Raghavan Bindu, Wilson Alby, Namboodiri Shruti, Selvaraj Manigandan, Karanth Krithi
Centre for Wildlife Studies, 37/5, Yellappa Chetty Layout, Sivanchetti Gardens, Ulsoor Road, Bangalore, 560042, Karnataka, India.
Duke University, 2080 Duke University Road, Durham, NC, 27708, USA.
BMC Public Health. 2025 May 6;25(1):1666. doi: 10.1186/s12889-025-22653-z.
Variations in healthcare perceptions, knowledge and behaviors across different socioeconomic strata and regions underscore disparities in healthcare access and satisfaction levels. The Covid-19 pandemic exposed the vulnerability of forest-dependent communities to increased disease risks and the need to involve local communities in pandemic preparedness through education and awareness regarding disease and ill-health. This article synthesizes the challenges with respect to health and disease, healthcare services, and access to the same among forest-fringe communities.
We undertook a Knowledge, Attitudes and Practices (KAP) survey of 35 villages in and around the Mudumalai Tiger Reserve in southern India. Semi-structured interviews using open-ended questions were used to collect information from households on these broad themes: self-reported health issues, healthcare-seeking behaviors, opinion on the healthcare options available to them, risky-behaviors related to disease and ill-health, and self-perceived risk factors for disease or ill-health. Data was also collected on socioeconomic status. Reponses were converted to nominal categories and analyzed using mixed methods.
Our respondents self-reported a mix of acute (31%) and chronic (62%) health issues, with undiagnosed fever being the most reported acute ailment (57%). Access to healthcare services showed a preference for government facilities for primary care (63%) but private facilities for surgical procedures (30%, p < 0.05). A substantial portion (15%) reported paying more than a month's income for healthcare services. Education levels seemed to influence perceptions, with higher education correlating to a broader understanding of disease causation (p < 0.05). Lack of basic amenities such as clean drinking water, proper methods of garbage and sewage disposal, and access to nutritious food seem to be important risk factors for disease and illness. Overall, majority of the respondents (76%) expressed satisfaction with government healthcare services, reporting dignified treatment (64%) and regular visits by healthcare workers (74%, p < 0.05).
Our study highlights the need to incorporate socioeconomic inequities and barriers while devising healthcare outreach, awareness and service program. We suggest interventions aimed at enhancing healthcare access and promoting healthier practices that mirror the specific needs and socioeconomic dynamics of the local communities for improved community health and well-being.
不同社会经济阶层和地区在医疗观念、知识及行为方面存在差异,这凸显了医疗服务可及性和满意度的差距。新冠疫情暴露了依赖森林的社区在面对疾病风险增加时的脆弱性,以及通过开展疾病和健康问题教育与宣传,让当地社区参与疫情防范工作的必要性。本文综合阐述了森林边缘社区在健康与疾病、医疗服务以及获取医疗服务方面所面临的挑战。
我们对印度南部穆杜马莱老虎保护区及其周边的35个村庄进行了一项知识、态度和实践(KAP)调查。通过使用开放式问题进行半结构化访谈,从家庭中收集有关以下广泛主题的信息:自我报告的健康问题、就医行为、对其可获得的医疗选择的看法、与疾病和健康问题相关的危险行为,以及自我认知的疾病或健康问题风险因素。还收集了社会经济状况数据。将回答转换为名义类别,并采用混合方法进行分析。
我们的受访者自我报告了急性(31%)和慢性(62%)健康问题的混合情况,未确诊的发烧是报告最多的急性疾病(57%)。在获取医疗服务方面,受访者倾向于选择政府机构提供初级保健(63%),但手术则选择私立机构(30%,p<0.05)。相当一部分人(15%)报告称,为医疗服务支付的费用超过了一个月的收入。教育水平似乎影响认知,受教育程度越高,对疾病成因的理解越广泛(p<0.05)。缺乏清洁饮用水、正确的垃圾和污水处理方法以及获取营养食品等基本生活设施,似乎是疾病和健康问题的重要风险因素。总体而言,大多数受访者(76%)对政府医疗服务表示满意,称得到了有尊严的治疗(64%),医护人员定期来访(74%,p<0.05)。
我们的研究强调,在制定医疗外展、宣传和服务计划时,需要考虑社会经济不平等和障碍。我们建议采取干预措施,旨在改善医疗服务可及性,推广更健康的行为方式,以反映当地社区的具体需求和社会经济动态,从而改善社区健康和福祉。