The study explores themes pertaining to access and utilization of healthcare embedded in Penchansky’s framework, viz. availability, affordability, accessibility, acceptability and accommodation, in conjunction with Anderson’s model of healthcare utilization amongst the transhumant pastoralist community of Bakarwals residing in Pir Panjal Range of Jammu and Kashmir. Bakarwals are fundamentally transhumant, but hordes of them sedentarized after militancy and conflict in the area reached its crescendo. Transhumants oscillate in space-time continuum, so it is imperative to conduct sample surveys due to non-existence of systematic surveillance data pertaining to health status and access of this group. The study employed a mixed method approach and took place during the reverse migration cycle from summer higher grazing pastures (dhoks) in the twin border districts of Poonch and Rajouri, comprising 250 structured questionnaire interviews coupled with 100 semi-structured interviews. Pir Ki Gali, Jammia Gali and Nurpur Gali transhumance routes were purposefully selected for discerning qualitative inquiry to yield cases with maximum information. A facility survey encompassing 12 primary health centres, three community health centres and two district hospitals was also conducted to ascertain supply-side factors in Bakarwal-concentrated areas. Results indicated lesser probability of utilization in higher pastures (dhoks) due to amalgamation of factors like geographical inaccessibility of modern medicine and cultural preference, but this is less pronounced in winter settlements and amongst the sedentarized. Demand for modern healthcare is also not commensurate with the supply for the same, exacerbated by non-availability of health professionals, drugs and poor quality of service provision found in the facility survey.

中文翻译：

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跨越边缘：巴卡尔瓦尔人在查mu和克什米尔邦的偏远和容易发生冲突的喜马拉雅地区获得医疗保健

该研究探索了与Penchansky框架中嵌入的医疗保健的获取和利用有关的主题。可用性，可负担性，可及性，可接受性和适应性，以及安达森在居住在查mu和克什米尔皮尔班加尔山脉的巴卡尔瓦尔人种的超人类牧民社区中的医疗利用模式。Bakarwals从根本上讲是超人类的，但是在该地区的好战和冲突逐渐加剧之后，他们成群结队。超人类在时空连续性中振荡，因此由于不存在与该人群的健康状况和进入相关的系统监视数据，因此必须进行样本调查。该研究采用了混合方法方法，并在Poonch和Rajouri的两个边境地区的夏季较高放牧牧场（dhoks）的反向迁移周期中进行，包括250个结构化问卷访问和100个半结构化访谈。特意选择了Pir Ki Gali，Jammia Gali和Nurpur Gali跨种族路线，以辨别定性查询，以产生具有最大信息的案件。还进行了一项设施调查，包括12个初级保健中心，三个社区保健中心和两个地区医院，以确定巴卡尔瓦尔集中地区的供应方因素。结果表明，由于现代医学在地理上的不可及性和文化偏爱等因素的合并，在较高的牧场（dhoks）中利用的可能性较低，但这在冬季定居点和定居者中不太明显。对现代医疗保健的需求也与对现代医疗保健的需求不相称，设施调查中发现，由于缺乏卫生专业人员，药品和服务质量低下，这一情况更加恶化。