Healthcare-seeking Behaviour among the Tribal People of Bangladesh: Can the Current Health System Really Meet Their Needs?

Despite the wealth of studies on health and healthcare-seeking behaviour among the Bengali population in Bangladesh, relatively few studies have focused specifically on the tribal groups in the country. This study aimed at exploring the context, reasons, and choices in patterns of healthcare-seeking behaviour of the hill tribal population of Bangladesh to present the obstacles and challenges faced in accessing healthcare provision in the tribal areas. Participatory tools and techniques, including focus-group discussions, in-depth interviews, and participant-observations, were used involving 218 men, women, adolescent boys, and girls belonging to nine different tribal communities in six districts. Data were transcribed and analyzed using the narrative analysis approach. The following four main findings emerged from the study, suggesting that the tribal communities may differ from the predominant Bengali population in their health needs and priorities: (a) Traditional healers are still very popular among the tribal population in Bangladesh; (b) Perceptions of the quality and manner of treatment and communication can override costs when it comes to provider-preference; (c) Gender and age play a role in making decisions in households in relation to health matters and treatment-seeking; and (d) Distinct differences exist among the tribal people concerning their knowledge on health, awareness, and treatment-seeking behaviour. The findings challenge the present service-delivery system that has largely been based on the needs and priorities of the plainland population. The present system needs to be reviewed carefully to include a broader approach that takes the sociocultural factors into account, if meaningful improvements are to be made in the health of the tribal people of Bangladesh.

[1]  M. Bhuiyan,et al.  Mothers' health-seeking behaviour and infant and child mortality in Bangladesh. , 1999, Asia-Pacific population journal.

[2]  R. Amin,et al.  Community health services and health care utilization in rural Bangladesh. , 1989, Social science & medicine.

[3]  S. Rahman Utilisation of primary health care services in rural Bangladesh : the population and provider perspectives. , 2001 .

[4]  S. Garg,et al.  Female feticide in India: issues and concerns. , 2008, Journal of postgraduate medicine.

[5]  A. Bhuiya,et al.  Changing health-seeking behaviour in Matlab, Bangladesh: do development interventions matter? , 2003, Health policy and planning.

[6]  W. Neuman,et al.  Social Research Methods: Qualitative and Quantitative Approaches , 2002 .

[7]  M. Rafi,et al.  Inequitable access to immunization and vitamin A capsule services: a case of ethnic minorities in three hill districts of Bangladesh. , 2005, Public health.

[8]  A. Khan Obstetric complications: the health care seeking behaviour & cost pressure generated from it in rural Bangladesh. , 2002, Mymensingh medical journal : MMJ.

[9]  A. Bhuiya,et al.  Gender, socioeconomic development and health-seeking behaviour in Bangladesh. , 2000, Social science & medicine.

[10]  Female Autonomy and Fertility Among the Garo of North Central Bangladesh , 1989 .

[11]  Philipa Gāina,et al.  Bangladesh, land, forest, and forest people , 1995 .

[12]  A. Ashraf,et al.  Health, disease and health-care in rural Bangladesh. , 1982, Social science & medicine.

[13]  Barkat-e-khuda,et al.  Unmet contraceptive need in Bangladesh: evidence from the 1993/94 and 1996/97 Demographic and Health Surveys. , 1999, Asia-Pacific population journal.

[14]  S. M. Ahmed,et al.  Differing health and health-seeking behaviour: ethnic minorities of the Chittagong Hill Tracts, Bangladesh. , 2001, Asia-Pacific journal of public health.

[15]  H. Bernard Research methods in anthropology : qualitative and quantitative methods , 2002 .

[16]  Syed Masud Ahmed Differing Health and Health-Seeking Behaviour: Ethnic Minorities of the Chittagong Hill Tracts, Bangladesh , 2001 .

[17]  A. Bhuiya,et al.  Immunization divide: who do get vaccinated in Bangladesh? , 2003, Journal of health, population, and nutrition.

[18]  S. Ahmed Exploring health-seeking behaviour of disadvantaged populations in rural Bangladesh , 2005 .

[19]  B. Paul,et al.  Medical pluralism and infant mortality in a rural area of Bangladesh. , 1986, Social science & medicine.

[20]  M. Petzold,et al.  Socioeconomic status overrides age and gender in determining health-seeking behaviour in rural Bangladesh. , 2005, Bulletin of the World Health Organization.

[21]  Bimal Kanti Paul,et al.  Utilization of health facilities and trained birth attendants for childbirth in rural Bangladesh: an empirical study. , 2002, Social science & medicine.

[22]  J. Kaewkungwal,et al.  Gender difference in treatment seeking behaviors of tuberculosis cases in rural communities of Bangladesh. , 2004, The Southeast Asian journal of tropical medicine and public health.