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Navigating delayed diagnoses, self-neglect, and lost livelihoods: a qualitative exploration of fisherfolk's health perspectives and management of non-communicable diseases in Kerala, India. | LitMetric

Navigating delayed diagnoses, self-neglect, and lost livelihoods: a qualitative exploration of fisherfolk's health perspectives and management of non-communicable diseases in Kerala, India.

BMC Prim Care

Health Systems and Equity, The George Institute for Global Health, 308, Third Floor, Elegance Tower, Plot No. 8, Jasola District Centre, New Delhi, 110025, India.

Published: September 2024

AI Article Synopsis

  • * A qualitative study was conducted in Kerala, involving in-depth interviews with fisherfolk living with NCDs to assess their health-seeking experiences and understand the relationship between their work conditions and health challenges.
  • * The study found late diagnosis of NCDs among participants, with seafaring fisherfolk preferring public healthcare facilities and inland fisherfolk favoring private ones despite the costs; both groups faced difficulties accessing care due to health center hours conflicting with their work schedules.

Article Abstract

Introduction: Non-Communicable Diseases (NCDs) place a significant burden on India's healthcare system, accounting for approximately 62% of all deaths in the country in 2017. The southern Indian state - Kerala - has some of the highest rates of NCDs. Within the state, the fisherfolk community has a high prevalence of risk factors such as tobacco use and alcohol consumption. Working in the fisheries industry demands physical exertion, night shifts alongside extended periods of time at sea (for seafaring fisherfolk). Evidence is scant on how these conditions relate to the health-seeking experiences of fisherfolk, particularly in the context of NCDs. We conducted a qualitative study in two districts of Kerala to fill this gap.

Methods: In-depth individual and small group interviews- as per participant preference -  with male and female fishing community members living with NCDs were conducted between October 2022 and February 2023 in two districts of Kerala. Interviews were conducted to explore community members' experiences with health-seeking for NCDs. Transliterated English transcripts were coded using ATLAS.ti software and analysed using thematic analysis with inductive generation of codes, with indexing against Levesque, Harris, and Russell's 2013 access to healthcare framework.

Results: Thirty-three interviews with 42 participants were conducted. We found that NCDs were usually diagnosed late- either when admitted/consulted for other illnesses or when the symptoms became unbearable. Health-seeking patterns differed between seafaring and inland fishing subgroups, who were sampled from two districts in the state. Seafaring fisherfolk preferred public facilities for regular checkups and medicines while in-land fisherfolk relied on private facilities, although it was considered expensive. Ability to seek care was impacted by the working hours of the health centre which did not suit their working hours. Health constaints and related expenses also impacted their financial status and occupation, with some opting for less strenuous jobs.

Conclusion: This study highlights the NCD-related health-seeking experiences of the fisherfolk community in Kerala, India. Fisherfolk reported self neglect, delayed diagnosis, cost and livelihood constraints owing to the onset of NCDs, even as dual practice and medicine access in the public sector were appreciated. Overall, larger studies and policymaking processes should consider in depth the experiences faced by particular economic groups like fisherfolk, who may face unique health and care-seeking challenges.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437729PMC
http://dx.doi.org/10.1186/s12875-024-02575-2DOI Listing

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