A Cross-Sectional Study to Assess the Healthcare-Seeking Behaviour of Tribal Communities in a District of Maharashtra

TL;DR

This study examines healthcare-seeking behavior among tribal communities in Maharashtra, finding that only a small fraction seek formal healthcare, influenced mainly by perceived illness severity.

Contribution

The study identifies perceived illness severity as a key determinant of formal healthcare use in tribal populations, highlighting cultural and structural barriers.

Findings

Only 29.8% of ill individuals sought formal healthcare, while 34.5% accessed informal providers.

Perceived severity of illness was significantly associated with formal healthcare utilization.

Cultural reliance on spiritual healers and non-action persists despite illness.

Abstract

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.

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