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. Key words: Health seeking behaviour, barriers to care, out of pocket expenses, vulnerable population, tribal group.
Highlights
The state of health care provided around the world is an often ignored and under researched topic
A ubiquitous challenge for Indigenous communities globally is adequate access to and utilization of quality health care services. Many of these communities tend to be isolated in remote rural locations and have limited access to ambulatory, acute and specialized health care (Marrone, 2007)
Most of the health service delivery pertaining to indigenous population has drawn flake as cultural sensitivities are not imbibed in it whereas the interpretation of illness amongst these communities is a culturally informed process
Summary
BackgroundThe state of health care provided around the world is an often ignored and under researched topic. A ubiquitous challenge for Indigenous communities globally is adequate access to and utilization of quality health care services. Many of these communities tend to be isolated in remote rural locations and have limited access to ambulatory, acute and specialized health care (Marrone, 2007). The fundamentals of health are understood from „functional perspective‟ and as a state of dynamic equilibrium between an organism and its environment. Both patient and provider attributes have a bearing on the health seeking behaviour. There is a unanimous agreement pertaining to the rudimentary health status of tribals the primitive tribes owing to their isolation, geographic remoteness and more recently land alienation endangering the nutritional status and access to healthcare
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