Centre for Training, Research, and Innovation in Tribal Health (CTRITH)
Centres for public health research and training embedded within tribal health centres and hospitals are scarce. Such an effort could help address important gaps in our knowledge (and action) on tribal health especially given the trend of increasing non-communicable diseases among tribal communities (including diabetes, hypertension, stroke, and COPD). Tobacco and alcohol addictions are among the most crucial risk-factors driving mortality and morbidity among tribal populations, yet efforts to design community-based interventions adapted to tribal populations to address these are limited.
In September 2021, DBT/Wellcome Trust India Alliance has awarded Institute of Public Health Bengaluru, Indian Institute of Public Health, Hyderabad and JSS Medical College, Mysuru with a grant titled Centre for Training, Research and Innovation in Tribal Health (CTRITH), under their Clinical/Public Health Research Centres (CRC) grant. Under this project a team of researchers from two public health research organizations – Institute of Public Health Bengaluru and Indian Institute of Public Health, Hyderabad and two medical colleges – JSS Medical College, Mysuru and Mysore medical College shall partner with a local non-governmental organization, community-based organizations and government health departments to
- Use state-of-the-art implementation research and theory-driven approaches to design, implement and evaluate innovative community health interventions for neglected health problems including hemoglobinopathies and substance (tobacco and alcohol) use among tribal populations
- Set up a birth cohort (including family members) among tribal populations in and around forested areas to characterize individual, household and population-level effects of tobacco and alcohol use.
- Create a field-practice area for physician-researcher and community medicine training in southern Karnataka.
Project Geographical area:
Chamarajanagar district of Karnataka and neighbouring districts.
The Centre’s overall strategy involves setting up a multi-institutional centre in Chamarajanagar district, where the PI shall be based along with a field team. This will allow field-level mentorship, oversight, and coordination across a wide range of stakeholders. In order to ensure smooth coordination across a variety of activities proposed in this grant, the activities are divided into specific Work-Packages (WP 1-8), each with a well-defined plan and milestones . The list of collaborators identified for each WP is provided with their roles in the Additional Information section.
| WP No. | Title | Main activities with corresponding cross-cutting (CC) /vertical (V) theme | Lead institute (co-lead) |
| WP1 | Realist and Implementation research Action Lab (RIAL) | Co-production of interventions using participatory approach with an in-built theory-driven design and implementation research to assess effectiveness in differing contexts (CC1) | IPH (MMCRI*) |
| WP 2 | Inter-disciplinary tribal population cohort | Establish a family cohort of 2000 tribal households studying parental tobacco and alcohol use (exposure) with child health and development (outcome) (CC2) | IIPHH/PHFI Bengaluru |
| WP 3 | Population-based Hemoglobinopathy Registry (PHR) | Study the genetic profile, clinical characteristics and establish a population-based registry for haemoglobinopathies (V1) | JSSMC |
| WP 4 | Socio-behavioural aspects of substance use among tribal populations | Explore sociocultural and historical pathways of interaction of substance use among tribal populations Identify and design health services and community-based approaches for treatment and support for harmful substance use among tribal populations | IPH |
| WP 5 | Capacity-building and mentorship | Prepare a plan, curriculum and administer programmes. WP5 covers the training and mentorship plan and will be led by the Programme Head for 7 CRTP fellowships, 3 PhD and 2 postdoctoral fellows. An Assistant Professor-level support staff will assist her. They will work with Coordinators in other institutions. | IPH |
| WP 6 | Public and policy engagement | Identify pathways to impact the district and state-level programmes and policies affecting tribal health with respect to neglected health problems Translation of research findings into knowledge outputs for different actors (decision-makers, communities, civil society) | IPH |
| WP 7 | Research management (including collaborations, quality, and sustainability) | Setting up MoUs/collaborations, permissions, ethics approval, material transport logistics, recruitment, performance appraisals, documentation and reporting and coordinating external engagements including social media/print/electronic media | IPH |
| WP 8 | Monitoring and evaluation | Monthly and annual meetings, collaborator workshops for discussion and dissemination, and independent mid-term and end-line evaluations | IPH
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The establishment of such a research and training centre embedded within a tribal hospital setting and landscape will be a pioneering effort in southern India. The Centre will provide a unique platform for incubating research and action on tribal health in the field. Various collaborations with leading institutions will be established via the creation of such a centre in a remote tribal setting. The Centre will have the following outcomes over the next five years:
Research:
- Tribal people birth cohort: Possibly the first of its kind, an interdisciplinary cohort of tribal households in and around forest areas in India shall be established enabling long-term research on tobacco and alcohol use and other related aspects like NCDs and associated morbidity and mortality profile.
- Population-based haemoglobinopathy registry for a district.
- Community-based interventions to address harmful substance use along with a model for studying socio-behavioural aspects of substance abuse among tribal populations.
Training:
- PhD, CRTPs and PDs sensitised to working in limited-resource settings with communities
- Certificate courses for physician-researchers and social scientists looking to work with communities
- Multiskilling the existing health workforce in a limited resource tribal setting to address health inequities.
Duration of project
October 2021- September 2026
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