Vulnerability Assessment: Evidence From A Rural Community-Based Multidimensional Survey in Jharkhand, India

Abstract

Background: Understanding the health of residents in a given community may not be a new concept but, exploring and deriving social factors that determine the health dimensions and its outcomes are very complex. Household vulnerability in rural India is shaped by intersecting residential, social, occupational, and health-related factors. Panchayat-level evidence on multidimensional vulnerability remains limited despite its need for local health planning and primary care delivery. This study assessed the vulnerability status of households across rural communities of Jharkhand. Methods: A community-based cross-sectional survey was conducted among all 1605 households in one panchayat of Community Health Centre (CHC), Devipur Block, Deoghar District, Jharkhand. Sociodemographic information and vulnerability indicators were collected using the NHM vulnerability assessment tool, supported by social maps for systematic field navigation. Results: Among the 1,605 households surveyed, 22.1% were categorized as most vulnerable, 40.4% as highly vulnerable, and 37.5% as vulnerable. Multivariable binary logistic regression showed significantly higher odds of severe vulnerability among male-headed households (AOR: 2.40; 95% CI: 1.07–5.35), lower-income households (AOR: 12.09; 95% CI: 5.36–27.26), and scheduled tribes (AOR: 5.52; 95% CI: 3.30–9.23). Whereas, muslim households had lower adjusted odds of severe vulnerability than hindu households (AOR: 0.46; 95% CI: 0.35–0.62).Marked inter-village variation in household vulnerability was observed across the study villages. Conclusion: The findings highlight the need for localized, equity-focused strategies that address housing, sanitation, livelihood security, and access to health services, and emphasize the importance of periodic vulnerability assessment to monitor and guide community health action.