This webinar will explore the reasons why inequity in access to healthcare is still a feature of the health system in Attapadi in Kerala, India. The findings will be discussed in the context of social exclusion, and the webinar will present the implications for the dominant approach to achieve Universal Health Coverage.
Kerala is a south Indian state that leads the other states of India when it comes to health and development. The ‘Kerala model’ refers to the successful efforts of the state to provide good health at low cost. In all classic public health indicators Kerala leads the rest of India. For example, the infant mortality rate in Kerala is 7 compared to the national average of 32.
Despite its successes in health and development, the South Indian state of Kerala is not immune to the social exclusion and marginalisation of Indigenous communities living in the state. In 2013, the Kerala Department of Health responded to high levels of infant mortality in Attapadi by implementing reparative measures including upgraded health facilities and the appointment of specialist doctors to improve both the quality of care and the services available. They also introduced a complete financial protection scheme which addressed both direct and indirect healthcare costs ensuring free healthcare services and launched a system to ensure free referral care by specialists. In addition to these initiatives, the Scheduled Tribes Development Department, in charge of the welfare of Indigenous communities, rolled out specific programmes to promote healthcare services among the community including a financial package to incentivise hospital-based antenatal care and delivery. Acknowledging the importance of social determinants, the Government of Kerala also established an active review mechanism to ensure intersectoral collaboration and promote convergence among the various departments. Yet despite these measures, the Indigenous communities in Attapadi continue to experience high levels of infant mortality and poor health.
About the speaker
Sunil George is a public health researcher from India with several years of experience working among excluded communities in India and Africa. His PhD thesis focussed on why, even in a progressive Indian state such as Kerala with a well-developed public health system, excluded communities such as the Indigenous communities and elderly widows living alone face inequitable access to healthcare.
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