Vulnerable Populations’ Access to Health Care: A study of the nomadic “Gypsy’ Narikuravars in Tamil Nadu, India

Dragomir, Cristina Ioana; Zafiu, Mara

doi:10.17583/ijrs.2019.3034

Cited by 6 publications

(9 citation statements)

References 14 publications

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“…The Narikuravar are a semi-nomadic tribe of Tamil Nadu similar in origin to the Romani or Roma communities of Europe [14]. This community has low literacy, poor access to public welfare services such as health care, and limited sources of income [15]. The Irular are a large tribal group of Tamil Nadu characterized by low literacy, extreme poverty, and facing a degree of cultural and geographic isolation [16,17].…”

Section: Study Setting and Communitiesmentioning

confidence: 99%

Vaccination coverage and the factors influencing routine childhood vaccination uptake among communities experiencing disadvantage in Vellore, southern India: a mixed-methods study

et al. 2021

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Background In 2015, the Vellore district in southern India was selected for intensified routine immunization, targeting children from communities experiencing disadvantage such as migrant, tribal, and other hard-to-reach groups. This mixed-methods study was conducted to assess routine immunization coverage and the factors influencing childhood vaccination uptake among these communities in Vellore. Methods We conducted a cross-sectional household survey (n = 100) and six focus group discussions (n = 43) among parents of children aged 12–23 months from the known communities experiencing disadvantage in Vellore during 2017 and 2018. Multivariate logistic regression was conducted to examine associations between the parental characteristics and children’s vaccination status in the household survey data; the qualitative discussions were analyzed by using the (previously published) “5As” taxonomy for the determinants of vaccine uptake. Results In the household survey, the proportions of fully vaccinated children were 65% (95% CI: 53–76%) and 77% (95% CI: 58–88%) based on information from vaccination cards or parental recall and vaccination cards alone, respectively. Children whose mothers were wage earners [Adjusted prevalence odds ratio (aPOR): 0.21, 95% CI = 0.07–0.64], or salaried/small business owners [aPOR: 0.18, 95% CI = 0.04–0.73] were less likely to be fully vaccinated than children who had homemakers mothers. In the focus group discussions, parents identified difficulties in accessing routine immunization when travelling for work and showed knowledge gaps regarding the benefits and risks of vaccination, and fears surrounding certain vaccines due to negative news reports and common side-effects following childhood vaccination. Conclusions Vaccination coverage among children from the surveyed communities in Vellore was suboptimal. Our findings suggest the need to target children from Narikuravar families and conduct periodic community-based health education campaigns to improve parental awareness about and trust in childhood vaccines among the communities experiencing disadvantage in Vellore.

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Section: Study Setting and Communitiesmentioning

confidence: 99%

Vaccination coverage and the factors influencing routine childhood vaccination uptake among communities experiencing disadvantage in Vellore, southern India: a mixed-methods study

et al. 2021

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“…Oral diseases are a product of socio-economic, cultural status, behavioural and environmental factors. Poor hygiene, poor nutrition and smoking contribute to dental and oral problems (Dragomir and Za iu, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Every culture has its concepts of health, sickness and health promotion depicting values, beliefs, knowledge and practices shared by its people (Dragomir and Za iu, 2019).…”

Section: Introductionmentioning

confidence: 99%

Caries Experience among Tribal Gypsies in Thoothukudi District - A Cross-Sectional Study

Chellappa¹,

Leelavathi²,

Rathinavelu³

et al. 2020

ijrps

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Dental caries, or tooth decay, is an infectious process involving breakdown of the tooth enamel. Caries form through a complex interaction between cariogenic acid-producing bacteria in combination with fermentable carbohydrates and other dietary, genetic, behavioural, social, and cultural factors. Poor oral hygiene and low dental service levels were found in marginalised areas. The study aimed to assess the caries experience of Narikuravars in Thoothukudi district. A cross-sectional study was done among gipsies in Thoothukudi district. Oral health examination was done the gipsies in the above three taluks in which they were present. All the study participants were examined under adequate illumination, and clinical data were collected on dental caries as described by the World Health Organization (WHO). DMFT (Decayed, Missing and Filled teeth) was used to assess the caries experience. For statistical analysis, t-test and ANOVA was used. The total size of the screened population was 164. There were 128 adults and 36 children who are below 18 years of age. Mean Decayed teeth, mean Missed teeth and mean Filled teeth was found to be 3.38±1.730, 1.01± 2.109, 0.01± 0.088 respectively. Decayed teeth were most common in the study population. Mean DMFT score among the adult study population was found to be 4.40 ± 2.603. The difference between the different age groups to Mean DMFT and was found to be statistically significant (F value- 22.679; p < 0.05). The present study concluded that the experience of dental caries was low in the study population. It was more prevalent in males as compared to the female population.

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“…Three years into my fieldwork together with Aparna, 1 a middle-age female of Tamil background who was my interpreter, I visited the Narikuravar semi-nomadic community (Dragomir and Zafiu, 2019) in Tamil Nadu, located in Southern India. Only the women in the community met me, as most of the men were out that day.…”

mentioning

confidence: 99%

“…One group of this community lives about 45 km from in Mettupalayam city in Tamil Nadu. Despite living in a government-organized settlement for about 50 years, they still see themselves as nomadic, able to take off at will (Dragomir and Zafiu, 2019). They are a small community of about 200 (the numbers fluctuate due to their mobility).…”

mentioning

confidence: 99%

Destabilizing the privilege of the knower to establish forms of solidarity: Reflections on conducting fieldwork with vulnerable communities in India and Romania

Dragomir

2020

Methodological Innovations

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In this article, I interrogate the researcher’s role in conducting ethnographic and qualitative fieldwork with vulnerable communities and argue that increased epistemological reflexiveness is needed to support solidarity ties between researchers and participants. In line with critical feminist literature and methodology, I present the inconsistencies of the power relations I entered as a researcher, as well as the systemic inequalities I found operating in the background. Using several vignettes based on my fieldwork with communities labeled as “Gypsy” in Romania and India, I make the argument that power dynamics encountered in the field reveal the researchers’ simultaneous privilege and their subaltern status, creating an epistemological position grounded in the intersection of gender, race/ ethnicity, and class, which in turn could deter from bonds of solidarity. In line with feminist methodologies and intersectionality literature, I argue that the researcher’s gender, race, ethnicity, and class (co)generate epistemological outcomes, and that without critical reflection researchers may reinforce hierarchies of power. Thus, I both adopt and innovate this approach, by showing how as researchers we inhabit concomitantly different and fluctuating positionalities. I end by advocating for reflexiveness on the researchers’ power to create epistemological categories and processes, which may (re)enforce solidarity relations between researchers and communities.

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Vulnerable Populations’ Access to Health Care: A study of the nomadic “Gypsy’ Narikuravars in Tamil Nadu, India

Cited by 6 publications

References 14 publications

Vaccination coverage and the factors influencing routine childhood vaccination uptake among communities experiencing disadvantage in Vellore, southern India: a mixed-methods study

Vaccination coverage and the factors influencing routine childhood vaccination uptake among communities experiencing disadvantage in Vellore, southern India: a mixed-methods study

Caries Experience among Tribal Gypsies in Thoothukudi District - A Cross-Sectional Study

Destabilizing the privilege of the knower to establish forms of solidarity: Reflections on conducting fieldwork with vulnerable communities in India and Romania

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