Unearthing transformation: a qualitative study on the impact of Radio Dhimsa bringing changes in health-seeking behaviour in Odisha's Tribal-Rich Koraput district

INTRODUCTION

The convergence of health communication and behavior change has received a lot of attention in public health, especially in rural and underserved communities where health-seeking behaviors are influenced by cultural, social, and economic variables. Among numerous initiatives, community radio has emerged as an effective medium for closing the gap between health information transmission and behavioral change, particularly in areas with limited access to traditional media and healthcare services. Globally, community radio is credited with solving local health issues, engaging communities, and encouraging beneficial health behaviors. In India, there are approximately 300 operational community radio stations, many of which target rural people to raise awareness and promote health interventions.^1,2

In Odisha, Koraput district is a tribal-dominated and geographically isolated region with over 50% of its population belonging to Scheduled Tribes. The district faces significant challenges in healthcare delivery, with maternal mortality rates as high as 258 per 100,000 live births and infant mortality rates at 45 per 1,000 live births, both well above the national average.³ High poverty levels, low literacy rates, and adherence to traditional health practices hinder access to modern healthcare services. Additionally, mistrust of formal health systems and geographical inaccessibility exacerbate poor health outcomes.⁴ To address these barriers, Radio Dhimsa, a community radio station established in 2008 by South Orissa Voluntary Action (SOVA), was launched to empower tribal communities by promoting health awareness and encouraging positive health-seeking behaviors.

Radio Dhimsa broadcasts in tribal languages such as Kui, Desia, and Odia, ensuring effective communication with the local population. Its programming encompasses a range of health topics, including maternal and child health, nutrition, sanitation, disease prevention, and access to healthcare services. By employing culturally resonant formats like storytelling, songs, and interactive sessions, the station fosters trust and relatability among its listeners. Studies indicate that over 70% of the population in the station’s coverage area regularly tunes into Radio Dhimsa, highlighting its reach and impact.^5,6

This study aims to explore the role of community radio in shaping health behaviors among tribal populations. Specifically, it investigates how Radio Dhimsa has influenced addressing health-related misconceptions, encouraging the utilization of formal healthcare services, and empowering communities. Tribal communities often rely on traditional practices and local healers, leading to delayed or inappropriate health interventions. Radio Dhimsa’s targeted messaging aims to challenge these practices by promoting evidence-based health behaviors.⁷

The broader context of this study aligns with global efforts to leverage communication strategies for improving public health, as emphasized by the World Health Organization’s framework for health promotion. By delving into the narratives of community members, this research seeks to uncover the transformative impact of Radio Dhimsa on health-seeking behavior. Findings from this study will provide actionable insights for policymakers, public health practitioners, and development organizations on utilizing community radio as a catalyst for behavior change in tribal and underserved regions. Such evidence is crucial for designing scalable and sustainable health communication strategies that prioritize inclusivity and cultural sensitivity.⁸

METHODS

The qualitative case study was conducted from May to July 2023 to comprehensively examine the influence of Radio Dhimsa on health-seeking behavior among tribal communities in Odisha's Koraput district. A qualitative approach was chosen as it was particularly well-suited to explore the nuanced experiences, perceptions, and cultural dynamics of diverse populations. Ethical approval (IEC No. 1339) was obtained from the Institutional Ethical Committee. Written informed consent was obtained from all participants before their recruitment into the study. The study population comprised individuals aged 18 years and above from tribal communities who were regular listeners of Radio Dhimsa. The study was conducted over a three-month period, allowing for sufficient interaction with participants to gather diverse and in-depth data while capturing temporal variations in their responses. The research was conducted in 62 villages distributed across six panchayats in the Koraput and Lamtaput blocks of Odisha. Data collection relied primarily on unstructured interviews, providing participants with the opportunity to freely articulate their thoughts, perceptions, and experiences regarding the radio station's health-related programming. Supplementary tools such as photographs, audio recordings, and video clips were employed to enrich the data collection process. Purposive sampling was used to select participants who met specific inclusion criteria, such as regular listenership of Radio Dhimsa and relevance to the research objectives. Study participants were individually interviewed by the first author in a private room using a narrative style. Participants were prompted to elaborate on any unclear concepts until clarification was achieved. The interview guide is available in the supplementary file. Each interview lasted 20–30 minutes. All conversations were audio recorded and transcribed verbatim by the interviewer. Data saturation was reached after interviewing 16 participants, providing sufficient confidence to answer the research questions. Analysis was conducted manually by three researchers from different cultural backgrounds using appropriate software in the Department of Community Medicine, MKCG Medical College and Hospital, ensuring rigor and reliability.

RESULTS

A total of 16 participants were interviewed in this study. Figure 1 depicts all the emergent themes and subthemes.

28 codes emerged from the manual analysis of the 16 transcripts. These were grouped into 13 subthemes which led to the emergence of 4 themes, namely Role of Radio Dhimsa, Community Health Awareness, Community-led Interventions and Sustainability and Future Impact (Table 1).

Figure 2 showed the various code clouds based on frequencies. The code cloud highlighted the key themes and patterns that emerged from the qualitative study on the role of Radio Dhimsa in shaping health-seeking behaviors among tribal communities in Odisha’s Koraput district. The most prominent codes-represented in larger font sizes-indicated the most frequently mentioned aspects of the study, demonstrating the areas where the radio station had the most significant influence.

One of the strongest themes observed in the study was Information Dissemination, where Radio Dhimsa emerged as a trusted health information source, particularly due to its easy-to-understand health messages delivered in the Desia language. The prominence of “Broadcasts in Desia language” and “Addresses tribal-specific issues” in the code cloud signified how linguistic and cultural relevance played a crucial role in making health information more accessible and relatable to the community. Participants reported that hearing health messages in their native language made them feel included and encouraged them to engage more actively with the information provided.

The theme of Community Engagement and Empowerment was also highly emphasized. The radio platform served as a medium for voicing concerns, fostering active listener engagement, and increasing community-led health discussions. The significance of these codes in the cloud suggested that Radio Dhimsa went beyond passive broadcasting and facilitated interactive dialogues, allowing tribal listeners to share their health challenges and learn from each other’s experiences.

Another key insight reflected in the cloud was the Behavioral Changes and Decision-Making fostered by Radio Dhimsa. The codes “Seeking medical care over traditional healers” and “Increased hospital visits” appeared prominently, indicating a clear shift in health-seeking behavior. Traditionally, many community members relied on local healers (Disharis) for medical treatment, but Radio Dhimsa’s programs encouraged people to seek modern medical care. The increased awareness of free healthcare facilities further strengthened this transition, reducing financial barriers that might have previously discouraged hospital visits.

The Community Health Awareness theme also stood out, particularly in terms of knowledge of symptoms and treatments and the adoption of preventive measures. The prominence of handwashing, sanitation improvement, and immunization awareness suggested that the radio programs successfully contributed to promoting preventive healthcare practices, reducing the prevalence of communicable diseases in these tribal areas. The memorization of health jingles/messages further reflected the effectiveness of repetitive health messaging, as community members internalized key health messages and applied them in their daily lives.

A particularly interesting observation was the emergence of community-led interventions, where children and adolescents became health ambassadors. The codes “Health ambassadors among children and adolescents” and “Parents adopting health tips from children” highlighted an intergenerational knowledge transfer, where young listeners took the initiative to educate their families on healthy behaviors. Additionally, there was a decline in addiction and antisocial behavior among youth, indicating that engagement with Radio Dhimsa contributed to positive social change.

The Sustainability and Future Impact of the radio program was also reflected in the cloud. The consistent shift towards modern healthcare (as seen in the “Preference for hospitals over traditional healers” code) suggested that the impact of Radio Dhimsa was not short-lived but rather led to long-term behavioral transformation. The radio became a trusted health resource, and there were growing demands for expanded health content and more local health services, indicating an increasing reliance on credible health information sources. Furthermore, the formation of self-help groups and partnerships with medical institutions suggested that the community actively worked towards sustaining and expanding health interventions beyond just radio broadcasts.

Radio Dhimsa, a community-driven radio station, profoundly impacted the tribal communities of the Koraput district, fostering a sense of belonging and empowerment. Unlike other radio channels in English and Hindi, Radio Dhimsa broadcasted in Desia, the local dialect, creating a deep connection with its listeners. As one participant fondly expressed, “We had many radio channels in English and Hindi but not in Desia… It gave us a feeling that it was our own station, by our own people, working for us” (Participant 1).

A voice for the community

For many, Radio Dhimsa became more than just a source of entertainment; it served as a powerful medium for voicing health concerns. Listeners felt heard, validated, and included in discussions about their well-being. "The radio station gave us a platform to voice our health concerns” (Participant 3), shared one participant, highlighting its role in bridging the communication gap between healthcare providers and the community. Another listener emphasized the emotional connection fostered by the station, stating, “The personalized health stories on Radio Dhimsa made us feel connected. It was like learning from our neighbors” (Participant 4).

Community-led awareness

One of the most remarkable aspects of Radio Dhimsa’s impact was its ability to deliver health messages in an engaging and memorable way. Through catchy jingles and relatable storytelling, health awareness seamlessly wove itself into the fabric of everyday life. As one listener noted, “The radio jingles were catchy, but the health messages were even more memorable. We found ourselves repeating them” (Participant 2). This repetition transformed casual listeners into active participants, reinforcing positive health behaviors within the community.

Empowering community-led interventions

Beyond awareness, the station inspired proactive health initiatives within families and neighborhoods. Children, in particular, emerged as key agents of change. A proud parent shared, “Our children became health ambassadors… Instead of spending their free time gambling or drinking, they took part in creating programs and taught the same to us” (Participant 5). This shift in youth engagement had a ripple effect on older generations as well. Another participant reflected, “How could we not follow something that our children said and did? Today’s children knew the best, right?” (Participant 7). This generational transfer of knowledge underscored the sustainability of health awareness fostered by Radio Dhimsa.

Sustainability and future impact

The transformation sparked by Radio Dhimsa extended beyond individual behavior to systemic changes in health-seeking practices. Many listeners, who once relied solely on traditional healers, actively sought medical assistance at healthcare centers. “Earlier, we used to go to local Disharis for our treatment, but Radio Dhimsa encouraged us to go to hospitals as well” (Participant 6). Others emphasized how their understanding of health and available services deepened over time. “Our understanding of health evolved. We now knew about the health services available to us free of cost” (Participant 9), shared another listener, reflecting the long-term impact of the radio station on informed decision-making.

DISCUSSION

The findings from this qualitative study highlight the transformative impact of Radio Dhimsa on health-seeking behavior in Odisha’s tribal-rich Koraput district. Through in-depth interviews with 16 participants, the study identified four major themes-Role of Radio Dhimsa, Community Health Awareness, Community-led Interventions, and Sustainability and Future Impact-each contributing to the broader shift towards informed health decisions within the tribal communities. The analysis, supported by a code cloud visualization, underscores the significant role played by Radio Dhimsa in fostering health awareness and behavioral change.

One of the most striking findings is the importance of information dissemination through culturally relevant and linguistically accessible content. Radio Dhimsa, broadcasting in the Desia language, has bridged the gap between healthcare providers and tribal communities by presenting complex health messages in an easy-to-understand manner. This localization of health communication has not only made information more relatable but has also encouraged greater community engagement. Participants expressed a deep connection with the station, reinforcing the idea that accessible communication is fundamental in improving health literacy.

Community engagement and empowerment emerged as another crucial theme, with the radio station providing an interactive platform for discussions on health issues. The active listener engagement demonstrated in the study highlights how Radio Dhimsa has gone beyond passive broadcasting to create a two-way dialogue where community members can voice their concerns and learn from one another’s experiences. This participatory approach has strengthened the trust in health messages and has encouraged tribal communities to take ownership of their health outcomes.

A significant behavioral shift was also observed in terms of health-seeking practices and decision-making. Traditionally, reliance on Disharis (local healers) was prevalent in these communities, but Radio Dhimsa has played a critical role in shifting this paradigm towards hospital-based care. Participants reported an increase in hospital visits and utilization of free healthcare services, indicating a move towards evidence-based medical treatment. The repetitive health messaging strategy, including jingles and storytelling, further solidified key health concepts, leading to greater awareness and proactive health behaviors.

The study also sheds light on community-led interventions, particularly the role of youth as health ambassadors. A notable finding was the intergenerational transfer of knowledge, where children and adolescents, after learning from the radio programs, influenced their families’ health decisions. This shift not only improved household health practices but also contributed to a decline in addiction and antisocial behaviors among youth. The emergence of local health committees and community-driven health education initiatives signifies a broader social impact, as the radio’s influence extends beyond individual listeners to collective action for improved health outcomes.

Finally, the study highlights the sustainability and long-term impact of Radio Dhimsa’s programs. The consistent preference for modern healthcare services suggests a lasting change in health-seeking behavior rather than a temporary shift. Additionally, the institutional linkages formed with healthcare providers indicate a growing synergy between the community and formal health systems. Participants also expressed a desire for expanded health programming and better healthcare access, emphasizing the need for continued investment in community-based media as a tool for health promotion.

CONCLUSION

Radio Dhimsa has emerged as a powerful catalyst for health transformation in Odisha’s tribal communities. By combining local language broadcasting, interactive engagement, and culturally sensitive content, the radio station has successfully fostered health awareness, behavioral shifts, and community-driven health initiatives. The findings of this study reinforce the potential of community radio as a sustainable medium for public health communication, especially in marginalized and underserved regions. Future efforts should focus on expanding the scope of health programming, strengthening partnerships with healthcare providers, and ensuring long-term sustainability of such initiatives to further enhance health outcomes in these communities.

ACKNOWLEDGEMENTS

We would like to thank the staff of Radio Dhimsa, members of SOVA Organisation and everyone in the Department of Community Medicine, SLN Medical College and Hospital and the department of Community Medicine, MKCG Medical College and Hospital for the successful completion of this project. I would also like to express my gratitude to all the participants who gave their valuable time and consented to the interviews.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee (approval IEC No. 1339)

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