A qualitative study of the barriers to utilizing healthcare services among the tribal population in Assam.

Bandita Boro,Nandita Saikia,Judith Katzenellenbogen

doi:10.1371/journal.pone.0240096

Abstract

ObjectiveWe aim to explore the barriers to accessing modern healthcare services in two tribal populations in Assam.MethodsIn March 2018, we conducted qualitative research through 60 in-depth interviews with men and women aged 15 to 50 from Bodo and Rabha tribes in Udalguri and Baksa districts of Assam. We interviewed a group of health-service providers from public health facilities to understand the demand-supply balance in those facilities.FindingsOn the demand side, direct and indirect financial obstacles, distance to health facilities, poor public transportation, perceived negative behavior of hospital staff, and lack of infrastructure were the main barriers to utilizing healthcare facilities. On the supply side, doctors and nurses in government health facilities were overburdened by demand due to a lack of human resources.ConclusionsOur study highlights the barriers to utilizing health facilities; these are not always driven by factors linked to the patient’s socio-economic status but also depend significantly on the quality of the health services and other contextual factors. Although the government has made efforts to improve the rural healthcare system through national-level programs, our qualitative study shows that these programs have not been successful in enhancing the rural healthcare system in the study area.

Highlights

Tribal people are diverse populations and live in varied local environments and nations, with important implications for their health [1]
Our study highlights the barriers to utilizing health facilities; these are not always driven by factors linked to the patient’s socio-economic status and depend significantly on the quality of the health services and other contextual factors
The government has made efforts to improve the rural healthcare system through national-level programs, our qualitative study shows that these programs have not been successful in enhancing the rural healthcare system in the study area

Summary

Introduction

Tribal people are diverse populations and live in varied local environments and nations, with important implications for their health [1]. International studies provide evidence that tribal populations have poorer health and social outcomes than non-tribal populations [3]. India’s indigenous or tribal people too exhibit poorer health and lower social indicators than the general population [4, 5]. These indicators vary widely within these populations across regions [6]. The challenges in accessing modern healthcare services and the unique ways in which tribal people seek health care are the main issues in the area of tribal health [8]. People with a severe illness sometimes stop their treatment midway due to money concerns, irrespective of whether they were cured

Results

Discussion

Conclusion