Health inequities around gender, disability and internal migration: are local governments doing enough.

IF 1.3 Q4 RESPIRATORY SYSTEM Public Health Action Pub Date : 2023-03-21 DOI:10.5588/pha.22.0032
M R Nair, S S Kumar, S S Babu, B A Chandru, K S Kunjumon, C S Divya, R P Varma
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引用次数: 1

Abstract

Setting: The Kerala health system in India has more than 25 years of decentralised implementation experience. Decentralization could assist in addressing health disparities such as gender, disability, and migration.

Objective: To explore how inequity issues comprising gender, disability and internal migrations were being addressed at present by the decentralised Kerala health system.

Design: Our approach was qualitative, using document review, key informant interviews and in-depth interviews with policy makers, health staff and other stakeholders.

Results: Gender aspects were incorporated into planning and budgeting, with 10% funds earmarked for women. Projects were gender-specific to women, and within conventional social roles of livelihood, welfare or reproductive health. Recently, transgender focused projects were also initiated. Schemes for people with disabilities remained welfare-centric and driven by top-down policies. The local governments performed beneficiary identification and benefit disbursal. Migrant health aspects were focused on infectious diseases surveillance and later living conditions of migrant workers.

Conclusion: The importance that health systems place on socioeconomic determinants of health and fundamental human rights is reflected in the health interventions for marginalised communities. In Kerala, there is now a passive application of central rules and a reluctance to utilise local platforms. Changing this is a necessary condition for achieving equal development.

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围绕性别、残疾和国内移徙的卫生不平等:地方政府做得够不够?
环境:印度喀拉拉邦卫生系统有超过25年的分散实施经验。权力下放有助于解决诸如性别、残疾和移徙等保健差异。目的:探讨目前分散的喀拉拉邦卫生系统如何解决包括性别、残疾和内部移民在内的不平等问题。设计:我们的方法是定性的,使用文件审查、关键信息提供者访谈以及与决策者、卫生工作人员和其他利益攸关方的深入访谈。结果:性别方面被纳入规划和预算,10%的资金专门用于妇女。项目针对妇女的具体性别,并在生计、福利或生殖健康等传统社会角色范围内。最近,以跨性别者为重点的项目也开始了。残疾人计划仍然以福利为中心,由自上而下的政策驱动。地方政府进行受益人认定和福利发放。移徙工人健康方面的重点是传染病监测和移徙工人后来的生活条件。结论:卫生系统对健康和基本人权的社会经济决定因素的重视反映在对边缘化社区的卫生干预措施中。在喀拉拉邦,现在被动地执行中央规定,不愿利用地方平台。改变这种状况是实现平等发展的必要条件。
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来源期刊
Public Health Action
Public Health Action RESPIRATORY SYSTEM-
自引率
0.00%
发文量
29
期刊介绍: Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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