Assessment of the health status and risk factors of Kham Tibetan pastoralists in the alpine grasslands of the Tibetan plateau.

The health status of Tibetan herders in the Sanjiangyuan region of the Tibetan Plateau, in southwest Qinghai Province, is assessed in this paper. The field study was conducted in 2002 in the context of a broader community development and research framework, the ultimate goal of which is to achieve an effective region-specific programme of preventative health care and training for Tibetan pastoralists. Specifically, the authors analysed the impact of a number of potentially health-related environmental and lifestyle risk factors on self-reported health indicators, with a special emphasis on mother and child health. Several health status indicators were used, including a general morbidity index and a measurement of functional incapacity due to illness in the sample households. Maternal and child health findings were alarming with high rates of miscarriage and infant loss, with no traditional midwives to assist in pregnancy and delivery. Preventable childhood illnesses were also common. Other debilitating diseases included hepatitis, tuberculosis, arthritis (gout), gall bladder disease, peptic ulcers and back pain. Finally, binary logistic regression analysis showed a significant link between general morbidity and the time it takes to obtain water. The survey findings, validated by the focus groups, indicate a real need for increased accessibility and quality of health service provision to women and men and effective preventative health strategies.