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LETTERS TO EDITOR  
Year : 2021  |  Volume : 63  |  Issue : 3  |  Page : 312-313
Alcohol consumption during pregnancy among tribal women in India: Need for a concerted action


1 Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
2 Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India

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Date of Submission03-Jan-2021
Date of Acceptance26-Jan-2021
Date of Web Publication17-Jun-2021
 

How to cite this article:
Mahapatra P, Pati S, Sahoo KC. Alcohol consumption during pregnancy among tribal women in India: Need for a concerted action. Indian J Psychiatry 2021;63:312-3

How to cite this URL:
Mahapatra P, Pati S, Sahoo KC. Alcohol consumption during pregnancy among tribal women in India: Need for a concerted action. Indian J Psychiatry [serial online] 2021 [cited 2021 Sep 25];63:312-3. Available from: https://www.indianjpsychiatry.org/text.asp?2021/63/3/312/318708




Sir,

We read with interest the systematic review “Mental health research on scheduled tribes (ST) in India,” authored by Devarapalli et al. in the recent most issue of Indian J Psychiatry.[1] The maiden efforts of the authors to landscape the terrain of mental health research in tribal population and identify the knowledge gaps are laudable. Particularly, the contrasting alcohol consumption patterns observed in tribal population between Kerala, a Southern state and Arunachal Pradesh, a Northeast state offers an impetus for a reflective discourse.[2],[3]

In Paniyas of Wayanad district in Kerala, alcohol drinking is predominantly a masculine behavior, while in North East, females reported higher consumption than male counterparts.[2],[3] The key factors attributed were the traditional practice with clustered drinking within families and ease of access, leading to reinforcement of the behavior through time. Both studies albeit from diverse geopolitical settings are congruent in inferring that alcohol consumption is a complex phenomenon evolving from the interplay of cultural factors with contemporaneous societal and economic conditions rather than just a “choice.”[2],[3]

Odisha, an eastern state of India, is tribal dominated and unique in having highest varieties of ST. Similar to the studies reported in the systematic review,[1] alcohol consumption is significantly prevalent among ST population in Odisha as well; characterized by earlier onset in younger population with no gender difference. We had undertaken a qualitative study among Santal and Munda tribal women residing in Sundergarh district to explore their views and beliefs regarding homemade alcoholic brew (Handia) consumption during pregnancy. Majority women did not perceive alcohol as harmful even during pregnancy owing to its homemade nature. Further, the symbolic offering of alcohol during rituals and family drinking has made it a normative behavior with intergeneration transmission. Moreover, the emic and etic beliefs on alcohol's benign nature and health benefits along with the explanatory models of its adoption influence what is “perceived” and “entails” as “harmful” or “problem use” of alcohol. Some pregnant women though were cognizant of the potential effects on the unborn child; however, expressed their inability to quit. Thus, the inextricable weaving of “alcohol drinking” into the tribal sociocultural fabric and deep embeddedness within indigenous health belief ecosystem makes “problem alcohol use” a daunting behavioral challenge to address in these populations.[4]

With the growing gap in maternal and child health indicators between tribal and their nontribal counterparts, these behaviors merit in-depth exploration. The existing inequity in social determinants adds to the vulnerability of these mothers and their offspring and necessitate well-designed, culturally appropriate, and socially acceptable intervention.[5] Toward this, having a cross-disciplinary team encompassing alcohol researchers, mental health specialists, public health academicians, and medical anthropologists appears to be critical. Undeniably, the STs occupy a special space in the mental health research map; the attributes are relatively unexplored and misty to date. Constituting a Tribal Mental Health Consortium at the National level may help mount collaboration to garner a holistic perspective on the issue and implement multisectoral strategy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Devarapalli SV, Kallakuri S, Salam A, Maulik PK. Mental health research on scheduled tribes in India. Indian J Psychiatry 2020;62:617-30.  Back to cited text no. 1
  [Full text]  
2.
Mohindra KS, Narayana D, Anushreedha SS, Haddad S. Alcohol use and its consequences in South India: Views from a marginalised tribal population. Drug Alcohol Depend 2011;117:70-3.  Back to cited text no. 2
    
3.
Chaturvedi HK, Mahanta J, Bajpai RC, Pandey A. Correlates of opium use: Retrospective analysis of a survey of tribal communities in Arunachal Pradesh, India. BMC Public Health 2013;13:325.  Back to cited text no. 3
    
4.
Pati S, Chauhan AS, Mahapatra P, Hansdah D, Sahoo KC, Pati S. Weaved into the cultural fabric: A qualitative exploration of alcohol consumption during pregnancy among tribal women in Odisha, India. Subst Abuse Treat Prev Policy 2018;13:9.  Back to cited text no. 4
    
5.
Pati S, Chauhan AS, Panda M, Swain S, Hussain MA. Neonatal care practices in a tribal community of Odisha, India: A cultural perspective. J Trop Pediatr 2014;60:238-44.  Back to cited text no. 5
    

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Correspondence Address:
Sanghamitra Pati
Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_11_21

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