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Table 6 Recommendations for improving access to healthcare for the Indigenous community 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?

Recommendations to improve access to healthcare for the Indigenous

Policy

 1. Decentralise services to ensure that appropriate services are delivered at each of the sub-centres, PHCs, and CHC with the Speciality Hospital acting more as a referral hospital for secondary and specialist care.

 2. Training and sensitisation of medical officers and other health staff an essential part of working among Indigenous communities

 3. Address social determinants of health including return lands that rightfully belong to the Indigenous communities in Attapadi

 4. Appoint local Indigenous youngsters as community health workers to work in Indigenous villages

Programme

 1. Form health committees in villages involving the community health worker, the village chief or a representative and engage them in decision making about local health programmes.

 2. Form council of village chiefs from all three communities with advisory role to guide delivery and update of health programmes

 3. Ensure doctors working in Attapadi visit each of the villages and interact with the community on periodic basis.

 4. Upgrade capacity of

 5. Periodic exposure and sensitisation programmes on strategies to integrate Indigenous traditions and culture into the delivery of healthcare in Attapadi