STRUCTURAL DETERMINANTS OF HEALTHCARE: PANIYA WOMEN IN KERALA

Abstract

Background:-The Paniya tribal community, a marginalized group in Kerala (Wayanad), faces significant health disparities due to socio-economic and cultural barriers. Tribal women in particular experience heightened vulnerability in accessing healthcare services, which is further compounded by limited infrastructure, inadequate awareness, and systemic inequalities. This study explored the structural determinants influencing healthcare access, reproductive health practices, and the prevalence of diseases among Paniya tribal women in Wayanad district, Kerala, South India. Methods:-A cross-sectional study was conducted among 1205 Paniya tribal women aged 18–90 years residing in WayanadDistrict of Kerala. A multistage random sampling technique was employed to select the participants. Data was collected using a pretested structured interview schedule, capturing socio-demographic characteristics, maternal and reproductive health details, availability of medical facilities in tribal colonies, prevalence of communicable and chronic diseases, and healthcare-seeking behavior. The data was analyzed using SPSS software. Descriptive statistics such as frequencies and percentage were used to summarize the findings. Chi-square test was conducted to determine the associations between the key variables and healthcare access or utilization patterns.  ANOVA, Linear Regression, Correlation and Coefficient values were calculated.Results:-The majority of women respondents with reproductive age (68%), among them 63.5% of the household depend on agriculture. Economic challenges were evident, as 45% of respondents lived below the poverty line. Only 49.4% of the respondents had access to proper sanitation facilities. Traditional health practices were used by 63.6% of the women, while 52% reported limited access to modern healthcare services. A significant positive correlation (p< 0.05) was found between the educational level and healthcare access, while educated women being more likely to seek professional healthcare system. Additionally, women with stable income sources (p< 0.01) had better health outcomes and were more likely to use healthcare facilities.