Understanding health seeking behavior and evaluating adequacy of health system for catering to health needs of hard-to-reach tribal populations in a north Indian hilly province

Abstract

Background: In India, tribal communities constitute about 8.6% of total population, residing mainly in isolated and hard-to-reach regions. Considering the lack of knowledge of local health needs, nonspecific health policies, far-flung inhabitation, sociocultural peculiarity, and challenges of local health system; the present study tried to explore the health-care behavior, needs of the tribal communities in a North Indian State, simultaneously evaluating the adequacy of local health system addressing those needs. Materials and Methods: A qualitative approach (Focus Group Discussions, In-Depth Interviews) was adopted for understanding health care of tribal communities. Issues such as prevailing health problems, risk factors, difficulties faced accessing healthcare, preference of health system, shortcomings of the current health system, and expectations from service providers were discussed with the natives. Regional health-care administrators, managers, and providers were also interviewed. Results: The study identified noncommunicable diseases as a common health problem in these communities and locals could associate lifestyle behavior with these. Poor all-weather road connectivity, lack of transport facilities, unavailability of doctors (especially specialists), frequent referral to distantly located higher-level institutions, and incurring high out-of-pocket expenditure were the common difficulties cited by the locals while accessing health care. Conclusions: The study highlighted a mismatch between the health-care needs of the indigenous communities and service provision. These observations warrant the aligned effort of various stakeholders of tribal health to realize the vision of sustained development.

Keywords

• health behavior
• health system
• qualitative study
• tribal communities