An Anthropological Investigation of Individual and Contextual Barriers to Modern Healthcare Utilization Among Santal Women in the Barind Tract of Rajshahi

Indigenous women in low-resource settings face compounded barriers to healthcare access, yet limited research explores how cultural, structural, and gendered inequities intersect to shape these challenges. This study investigates of individual and contextual barriers to modern healthcare utilization among Santal women in the Barind Tract of Rajshahi, Bangladesh, a region marked by geographic remoteness and socio-economic marginalization. A qualitative approach was employed, combining 25 in-depth interviews, two focus group discussions (FGDs), and field observations with Santal women (October–December 2024). Purposive sampling ensured representation across age, marital status, and occupation. Secondary data from peer-reviewed articles, government reports, and gray literature were analyzed thematically to contextualize. Cultural beliefs (e.g., viewing pregnancy as a “natural event”), reliance on traditional healers, and patriarchal restrictions on mobility emerged as primary individual barriers. Structural barriers included geographic remoteness (nearest clinic: 15–20 km), economic constraints from daily wage labor, and institutional mistrust fueled by discriminatory healthcare staff. Women who are widowed or unmarried experienced significant marginalization, as they did not have male guardians to assist them in accessing clinics or hospitals. The exclusion of Santal women from healthcare is fundamentally linked to overlapping cultural and structural inequities, highlighting systemic shortcomings in addressing the health needs of Indigenous populations. Findings inform SDG 3 (health), SDG 5 (gender equality), and SDG 10 (reduced inequalities), urging policymakers to integrate traditional healers into primary care systems and deploy mobile clinics in remote Indigenous communities.