Scheduled Tribe Women and Health Services in India during COVID-19: What the Evidence Can and Cannot Show

Abstract

Could Scheduled Tribe (ST) women in India reach, enter and use health services during the COVID-19 pandemic? We reviewed the available evidence and audited the published outputs of India's principal health information systems. Evidence exists for individual programmes; beyond them, we located no published population estimate of pandemic-period service use by ST women. Three distinct limitations explain this. Routine facility reporting publishes no social-category breakdown, although such disaggregation is possible and its trade-offs have been documented within the health system. The published tables of the National Family Health Survey report indicators for ST women, but for reference periods that span the pandemic without isolating it. And the beneficiary-tracking system used by auxiliary nurse-midwives records social category at registration without crossing it with service records in its documented reports. The evidence does establish that, over the survey's reference period, ST women were more dependent on public facilities than any other caste group, more often received antenatal care from nurse-midwives and allied providers, and had the lowest rates of personal phone ownership and internet use — the tools through which substitute services were offered. We argue that using access frameworks for timely equity monitoring requires populations to be legible to the systems serving them — recorded, used internally and published in time for a response — and propose measures for data, research and social work practice. Claims are bounded to reproductive and maternal health.