Health seeking behaviour among particularly vulnerable tribal groups: A case study of Nilgiris

Abstract

The article hinged upon exploring the patterns and determinants of healthcare utilization and financing amongst particularly vulnerable tribal groups (PVTG's) in Nilgiri district of Tamil Nadu. Three PVTG's viz Paniyas (P), Kattunayakans (KN) and Bettakurumbas (BK) are explored in the study. These groups have some quint essential features impacting the healthcare seeking behaviour e.g. Paniyas were subject to historical repression after they were brought over from Kerala as agricultural labourers culminating into their seclusion and accentuated patient provider wedge. Kattunayackans have their behaviour embedded in using magico-religious beliefs and indigenous medicines. Bettakurumbas are the other forest dwellers residing in Nilgiris biosphere reserve and contemporaneously seek institutional care. Mixed method approach (amalgamation of quantitative and qualitative) was adopted and the households were selected through two stage stratified random sampling. The health seeking behaviour was captured by running a Logit model and Blinder Oaxaca decomposition analysis was conducted to decompose the health gap amongst the tribal groups.

Understanding health care-seeking behaviour of the tribal population in India among those with presumptive TB symptoms

“…Secondly, our study helps gain insight into the reasons for not seeking care among the tribal population, which were lack of money, symptoms not being severe enough, distance to health facilities and dissatisfaction with the healthcare providers. These findings are in concordance with other studies that reported lack of money, non-severity of symptoms and long-distance to health facility [ 5 , 20 , 24 – 27 ]. The reasons were similar across gender except that more males reported less severity of symptoms as a reason for not seeking care.…”

“…This diversity includes a large tribal population that makes 8.6% of the Indian population which translates to 111 million people [3]. The tribal population contributes 9.8% to the total TB incidence in India [4], This group is categorized as one of the key affected populations in the National Strategic plan as they are scattered across India with limited access to health care, accentuated by low levels of awareness and they are highly influenced by distinctive social, cultural and economic factors [5][6][7].…”

Issues, challenges and opportunities in accessing primary health services in tribal-rural setting in India: a decadal view

“…The indigenous population underutilizes healthcare services, primarily due to nonavailability of public health services. [21][22][23][24] In determining whether to seek health care, perceived quality of care is crucial. 25 In tribal areas, the quality of the healthcare is still inadequate.…”

“…The issue of inaccessibility to health services also seems to direct the discussion on tribal health and is directly linked to the utilization of healthcare facilities among tribal groups due to its low inaccessibility. 23,35 Cone of the important findings that emerged from one of the study was the remoteness from the primary public health care setup, namely the health and wellness centre. The majority of primary health centres were more than 10 kilometres away.…”

“…Due to cultural barriers, tribal tribes access to healthcare services is poor. 23 The substantial cultural divide between tribal communities and non-tribal healthcare professionals leads to dismissive and discriminating behaviour on the part of healthcare personnel. 42 Health staffs behaviour towards tribal people is unfair and unfriendly which makes access to health more difficult and complex.…”