during certain months of the year. 

The Gujjars and the Bakharwals are the largest and second-largest nomadic tribes in Jammu Kashmir. These tribes are widely pastoral in their occupation and lifestyle, have been affected by marginalization in various forms such as social discrimination and political isolation, and have also been found to reside in extremely poor socio-economic conditions (Ganie et al., 2020). The conflict-prone nature of the areas where these tribes reside and move complicates their health access. 

There is also a lack of systematic health surveillance data available on these groups because of their transhumance (Verma, Gandhi & Dash, 2019). The study by Verma, Gandhi & Dash (2019) has shown that these communities, when living in the higher pastures, have serious problems with access to public and private providers, because of which they often rely on traditional healers. As this study argues, the cultural beliefs of these communities also predispose them towards seeking care from traditional healers.

The Govt of J&K has been attempting to address the health access of these mobile communities through measures such as the provision of MMUs for their benefit, and provision of one ASHA per 250 persons in the Dhoks (temporary settlements). Evidence on the health status, needs, social determinants, and healthcare access of these communities, gathered through a systematic and comprehensive approach, is expected to be beneficial to the authorities for future planning and implementation of healthcare measures for the benefit of these communities.

1.  To understand the demographic profile of the nomadic tribes of J&K and their patterns of mobility and settlement
2. To assess the health status of the nomadic tribes of J&K (in terms of major health indicators) and the health needs of the nomadic tribes of J&K
3. To understand the status of social determinants of health among the nomadic tribes and the healthcare-related beliefs, customs, habits, and traditional practices among them
4. To assess the access of nomadic tribes of J&K to health care facilities, including from a gender perspective
5. To understand the healthcare-seeking behaviour and provider choice of the nomadic tribes of J&K, and the demand-side and supply-side factors that shape the communities’ utilization of public health facilities.

Over the past months, the project has achieved significant milestones, furthering our understanding of the healthcare needs of this marginalized community.

1. Data Collection Completion: The project has successfully completed both qualitative and quantitative data collection processes. This crucial phase allowed us to gather comprehensive information about the healthcare practices, challenges, and requirements of the Bakarwal community. The data collected will serve as a foundation for informed decision-making and targeted interventions.

2. Interim Report Submission: We have submitted an interim report to the World Health Organization (WHO) team, providing an overview of our findings, key observations, and preliminary recommendations. This report marks an important step in sharing our progress and insights with our partners and stakeholders.

Ongoing Activities:

1. Project Wrap-up: We are currently in the process of wrapping up the project, including the analysis of the data collected, consolidating findings, and reviewing our research methodologies. This phase is crucial in ensuring that we draw meaningful conclusions from the project's outcomes.

2. Preparation for Final Report: Simultaneously, we have initiated the planning and preparation of the final project report. This comprehensive document will encompass the entirety of our research, from data collection to analysis, and will provide detailed recommendations for healthcare interventions that can benefit the Bakarwal community.

Our commitment to fostering positive change in underserved communities remains unwavering, and we look forward to sharing our final report, which will outline actionable steps toward better health outcomes for the Bakarwal community.