Knowledge, Attitudes And Practices Related To Health And Well-Being In A Forest Fringe Community In Southern India

Highlights:

*  A recent research study of 322 households in 35 villages conducted between 2021 and 2022 near Mudumalai Tiger Reserve (MTR) in Tamil Nadu analyzed healthcare access, socio-economic factors, and health practices to better understand the linkages between biodiversity conservation, human health and well-being.

* Respondents self-reported a mix of chronic (62%) and acute (31%) health issues, with undiagnosed fever being the most reported acute ailment (57%).

* Despite having lower levels of formal education, people living in the core zone of the reserve demonstrated greater awareness of disease risks and reported more proactive health-seeking behaviors compared to those in more urban-adjacent areas.

* Chronic conditions, such as cardiovascular diseases and diabetes were reported by 62% of respondents and were more prevalent in villages in the buer and boundary zones that are closer to urban areas.

* Education levels were a key determinant in healthcare access and perceptions, with individuals with higher education being more likely to utilize formal healthcare services and demonstrate greater awareness of health risks and illness prevention.

* Most residents (63%) preferred government healthcare for primary care, while 30% opted for private facilities for surgeries. A majority (76%) expressed satisfaction with public services, citing dignied treatment (64%) and regular visits from healthcare workers as reasons for seeking care.

* With 15% of respondents spending more than a month’s income on healthcare services, the study emphasizes the urgent need for improved healthcare infrastructure, including access to clean water, sanitation, and health insurance coverage for these marginalized populations.

The research study titled ‘Knowledge, attitudes, and practices related to health and well-being in a forest fringe community in southern India’, published in BMC Public Health on 6th May 2025, examines the healthcare challenges faced by rural villages surrounding the Mudumalai Tiger Reserve (MTR) in Tamil Nadu. Led by Dr. Bindu Raghavan, the study draws on data collected through semi-structured interviews in 322 households across 35 villages to understand how healthcare access is shaped by socio-economic conditions, disease awareness, and local health practices in tribal and marginalized populations living in the core, buer, and boundary zones of the reserve. Co-authors include Alby Wilson, Shruti Namboodiri, Manigandan Selvaraj and Dr. Krithi K. Karanth from the Centre for Wildlife Studies.

This research study reveals that healthcare practices in these rural communities are inuenced by a complex interaction of environmental, social, and cultural factors. In villages located within the core zone of the MTR there is a marked reliance by people on traditional knowledge and practices for preventing and treating health conditions. Despite lower levels of formal education, these communities demonstrate a high degree of awareness of health risks, particularly regarding lifestyle-related chronic diseases. However, they were less aware of risks from zoonotic and vector-borne diseases.

In villages closer to urban areas in the buer and boundary zones, 62% of people reported chronic illnesses such as diabetes, high blood pressure, and heart problems, largely due to low awareness of how lifestyle aects health. In these areas, healthcare providers struggle to oer eective preventive care or manage these chronic conditions.

Additionally, acute illnesses such as fevers as well as respiratory infections and gastrointestinal disorders are widespread in the studied communities. The study suggests that these illnesses may be linked to zoonotic diseases. This is based on the higher number of acute symptoms like fever reported in villages near the core reserve, where people are more likely to interact with wildlife. This highlights a correlation between human health and wildlife conservation and the need for health interventions that consider the specic risks faced by people living close to wildlife habitats.

Dr. Bindu Raghavan, lead author of the study says, ‘While our study population seemed to suer mainly from lifestyle-related chronic illnesses, the low self-reported incidences of tuberculosis, a chronic disease with high national prevalence, and sickle cell anemia, a genetic disorder with high prevalence in tribal populations of southern India, were unexpected ndings that need deeper investigation.’

A key insight is the community’s reliance on a wide range of healthcare options. The study found that 63% of respondents preferred government healthcare services for primary care, while 30% opted for private facilities for surgical procedures. Education levels were a key determinant in healthcare access, with individuals with higher education being more likely to utilize clinical healthcare services.

Meanwhile, those with lower education levels often turned to traditional healers or avoided medical care altogether. The study also identies systemic barriers that hinder healthcare access, such as inadequate infrastructure. For instance, 15% of respondents reported spending more than a month’s income on healthcare services. Furthermore, marginalized groups, particularly women and low-income households, face additional challenges in accessing healthcare, exacerbating health disparities in these communities.

Co-author Dr. Krithi K. Karanth says, ‘ Our study provides valuable insights to improving targeted health care services to people living in close proximity to wildlife and interestingly nds variability in awareness and access to health care across chronic lifestyle-related illnesses and acute infectious illnesses among dierent communities’.

Given these ndings, the authors call for integrated healthcare interventions that address the immediate health needs of rural populations. These interventions should enhance and facilitate access to clean water, sanitation, and health insurance, alongside expanding culturally appropriate health education programs tailored to the specic needs of these communities. In conclusion, the study underscores that for conservation eorts in wildlife reserves like MTR to be successful and sustainable, the well-being of local communities must be considered alongside ecological goals. Ensuring that rural populations have access to comprehensive healthcare services will not only improve their quality of life but also foster better cooperation between people and wildlife.

The Centre for Wildlife Studies (CWS) is an internationally recognized centre-of-excellence in the areas of wildlife research, conservation, policy, and education. Our mission is to safeguard and conserve India's rich and diverse wildlife heritage through cutting-edge research, eective conservation strategies, and community engagement. For forty years, we have been committed to advancing scientic knowledge, promoting sustainable practices, and inspiring a collective sense of stewardship to ensure the survival of India’s wildlife and their habitats for future generations. Our vision is of a society that values and protects its natural heritage, fostering a sustainable environment where wildlife thrives and human well-being is interconnected with the health of the natural world. Through our research, conservation eorts, and community empowerment, we aspire to create a future where wildlife and humans can coexist, ensuring the perpetuity of India's extraordinary natural wildlife heritage.