 | Prashanth Nuggehalli Srinivas Faculty & Wellcome Trust/DBT India Alliance Fellow - Institute of Public Health, Bangalore Medicine, Sociology, Epidemiology |
-
03.09.2024-27.09.2024
Towards Health Equity and transformative action on tribal health (THETA)
The THETA project is being implemented by the Institute of Public Health, Bengaluru along with collaborators from the local community-based organisation of the Soliga people, local NGOs and other researchers. India's tribal population lives largely in and around thickly forested areas, which are often difficult-to-reach. Most areas with high tribal populations also have poor health and nutrition indicators. However, the poor population health outcomes in tribal communities cannot be explained by geography alone. Social determinants of health, especially various social disadvantages compound the problem of access and utilization of health services and achieving good health and nutritional status. In the interest of achieving equitable health and universal health coverage, we need to better understand the reasons for poor health among tribal populations and generate scientific explanations for the drivers of health inequalities in tribal communities. This will help design and implement evidence-based and context-specific interventions to address health inequalities of tribal populations. In THETA project, we shall (1) describe and analyse the extent and patterns of health inequalities among forest-dwelling tribal communities in three major tribal regions; (2) use realist inquiry to explain the underlying reasons for health inequity among tribal communities through a contextualized and empirically validated theory; (3) design and pilot an intervention to address health inequalities by tribal communities. For objective 1, we are in the process of completing household surveys in seven forest areas in five states across India. At each site, we will equally sample 400 tribal and non-tribal households along a gradient of socio-geographic disadvantage. For objective 2, we will purposively select case studies illustrating processes through which socio-geographic disadvantages act at individual, household/neighborhood, village or population level paying careful attention to the interactions across various known axes of inequity. We will use a realist evaluation approach wherein context-mechanism-outcome configurations generated from wider literature on tribal health and results of objective 1 will be used to generate explanatory theories for the patterns of inequalities seen. We will iteratively refine and test these theories on survey data and the cases.For objective 3, we will partner with willing stakeholders to design and pilot an equity-enhancing intervention drawing from the theoretical explanation generated and evaluate it, thus arriving at a final explanatory theory what kind of interventions could mitigate the inequities. During my residency, I hope to be able to work on a theoretical framework that will integrate various advances in explaining/theorising social inequities for tribal communities in India and contextualise these to the specific cases that THETA project is examining. This work is in collaboration with Werner Soors and Bruno Marchal at the Institute of Tropical Medicine, Antwerp (Belgium). THETA project is funded via a Wellcome Trust/DBT India Alliance Clinical and Public Health Research Fellowship to Prashanth Nuggehalli Srinivas
My journey into health began with a degree in medicine from Mysore Medical College, after which I worked at Vivekananda Girijana Kalyana Kendra in BR hills in southern Karnataka as a doctor managing a hospital and community health programs. I subsequently worked in community health and on strengthening primary health care in Karnataka and Arunachal Pradesh, working closely with public health and wildlife conservation organisations. Most of my travels have been to forests and my work at BR hills has been the origin and the consequence of my passion for wildlife, especially birds, stemming from a larger interest in natural history and biology itself. I try to keep this alive by birdwatching, reading and writing about this.
I live and work out of the IPH field station in BR Hills, a tiger reserve in southern Karnataka. I teach short courses in public health and social science research methods, social determinants of health, health equity and human resources for health. I have broad research interests in health policy and systems research, health equity, mental health, OneHealth and planetary health.
I write most frequently on daktre.com
Previous