Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India
Background & objectives: Non-communicable diseases (NCDs) and cancers of breast, oral cavity and cervix contribute to around 5.87 million (60%) deaths in India. Despite this, there is limited evidence on preparedness of the tribal health system in mitigating these conditions. This mixed-methods...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Medical Research |
| Subjects: | |
| Online Access: | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=156;issue=2;spage=319;epage=329;aulast=Birje |
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| author | Shantanu Birje Anushree Devashish Patil Kiran Ramdas Munne Vidya Chavan Beena Nitin Joshi Anamika Akula Neha Salvi Smitha Nair Shahanara Prabhu Valawalkar Deepti Tandon Sanjay Chauhan Devendra Patil Bontha V Babu |
| author_facet | Shantanu Birje Anushree Devashish Patil Kiran Ramdas Munne Vidya Chavan Beena Nitin Joshi Anamika Akula Neha Salvi Smitha Nair Shahanara Prabhu Valawalkar Deepti Tandon Sanjay Chauhan Devendra Patil Bontha V Babu |
| author_sort | Shantanu Birje |
| collection | DOAJ |
| description | Background & objectives: Non-communicable diseases (NCDs) and cancers of breast, oral cavity and cervix contribute to around 5.87 million (60%) deaths in India. Despite this, there is limited evidence on preparedness of the tribal health system in mitigating these conditions. This mixed-methods study aimed at identifying enablers and challenges using a multistakeholder approach for the screening of NCDs and common cancers in a tribal block of Maharashtra, India.
Methods: This study was conducted in a tribal community of Dahanu taluka in Palghar district of Maharashtra. A total of nine focus group discussions (FGDs) among tribal women and accredited social health activists (ASHAs), 13 key informant interviews (KIIs) among auxiliary nurse midwives (ANMs) and community health officers (CHO) and facility surveys of five public health facilities were conducted. The FGDs and KIIs were conducted using guides, recorded digitally, transcribed, analyzed and triangulated to identify emerging themes.
Results: The tribal women had limited knowledge about NCDs and common cancers. Paucity of health facilities, out-of-pocket expenditure, misconceptions, belief on traditional healers and inability to prioritize health were identified as major challenges. The ASHAs were recognized as a key connecting link between health system and community while provision of culturally appropriate IEC materials and adequate training were recognized as critical enablers by healthcare providers in implementing screening for NCDs and common cancers.
Interpretation & conclusions: The study recommends incorporating socioculturally relevant strategies in the tribal population and strengthening health facilities in terms of infrastructure and training with involvement of ASHAs for successful implementation of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) through health and wellness centres. |
| first_indexed | 2024-04-10T09:56:34Z |
| format | Article |
| id | doaj.art-60febafa00ed4828a4a14e8389bab1d2 |
| institution | Directory Open Access Journal |
| issn | 0971-5916 |
| language | English |
| last_indexed | 2024-04-10T09:56:34Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Medical Research |
| spelling | doaj.art-60febafa00ed4828a4a14e8389bab1d22023-02-16T12:20:18ZengWolters Kluwer Medknow PublicationsIndian Journal of Medical Research0971-59162022-01-01156231932910.4103/ijmr.ijmr_3240_21Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, IndiaShantanu BirjeAnushree Devashish PatilKiran Ramdas MunneVidya ChavanBeena Nitin JoshiAnamika AkulaNeha SalviSmitha NairShahanara Prabhu ValawalkarDeepti TandonSanjay ChauhanDevendra PatilBontha V BabuBackground & objectives: Non-communicable diseases (NCDs) and cancers of breast, oral cavity and cervix contribute to around 5.87 million (60%) deaths in India. Despite this, there is limited evidence on preparedness of the tribal health system in mitigating these conditions. This mixed-methods study aimed at identifying enablers and challenges using a multistakeholder approach for the screening of NCDs and common cancers in a tribal block of Maharashtra, India. Methods: This study was conducted in a tribal community of Dahanu taluka in Palghar district of Maharashtra. A total of nine focus group discussions (FGDs) among tribal women and accredited social health activists (ASHAs), 13 key informant interviews (KIIs) among auxiliary nurse midwives (ANMs) and community health officers (CHO) and facility surveys of five public health facilities were conducted. The FGDs and KIIs were conducted using guides, recorded digitally, transcribed, analyzed and triangulated to identify emerging themes. Results: The tribal women had limited knowledge about NCDs and common cancers. Paucity of health facilities, out-of-pocket expenditure, misconceptions, belief on traditional healers and inability to prioritize health were identified as major challenges. The ASHAs were recognized as a key connecting link between health system and community while provision of culturally appropriate IEC materials and adequate training were recognized as critical enablers by healthcare providers in implementing screening for NCDs and common cancers. Interpretation & conclusions: The study recommends incorporating socioculturally relevant strategies in the tribal population and strengthening health facilities in terms of infrastructure and training with involvement of ASHAs for successful implementation of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) through health and wellness centres.http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=156;issue=2;spage=319;epage=329;aulast=Birjecommon cancers - health system - mixed-methods research - non-communicable diseases - screening - tribal |
| spellingShingle | Shantanu Birje Anushree Devashish Patil Kiran Ramdas Munne Vidya Chavan Beena Nitin Joshi Anamika Akula Neha Salvi Smitha Nair Shahanara Prabhu Valawalkar Deepti Tandon Sanjay Chauhan Devendra Patil Bontha V Babu Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India Indian Journal of Medical Research common cancers - health system - mixed-methods research - non-communicable diseases - screening - tribal |
| title | Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India |
| title_full | Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India |
| title_fullStr | Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India |
| title_full_unstemmed | Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India |
| title_short | Enablers & challenges of tribal women & health system for implementation of screening of non-communicable diseases & common cancers: A mixed-methods study in Palghar district of Maharashtra, India |
| title_sort | enablers challenges of tribal women health system for implementation of screening of non communicable diseases common cancers a mixed methods study in palghar district of maharashtra india |
| topic | common cancers - health system - mixed-methods research - non-communicable diseases - screening - tribal |
| url | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=156;issue=2;spage=319;epage=329;aulast=Birje |
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