Comparative health outcomes of Paniya tribes (Wayanad, Kerala): The need to address their differential vulnerability

Background

Although the state of Kerala is considered to be one of the most egalitarian states in India, large inequalities persist among castes and social groups. The Paniya indigenous group is consistently at the bottom of the social hierarchy. Paniyas are significantly disadvantaged as compared to other social groups; they suffer from social exclusion, are typically landless, and live in severely deprived conditions. Although their social and economic vulnerability is documented, there is little evidence regarding their health needs and differential vulnerability.

Objective

To assess the health needs and differential vulnerability of Paniyas.

Methods

A health survey was conducted in 2006 among a random sample of 543 households (2418 individuals) in a rural district with a high proportion of tribal populations (36%). Paniyas were oversampled (one third of the sample).

Results

56.9% of Paniyas are underweight, 12.2% are severely so and 18.1% show symptoms of anaemia (joint pallor in conjunctive, tongue and nail). Paniyas are almost twice as likely to be underweight as other social groups (OR=1.86 95% CI:1.3-2.6), and have a comparatively higher likelihood of presenting symptoms of anaemia (OR=4.7 95% CI:3.2-6.7). Paniyas are not more likely to have thyroid dysfunction (visual detection of goiter), hypertension or tuberculosis (coughing and fever, or tuberculosis test). A considerably higher likelihood of thyroid dysfunction is nonetheless observed among Paniya women (OR: 5.1 95% CI:1.0-24.5).

Conclusions

The plight of Paniyas translates into comparably lower health outcomes. This equity-gap needs to be addressed by designing interventions targeting this especially highly vulnerable population.