"Barriers to Accessing Targeted Interventions among Key Populations in Jharkhand, India: A Mixed-Methods Study in Two
Ravi Ranjan Jha1, Ratnesh Sinha2, Jai Ranjan3
1Department of PSM, Shaheed Nirmal Mahto Medical College and Hospital Dhanbad, Dhanbad, Jharkhand, India.
Summary
Barriers like stigma and discrimination hinder healthcare access for men who have sex with men (MSM), transgender individuals (TGs), and female sex workers (FSWs). Culturally sensitive approaches and structural changes are needed to improve inclusivity in health programs.
Area of Science:
- Public Health
- Health Services Research
- Social Sciences
Background:
- Key populations, including men who have sex with men (MSM), transgender individuals (TGs), and female sex workers (FSWs), face significant barriers to healthcare access.
- Targeted interventions (TIs) aim to address these barriers, but service delivery gaps persist.
Purpose of the Study:
- To identify barriers to healthcare access for MSM, TGs, and FSWs in Jharkhand.
- To understand participant experiences and identify service delivery gaps.
- To inform recommendations for improving healthcare access for these key populations.
Main Methods:
- A mixed-methods approach combining quantitative surveys and qualitative focus group discussions (FGDs).
- Quantitative data analyzed using SPSS; qualitative data analyzed using ATLAS.ti.
- Participant responses scored on a five-point Likert scale for acceptability.
Main Results:
- Key barriers identified include stigma, discrimination (especially for TGs), lack of awareness, and infrastructural challenges.
- High acceptability scores were noted, but only gender was statistically significant (P < 0.05).
- MSMs reported fear of disclosure, reluctance in partner testing, and high rates of alcohol/drug abuse.
Conclusions:
- Culturally sensitive outreach, peer inclusion, and structural changes in healthcare settings are crucial.
- Findings offer actionable insights for policymakers to enhance inclusivity in national healthcare programs.
- Addressing the unique challenges of key populations is essential for equitable healthcare access.
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