Abstract

Background: Internal migrants and tribal populations are vulnerable in India. Migrant tribal communities in urban areas, due to doubled vulnerability, are at the risk of low health-care access. Objectives: To appraise the extent of, and barriers to, accessing government health care by tribal migrants in an eastern Indian city. MaterialsandMethods:Thisstudy,undertakeninslumsofBhubaneswar,acityineasternIndia,adoptedamixed-method approach with quantitative data from mothers of children aged 0–14 years (n = 175) and qualitative data from community members (n = 50) and key informants (n = 26).
Results:Amajorityofparticipants(82%)didnotvisitanygovernmenthealthfacilityduringthepastyear.Barrierstoaccess governmenthealth-carefacilitiesarerelatedtoboththehealthsystemandthecommunity.Distanceandlackofknowledge regarding the location of government health facilities and lack of trust in the government services are responsible for low use. Some cultural perceptions such as perceived etiology of illness and faith in traditional healers contribute toward low health-care access. Conclusion: Thestudyemphasizes theneed toconsidertheculturalbeliefsandpractices ofpeoplewhile planninghealth programsfortribalmigrantcommunities,inadditiontoaddressingthehealthsystem-relatedissuestoimprovetheservices.