Under-five mortality exhibits uneven distribution, incurring heavy toll among tribal population compared to non-tribal population in India. This necessitates the persistent need for research on tribe-specific indicators of child mortality and life expectancy in India. In this context, Verma, et al. [1] provided tribe-specific estimates of infant mortality rate (IMR), under-five mortality rate (U5MR) and expectation of life at birth (LEB) for 123 tribes in India using Census 2011 data. As is evident from the study, majority of selected tribes depicted higher IMR and U5MR than the national average and the total scheduled tribe (ST) population. The study not only highlighted immense difference in these estimates among tribal and non-tribal population, but also the differences in the estimates among tribes residing in different states and even within the same state.

The above findings are critical with respect to availability of maternal and child health care services and the sporadic success of related government flagship programs in achieving universal health coverage in tribal areas. Although the study acknowledges the need to develop programs to reduce the gap in child mortality and life expectancy within tribal population and between tribal and non-tribal populations, but it left scope for many unaddressed questions. It is important to explore the factors underpinning such huge gap in the indicators of child mortality and life expectancy among tribal and non-tribal populations in India.

Socio-cultural, economic and environmental factors varying across states and social groups play a critical role in uneven distribution of child mortality and life expectancy between tribal and non-tribal populations and even within tribal population. Although various government programs and policies have been implemented to curb infant and childhood mortality and improve the maternal and child health (MCH) status, but these do not exhibit uniform improvement across all sections of society [2]. The investigators of the present study used Census 2011 data, which is about a decade old, and may not characterize currently prevailing conditions in tribal communities. In addition, the authors have also highlighted the limitations of the indirect method used to estimate IMR, U5MR and LEB.

Nevertheless, the present research has an added value in the absence of any other tribe-specific data source and estimates. The study opens the door for further research to explore disparities among tribal groups in health-seeking behavior so as to address differences in child mortality and life expectancy. Cultural acknowledgement, economic improvement and political empowerment are utmost crucial to address these disparities [3]. The inherent diverse nature of tribal population in India necessitates tribe-specific data. It is important to involve tribal people in the development of the tribe-specific data so as to ensure that indigenous values, beliefs, and notions related to health and wellbeing are captured effectively in the data system [4]. There is a need for ensuring ‘pro-culture’ tribe-specific action plans to address the disparities in child mortality rates and life expectancy among tribal communities.

1. Verma A, Sharma RK, Saha KB. Diversity in child mortality and life expectancy at birth among major tribes in selected states of India. Indian Pediatr. 2020: S097475591600252. [Epub ahead of print]

2. Vishwakarma M, Shekhar C, Dutta M, Yadav A. Gaps in infant and child mortality among social groups and its linkages with institutional delivery and child immunization using census and National Family Health Survey (2015- 16). J Public Health. 2020;28:293-303.

3. Kirmayer LJ, Brass G. Addressing global health disparities among indigenous peoples. Lancet. 2016;388:105.

4. Anderson I, Robson B, Connolly M, et al. Indigenous and tribal peoples’ health (The Lancet–Lowitja Institute Global Collaboration): A population study. Lancet. 2016;388: 131-57.