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Table 2 Interventions to improve universal access to healthcare for Indigenous communities in Attapadi

From: “Everything is provided free, but they are still hesitant to access healthcare services”: why does the indigenous community in Attapadi, Kerala continue to experience poor access to healthcare?

1. Complete financial protection for direct costs of all treatments including tertiary and specialist referral care

2. Upgrading of health facilities in Attapadi including the tribal speciality hospital and appointment of doctors including specialists and other healthcare personnel across the various health facilities in Attapadi

3. Addressing indirect costs for accessing healthcare through reimbursement of travel costs, providing free food for patient and one family member during hospitalisation, reimbursement of loss of wages at a fixed daily rate for one family member who remains with the patient during hospitalisation

4. Special salary package for healthcare workers opting to work in Attapadi

5. Establishment of a special referral arrangement with EMS Cooperative Hospital and Research Centre for tertiary care

6. Establishment of mobile medical units with dedicated teams under each of the three PHCs and the CHC in Attapadi to provide screening, limited primary treatment and immunisation services to those living in remote villages

7. Establishing a formal mechanism chaired by the nodal office of the state government to review the work of multiple government departments on a monthly basis and promote inter-sectoral coordination between various departments to address the challenges faced by the Indigenous communities living in Attapadi