Tuberculosis and utilization of healthcare facilities by the Lepchas of Sikkim

Abstract

All tuberculosis (TB) control programs in India since their inception have heavily depended on a medical model of diagnosis and cure. The socio-economic factors associated with TB control in India have not been adequately investigated. In spite of the heavy investments made on TB control, its prevalence rates remain high among a few sub-populations such as the Scheduled Tribes who live in isolation far away from urban areas. The state of Sikkim, for example, has a TB prevalence rate of 1002 per 100,000 population. Nearly 23% of this population is classified under Scheduled Tribes. Very little is known about the likelihood of tribals seeking modern medical treatment for TB in India. The objective of this study is to explore utilization of medical services among those suffering from TB in Sikkim. For this study a sample of 50 households was acquired using the quota sampling method from a tribal village called Chota-Singtham, in East Sikkim. We found that those who have TB are more likely to use modern healthcare than those who do not. The effect of “having tuberculosis” on “modern medical care utilization” is significant and positive. We also found that those who perceive their own experiences of poverty as a source of illness are less likely to seek modern medical care. Results of this study suggest that programs and projects to improve modern healthcare utilization should be undertaken in conjunction with poverty eradication programs.