Need and challenges of palliative care in tribal people: a qualitative analysis.

Abstract

Background: Indigenous people are the most vulnerable and marginalised parts of society. Health services available to the tribal people are in developing face when compared to non-indigenous people. The situation with palliative care services exhibits a similar discrepancy. This study aims to explore the challenges and needs of palliative care within the tribal communities of Kerala.

Methods: The study followed a case study method conducted among the Paniya tribal community in Kambhatti, Maani, and Ozhakodi settlements of the Wayanad district, Kerala. The researchers used semi-structured interviews and observation as data collection methods. The data were collected from tribal people, ASHA workers, and promoters. Tribal people older than 18 years are considered for this study. A six-step model of reflexive thematic analysis was used for analysis. Open coding, followed by axial coding, was used to analyse the data collected from the participants. The codes were combined to form themes.

Results: A total of 12 participants were interviewed for the study, among them 8 participants were tribal people, 2 participants were promoters and 2 participants were ASHA workers. The majority of the tribal individuals live in joint families inside their settlement. Most of the participants were women, compared to men. Most of the women are employed through the Mahatma Gandhi National Rural Employment Guarantee Act. Nine major themes related to the challenges of palliative care were derived after the analysis are, lack of awareness, accessibility, financial issues, cultural beliefs and practice, fear and communication barriers, insufficient health care workforce, palliative care services, and health-related issues.

Conclusions: This study highlights the significance of palliative care for tribal populations. There is an increased need for palliative care, accompanied by challenges with receiving it in a culturally acceptable and sensitive manner. Developing a hybrid healthcare approach that integrates both traditional and modern medications exclusively for tribes is essential. The tribal population requires support in accessing comprehensive palliative care services from various professionals. It is crucial to establish healthcare programs aimed at addressing the entire healthcare needs of the tribal populations.