Adhikari Tulsi, Nair Saritha, Grover Ashpinder Kaur
Indian Council of Medical Research, Ansari Nagar, New Delhi, India.
Faculty of Medical Research, Academy of Scientific and Innovative Research (AcSIR), New Delhi, India.
BMC Health Serv Res. 2025 Aug 18;25(1):1100. doi: 10.1186/s12913-025-13099-5.
The Indian tribal population is varied, with a wide range of customs, ways of life, and cultural practices. However, there is one thing that all Indian tribal communities have in common: they have worse health indicators, a higher rate of illness and mortality, and very restricted access to medical care. Their health issues require extra consideration in the right setting (Salil, Health and Population Perspectives and Issues 23:61-70, 2000). Growth in the utilization of reproductive and maternal health services will not only curtail down the reproductive morbidities, but it will also reduce the child mortality (Sharma et. al, Utilization of health services and RCH status in Madhya Pradesh: a District Level Analysis. In Proceedings of National Symposium on Tribal Health 2011). Men's participation in prenatal care, delivery and postpartum period is rarely found, especially among tribal communities, due to their economic instabilities and priorities. Also our health system does not promote the involvement of men in the maternal and child health care. Hence, there was a need felt for development of gender and community sensitive interventions package that could address the individual and the community health care facility level barriers of male involvement in utilisation of the maternal care services. Our study was an effort to determine the feasibility of implementing a behaviour Change Communication Interaction developed for improvement in utilisation of maternity care services through male participation among the Saharia Tribes in Gwalior District, Madhya Pradesh.
The Study utilised a qualitative approach. Various activities were organised as a part of BCC, viz., Community mobilization, Campaign/Rallies, Interpersonal Communication-Drama & Mock Sessions, Face to Face counselling and Quiz etc. Action technique called Transect was used in order to know more about the environment and living of the people of Saharia Tribes in Gwalior District, Madhya Pradesh. Feasibility of the model was assessed by focusing on three main principles i.e., acceptability, integration and limited-efficacy testing.
Acceptability testing study reveal that BCC intervention was successfully accepted by intended individual- both targeted individuals and those involved in implementing programs. Integration approach reveal that no major change in infrastructure of Govt. Programmes and facilities is required. Instead, effective application relies on the engagement of key community members and local health service workers. Limited-efficacy testing reveals that there is a behavioural change in men's perception of accompanying their spouse to the health centre; same was observed on the vaccination day in the village.
The BCC intervention proved to be feasible to implement. The Proposed BCC interaction is feasible and accepted by both Programme stake holders and beneficiaries.
印度部落人口多种多样，有着广泛的习俗、生活方式和文化习俗。然而，所有印度部落社区都有一个共同点：他们的健康指标较差，疾病和死亡率较高，获得医疗服务的机会非常有限。他们的健康问题需要在适当的环境中得到额外关注（萨利尔，《健康与人口视角及问题》23:61 - 70，2000年）。生殖和孕产妇健康服务利用率的提高不仅会减少生殖疾病，还会降低儿童死亡率（夏尔马等人，《中央邦健康服务利用情况及生殖、孕产妇、儿童健康状况：地区层面分析》。载于《2011年部落健康全国研讨会论文集》）。由于经济不稳定和优先事项，男性很少参与产前护理、分娩和产后护理，尤其是在部落社区。而且我们的卫生系统也不鼓励男性参与母婴保健。因此，人们感到需要制定对性别和社区敏感的干预措施包，以解决男性在利用孕产妇护理服务方面个人和社区卫生保健设施层面的障碍。我们的研究旨在确定在中央邦瓜廖尔地区的萨哈里亚部落中，实施一种为通过男性参与提高孕产妇护理服务利用率而开发的行为改变沟通互动措施的可行性。
该研究采用定性方法。组织了各种活动作为行为改变沟通的一部分，即社区动员、运动/集会、人际沟通 - 戏剧和模拟会议、面对面咨询和问答等。为了更多地了解中央邦瓜廖尔地区萨哈里亚部落人民的环境和生活，使用了一种名为横断面调查的行动技术。通过关注三个主要原则，即可接受性、整合性和有限效果测试，来评估该模式的可行性。
可接受性测试研究表明，行为改变沟通干预措施被目标个体——既有目标人群也有参与实施方案的人员成功接受。整合方法表明，政府项目和设施的基础设施无需重大改变。相反，有效实施依赖于关键社区成员和当地卫生服务工作者的参与。有限效果测试表明，男性陪配偶去健康中心的观念发生了行为改变；在村里的疫苗接种日也观察到了同样的情况。
行为改变沟通干预措施被证明是可行的。拟议的行为改变沟通互动措施是可行的，并且被项目利益相关者和受益者双方所接受。
