Asokan Dinesh, Gate Nita, Waghmare Rakesh, Mall Anjali, Pardeshi Geeta
Community Medicine, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND.
Cureus. 2025 Jun 10;17(6):e85687. doi: 10.7759/cureus.85687. eCollection 2025 Jun.
Introduction Tribal populations in India face longstanding barriers to accessing formal healthcare due to economic, geographic, and cultural constraints. This study assessed the healthcare-seeking behaviour of tribal households in Palghar district, Maharashtra, and examined associated determinants. Methods A community-based cross-sectional study was conducted from August 2023 to March 2024 using multistage cluster random sampling in eight tribal villages located within a 25 km radius of the district hospital. A total of 80 households were selected, and 306 individuals were enumerated. Of these, 84 individuals (27.5%) who reported illness in the past three months were included in the analysis. Data were collected using a pretested structured questionnaire and analysed using R software (R Foundation for Statistical Computing, Vienna, Austria). Chi-square tests were applied to assess associations between healthcare-seeking behaviour and independent variables. Results Only 25 (29.8%) of the ill individuals sought formal healthcare, while 29 (34.5%) accessed informal providers, and 30 (35.7%) took no action. Among all variables analysed, only perceived severity of illness was significantly associated with formal healthcare utilization. Formal care was accessed by 13 of 14 (92.9%) individuals who perceived their illness as severe, compared to 11 of 40 (27.5%) with moderate and five of 30 (16.7%) with mild perception. No significant associations were found with age, gender, education, number of symptoms, or timing of illness. Conclusion The study highlights low formal healthcare utilization and a strong influence of perceived illness severity on care-seeking behaviour. Continued reliance on spiritual healers and non-action reflects persistent cultural and structural barriers. Interventions should include culturally sensitive health promotion, expansion of nearby healthcare services, and financial support mechanisms. Further qualitative research is needed to explore contextual factors influencing healthcare choices in tribal communities.
引言 由于经济、地理和文化限制,印度的部落人口在获得正规医疗保健方面面临长期障碍。本研究评估了马哈拉施特拉邦帕尔加尔区部落家庭的就医行为,并研究了相关决定因素。方法 2023年8月至2024年3月,在距离区医院25公里半径范围内的8个部落村庄采用多阶段整群随机抽样进行了一项基于社区的横断面研究。共选取了80户家庭,对306人进行了清点。其中,在过去三个月内报告患病的84人(27.5%)纳入分析。使用预先测试的结构化问卷收集数据,并使用R软件(奥地利维也纳的R统计计算基金会)进行分析。应用卡方检验评估就医行为与自变量之间的关联。结果 只有25名(29.8%)患病个体寻求正规医疗保健,29名(34.5%)求助于非正规医疗服务提供者,30名(35.7%)未采取任何行动。在所有分析变量中,只有感知到的疾病严重程度与正规医疗保健利用显著相关。14名(92.9%)认为自己病情严重者中有13人接受了正规医疗,而40名(27.5%)病情中等者中有11人,30名(16.7%)病情较轻者中有5人接受了正规医疗。未发现与年龄、性别、教育程度、症状数量或患病时间有显著关联。结论 该研究凸显了正规医疗保健利用率低以及感知到的疾病严重程度对就医行为的强烈影响。继续依赖精神治疗师和不采取行动反映了持续存在的文化和结构障碍。干预措施应包括具有文化敏感性的健康促进、扩大附近的医疗服务以及财政支持机制。需要进一步开展定性研究,以探索影响部落社区医疗选择的背景因素。