Healthcare scheme coverage and treatment-seeking behaviour among Scheduled Tribe households in India: a multidimensional poverty perspective

Scheduled Tribe populations in India continue to experience significant socioeconomic disadvantage and unequal access to healthcare services. However, limited evidence exists on how multidimensional poverty is associated with healthcare scheme coverage and treatment-seeking behaviour among tribal households. This study examines the relationship between multidimensional poverty, healthcare scheme coverage, and healthcare utilisation among tribal populations in India. The study utilised nationally representative data from the fifth round of the National Family Health Survey (NFHS-5, 2019-21), covering 1,20,215 Scheduled Tribe households. Multidimensional poverty was measured using the Oxford Poverty and Human Development Initiative framework. Descriptive statistics and multivariate logistic regression models were employed to examine associations between multidimensional poverty, healthcare scheme coverage, and treatment-seeking behaviour. Overall, 47.28% of tribal households reported coverage under a healthcare scheme, with substantial variation across states and districts. Multidimensionally poor households had significantly lower odds of healthcare scheme coverage than multidimensionally non-poor households. Education, household size, wealth status, and financial inclusion were significantly associated with scheme enrolment. Public healthcare facilities were the primary source of treatment for 67.59% of tribal individuals, while private healthcare utilisation was more common among wealthier households. Modern healthcare was the predominant mode of treatment (98.47%), whereas utilisation of alternative treatments remained limited (1.53%). The absence of nearby facilities, long waiting times, and poor quality of care were the most frequently reported factors associated with lower utilisation of public healthcare facilities. Multidimensional poverty was significantly associated with healthcare scheme coverage and treatment-seeking behaviour among tribal households in India. Despite the expansion of health protection programmes, substantial disparities in healthcare coverage and utilisation persist. Strengthening healthcare scheme enrolment, improving accessibility of healthcare services, and addressing commonly reported service-delivery challenges may support more equitable healthcare access and progress towards universal health coverage among tribal populations.