This is a one year research projected funded by International Development Research Centre ( IDRC), Canada through Achutha Menon Center for Health Science Studies ( AMCHSS), Thiruvananthapuram
Kerala has been in the forefront of development with remarkable efforts in framing policies on health, education and employment. However significant gaps can be observed in the utilization of the delivery systems and reasons are manifold and can vary according to the socio-economic, cultural and educational contexts to which the population belongs. One of the glaring inequities in the present scenario is that seen in maternal and child health. The previous studies in this area has tried to establish inequities in health status and health care utilization but their focus was restricted to certain district like Wayanad or Palakkad. Also, the interplay of both provider side and the consumer side factors responsible for the inequity were not explored in these studies. These factors need to be identified in order to device proper intervention to control the present situation.
The study, “Exploring health inequity by assessing the nature of healthcare utilization and its correlates among the tribal population of Kerala”, attempts to give a holistic picture of the nature of health inequities in the tribal population in Kerala in terms of service provision and acquisition. This study also attempts to look at the policies enacted by the state to address these health inequities. The primary objective of the study is to explore the nature of health care utilization by assessing Ante natal care services, immunization services and supplementary nutrition services among tribal and non tribal population of Kerala. The study intends to use both quantitative and qualitative tools to bring out the differences in health care utilization among tribal and non tribal population and the factors contributing to the inequities. Further, the study also attempts to describe how policy and the health care system have addressed these issues.
PURE is a multinational, multicentred study guided and coordinated by McMaster University, Canada.
For most populations, the last century has witnessed dramatic improvements in health. Life expectancy has increased from a global average of 46 years in 1950 to 66 years in 1998. During the 1st half of the century, developed countries experienced rapid declines in deaths from infections, childhood diseases, and increases in chronic diseases. These changes are attributed to economic development and societal and lifestyle changes associated with urbanization. Low and middle-income countries (LIC and MIC) are undergoing several transitions (economic, nutrition, urbanization), which collectively affect health, giving rise to marked increases in obesity, diabetes, and CVD. It is expected that by 2020, >85% of global CVD will be in developing countries. Therefore there is an urgent need to understand how societal changes in LIC, MIC, and high IC (HIC) increase chronic diseases, e.g. CVD, in order to develop strategies that mitigate these processes. To do so a global research program that includes investigation of macro-environmental changes (urbanization and other societal factors) and individual level factors (lifestyle, metabolic and genetic) is required. Urban and rural cohorts are established to track changing environments, societal influences on lifestyle, risk factors and CVD, utilizing periodic standardized data collection in multiple communities from 25 countries representing every major region of the world involving a total of about 2,25,000,000 individuals. HAP is one of the study partners in India besides other partners in the country such as St John’s Research Institute , Bangalore, Dr Mohan’s Diabetic Research Institute , Chennai, PGI Chandigarh and Fortis Escorts hospital, Jaipur.
The baseline study of this project was from March 2003 till 2007 and recruited 5650 subjects from fifteen locations in Thiruvananthapuran district both rural and urban. The study population comprises people between age group of 35-70 years. The first three year follow up of this study was completed and the second round follow up is going to start soon.
This project is funded by Indian Council of Medical Research (ICMR).
With changes in the demographic and epidemiological structure, Kerala has become more similar to developed nations in terms of population aging and disease profile. This has meant an increase in the prevalence of non –communicable diseases in the state. Very few studies have been conducted to assess the prescription pattern of non- communicable diseases, especially diabetes and hypertension. The major objective this study is to assess the quality and pattern of diabetes and hypertension prescription in the state. It also aims to describe the barriers and facilitators which determine the quality of prescription. The study intends to cover 350 doctors from randomly selected seven districts of Kerala. Doctors from both public and private sector will be included in the study. In-depth interviews and focus group discussions will be used for identifying the barriers and facilitators of quality prescription.
