Empowering Healthcare Access: Ethnographic Insights into Sustainable Solutions for a Particularly Vulnerable Tribal Group (PVTG) in South India- a Qualitative Research

Introduction: India’s tribal population accounted for 8.6% of the country’s total population. Despite the advancements in healthcare that have occurred in recent decades, which have greatly improved disease prevention and treatment, certain marginalized and browbeaten tribal communities often encounter significant, yet unnoticed barriers when trying to access healthcare services, irrespective of the services and schemes available for them. Objective: This study aimed to undermine the confronting and promoting factors that influence the utilization of healthcare services by a Particularly Vulnerable Tribal Group (PVTG) in India. Methods: An ethnographic fieldwork was undertaken to explore the factors contributing to the persistent and alarming decline in healthcare accessibility among a selected PVTG in the Udupi district, located in the coastal region of southern India. The study involved conducting eight in-depth interviews (IDIs) and three focus group discussions (FGDs) with representatives from the PVTG community, healthcare providers, and key informants associated with institutions delivering healthcare services to this marginalized group. Results: Numerous barriers have been identified as significant determinants impeding the utilization of healthcare services and schemes by selected PVTG. These barriers encompass the lack of culturally sensitive care, discrimination faced by the community within healthcare establishments, centralized approach to service delivery, and limited collective capacity to advocate for services and schemes that are more inclusive and sustainable for their communities. Conclusions: Although several influential factors are behind the resistance to utilizing healthcare services and schemes by the PVTG in Udupi district, culturally oriented care, absence of discrimination, decentralized service delivery, and their capacity for collective bargaining might enhance their utilization of healthcare services, and this would enable the improvement of the tribe’s overall well-being and health status.