Health Beyond Hospitals: Understanding Socio-Cultural Practices and Student Learning Through the Family Adoption Program in Rural Shimla, Himachal Pradesh

Background: The Family Adoption Program (FAP) enables MBBS students to interact directly with households and understand how socio-cultural beliefs shape health behaviour. During these visits, students encountered practices linked to menstruation, newborn care, hygiene, gender norms and healthcare-seeking patterns. This study analyzes the socio-cultural issues observed, student perceptions and the advice they provided. Methods: A qualitative exploratory design was used. 1st year MBBS Students of Indira Gandhi Medical Collge, Shimla, Himachal Pradesh conducted home visits, informal interviews and observations, documenting responses as field notes. Data were analyzed thematically to identify recurring beliefs, attitudes and counselling approaches. Ethical principles of verbal consent, confidentiality and cultural respect were maintained. Results: Eight themes emerged: stigma and restrictions around menstruation; honey/ghutti feeding as a cultural blessing; gender and decision-making hierarchy; preference for traditional remedies over preventive care; hygiene practices based on familiarity rather than science; secrecy around reproductive issues; households showing positive adaptation; and marriage norms and contraceptive silence linked with socioeconomic factors. Students’ perceptions shifted from viewing these practices as misinformation to understanding their cultural and emotional significance. Their advice focused on menstrual hygiene, exclusive breastfeeding, boiling water, timely medical care and open communication-offered in a respectful, non-confrontational manner. Conclusion: Socio-cultural practices were maintained due to tradition, identity and generational influence rather than lack of knowledge alone. The program enabled students to learn empathy, cultural competence and real-world communication skills. Improving community health therefore requires partnership, trust-building and gradual behaviour change rather than direct rejection of tradition.