Publication:

Comparing primary health care delivery through family health centres in tribal Kerala: a two-centre study

Background ‘Aardram Mission’, a Government of Kerala health initiative, aims to transform Primary Health Centres (PHCs) into Family Health Centres (FHCs) -one of its four key-components - focusing on people-friendly outpatient-services, comprehensive health service access for all including marginalized populations and standardizing healthcare from primary to tertiary settings. The research study compares healthcare service provision, innovations and challenges in delivering healthcare to tribal communities at two distinct Family Health Centres.

Methods This qualitative study was conducted in FHC Noolpuzha in Wayanad and FHC Edamalakudy in Idukki districts, Kerala, India. It was carried out with provider stakeholders from two FHCs serving tribal populations in two different districts of Kerala, aiming to highlight contrasting examples of healthcare service delivery. These selections aim to showcase the diversity and mechanisms of service provision. Thematic analysis was done on the inputs obtained through the qualitative study.

Results While one FHC demonstrated judicious use of resources and better functioning, attributed to strong team-building efforts among human resources and active engagement from local political leaders and the community, the other FHC faced significant barriers to healthcare access for tribal communities, including inadequate infrastructure, high direct and indirect costs to the beneficiaries and limited social support.

Conclusions The findings offer practical insights for enhancing health services for tribal communities in Kerala by promoting stronger collaboration within and between departments, fostering political support and adopting more socially inclusive approaches to healthcare.