KOCHI: Tribals, who have been living on the fringes of modern society for ages, are off late being actively encouraged to join the mainstream. Even as a number of NGOs and Governmental agencies have been reaching out to them with new avenues in education, jobs and healthcare, recent studies have shown that much is left to be done in this direction.
A recent community-based study conducted among tribal women in Northern Kerala revealed that only 26.4 percent of the indigenous women in the reproductive age group used contraceptives. A majority of these use permanent methods of contraception. Also, women in the community prefer traditional practices for contraception over modern methods.
The pattern of contraceptive use among tribal women in Kerala was mainly studied in two communities in Kalpetta/Vythiri and Mananthavady in Wayanad district. 2495 tribal women, mainly from Paniya, Kurichiyar and Adiya tribes, in the age-group (15-49 years) participated. According to the 2011 census, the total population of tribal origin in the two community development blocks (Kalpetta/Vythiri-Manathavady) was 46,598.
“The objective was to assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills, and fertility intentions among tribal women in the reproductive age group. Earlier, there were reports of oral contraceptives widely being used in the tribal hamlets of Idukki. We wanted to analyse through the study whether any such practice was prevalent here as well. We found that use of oral contraceptives is way less here in these communities,” said Dr Aswathy S, Professor, Department of Community Medicine, Amrita Institute of Medical Sciences, who along with her team conducted the study.
The very low rate of education amongst the tribes makes them vulnerable to low contraceptive usage. “The primary objective was to assess the prevalence of contraceptive use and its determinants. The secondary purpose was to assess knowledge of contraceptives in general, oral contraceptives and fertility intentions. Though the use of contraceptives was less among the tribes, there is no significant increase in the family size. It was also noted that rather than relying on modern techniques, they used traditional methods of contraceptives,” said Dr Aswathy. The study conducted in 2019, was recently published in an International journal.
Earlier, a microlevel study conducted among Adiya and Kattunayakan tribes in Kerala found low contraceptive usage and high unmet need for family planning at 68% and 62% respectively. The healthcare services that women have used to access contraception include district hospitals, health centres, health workers and medical shops. Other than the medical shops, all services are free of cost.
“We are planning to carry out more studies on the traditional methods used by the tribals. The Valapuras--the homes in which the women are supposed to stay during the menstrual period--have now become a room in the house itself rather than outside, where they used to stay away from the family. Healthcare services should be strengthened by the state government. They should be able to respect the existing culture among them and usher in a change,” said Dr Aswathy.