Health in Kerala: exploring achievements and remaining challenges of health systems reform using an equity lens.

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Hari Sankar D, Anish Thekkumakara Surendran, Rakhal Gaitonde, Devaki Nambiar
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Abstract

Background: The southern Indian state of Kerala is often regarded as a global model for its impressive health outcomes at a low cost. While the state consistently invests in healthcare and showcases remarkable health indicators, disparities persist, particularly among underserved populations who experience poorer health outcomes. This special issue focuses on research work that examines health equity in the region.

Methods: Following an open call for the collection featuring research studies focusing on health equity in Kerala in 2022, we received 29 submissions; four editors handled the submissions, and after peer review, nine articles were finally published as part of the special issue.

Results: The final collection has nine articles which include studies describing health system efforts and user experiences about the control of tuberculosis, two evaluations of Universal Health Coverage (UHC) reforms in the state, a commentary on challenges faced by transgender persons in accessing gender-affirming medical care, two qualitative studies that span the UHC reform process and policies through the lens of a marginalized section of society, a case study on rabies death and a cross-sectional analysis characterizing the impact of COVID 19 pandemic in the mental health of school children.

Conclusion: The special issue contributes to the growing body of literature around health equity in Kerala and India and documents key challenges that plague the state health system like persisting access issues to seek necessary care, lack of acknowledgment of important social determinants in policies, absence of targeted interventions for underserved communities, and shortcomings in engaging with the private sector - that continue to plague the journey of moving towards Universal Health Coverage (UHC). The findings suggest that custom made policies are required to address the specific health needs of underserved population rather than a doing "more of same" approach.

喀拉拉邦的卫生:从公平的角度探讨卫生系统改革的成就和仍然存在的挑战。
背景:印度南部的喀拉拉邦以低成本取得了令人印象深刻的卫生成果,常常被视为全球典范。虽然国家一直在医疗保健方面进行投资,并展示了显著的健康指标,但差距仍然存在,特别是在服务不足、健康状况较差的人群中。本期特刊侧重于审查该区域卫生公平的研究工作。方法:在公开征集2022年喀拉拉邦卫生公平研究报告后,我们收到了29份意见书;四位编辑处理了投稿,经过同行评议,九篇文章最终作为特刊的一部分发表。结果:最后一集有九篇文章,其中包括描述卫生系统努力和控制结核病的用户体验的研究,对该州全民健康覆盖(UHC)改革的两项评估,对变性人在获得性别肯定医疗服务方面面临的挑战的评论,两项定性研究跨越了UHC改革过程和政策,通过社会边缘部分的镜头,狂犬病死亡个案研究和COVID - 19大流行对学龄儿童心理健康影响的横断面分析结论:本期特刊促进了围绕喀拉拉邦和印度卫生公平的文献越来越多,并记录了困扰国家卫生系统的主要挑战,如寻求必要护理的持续获取问题,缺乏对政策中重要社会决定因素的认识,缺乏对服务不足社区的有针对性干预措施,以及与私营部门合作的不足——这些问题继续困扰着实现全民健康覆盖的进程。调查结果表明,需要定制政策来解决服务不足人口的具体卫生需求,而不是采取“更多相同”的做法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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