JMIR Publications

ABSTRACT

Background:

The public health landscape in North-East India, situated in the eastern Himalayas, is marked by the foundational principle of equitable healthcare provision, a critical endeavor given the region's intricate geography and proximity to international borders. Healthcare workers grapple with challenges such as treacherous routes, limited infrastructure, and diverse cultural nuances in their efforts to deliver essential medical services. Despite improvements since the National Rural Health Mission in 2005, challenges persist, prompting a study to identify healthcare workers' challenges and coping strategies in Manipur and Nagaland.

Objective:

The aim of this study is to document the challenges experienced by healthcare workers while service delivery in geographically challenging terrains of various districts in North-East India. Method: In-depth interviews of 24 healthcare workers were conducted using semi-structured questionnaires in seven Primary Health Centres (PHCs), and three Community Health Centres (CHCs). Data was first recorded, then transcribed and translated, afterwards codes, sub-themes and themes were developed using Nvivo 14 for thematic analysis.

Results:

Healthcare workers have addressed a number of challenges in their routine work including the infrastructural issues, communication issues, and inadequate distribution of supplies in remote locations mainly due to poorly constructed roads. The pandemic had exacerbated healthcare staff's responsibilities, straining resources and time. Communication issues, and inadequate distribution of essential supplies in remote locations hinder healthcare delivery. Apart from this in pandemic they addressed fear of transmission, stigma, disruptions in routine facilities, increased workload, vaccine hesitancy, misinformation, and lack of diagnostic centers. Conclusion: Healthcare workers in Manipur and Nagaland have shown remarkable resilience in the face of numerous challenges exacerbated by the pandemic. Despite infrastructural limitations, communication barriers, and inadequate supply distribution in remote areas, they have demonstrated adaptability through innovative solutions like efficient data management, vaccination awareness campaigns, and leveraging technology for improved healthcare delivery. Their dedication and resourcefulness have been essential in navigating through these difficult times.