Knowledge, attitudes and practices related to health and well-being in a forest fringe community in southern India.

Background: Variations in healthcare perceptions, knowledge and behaviors across different socioeconomic strata and regions underscore disparities in healthcare access and satisfaction levels. The Covid-19 pandemic exposed the vulnerability of forest-dependent communities to increased disease risks and the need to involve local communities in pandemic preparedness through education and awareness regarding disease and ill-health. This article synthesizes the challenges with respect to health and disease, healthcare services, and access to the same among forest-fringe communities.

Methods: We undertook a Knowledge, Attitudes and Practices (KAP) survey of 35 villages in and around the Mudumalai Tiger Reserve in southern India. Semi-structured interviews using open-ended questions were used to collect information from households on these broad themes: self-reported health issues, healthcare-seeking behaviors, opinion on the healthcare options available to them, risky-behaviors related to disease and ill-health, and self-perceived risk factors for disease or ill-health. Data was also collected on socioeconomic status. Reponses were converted to nominal categories and analyzed using mixed methods.

Results: Our respondents self-reported a mix of acute (31%) and chronic (62%) health issues, with undiagnosed fever being the most reported acute ailment (57%). Access to healthcare services showed a preference for government facilities for primary care (63%) but private facilities for surgical procedures (30%, p < 0.05). A substantial portion (15%) reported paying more than a month's income for healthcare services. Education levels seemed to influence perceptions, with higher education correlating to a broader understanding of disease causation (p < 0.05). Lack of basic amenities such as clean drinking water, proper methods of garbage and sewage disposal, and access to nutritious food seem to be important risk factors for disease and illness. Overall, majority of the respondents (76%) expressed satisfaction with government healthcare services, reporting dignified treatment (64%) and regular visits by healthcare workers (74%, p < 0.05).

Conclusion: Our study highlights the need to incorporate socioeconomic inequities and barriers while devising healthcare outreach, awareness and service program. We suggest interventions aimed at enhancing healthcare access and promoting healthier practices that mirror the specific needs and socioeconomic dynamics of the local communities for improved community health and well-being.