2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Tribal communities in India experience poorer health outcomes than other population sub-groups. Supply-side barriers - both in the form of water, sanitation, and hygiene (WASH) amenities necessary for healthy living as well as public healthcare facilities for preventive and curative care - are well-documented. However, systematic examinations of these constraints have remained narrow, often lacking either a comprehensive range of indicators or the geographic granularity required to capture local-level disparities. This study addresses this critical gap in the literature by conducting a granular, village-level examination of health and WASH infrastructure deprivation across five Indian states with dominant tribal population. The study compares the deprivation across districts that are fully covered, partially covered, and not covered under Schedule V of the Indian Constitution, which deals with the management and administration of Scheduled Areas and S Tribes.  Utilizing a 12-indicator index constructed based on data from village-level infrastructure and amenities survey for the year 2022-23 (Mission Antodaya Survey), the research moves beyond aggregated national reports to identify localized supply-side bottlenecks. The analysis yields some nuanced findings. Tribal districts are not universally worse off than non-tribal areas, but they experience higher internal inequality. While fully covered Schedule V districts exhibit significantly higher deprivation, partially covered districts outperformed non-tribal districts in certain states. Based on multi-level modelling, the largest variation in the deprivation index is attributable to the gram panchayat level across all states, making GPs as the primary site of delivery success or failure. Evidence of highly deprived village clusters justifies a multilevel approach to intervention. Given India's decentralized structure, these results empower Panchayats to target specific amenities at the grassroots level to mitigate caste-based health inequalities.