ArticlePublic health action2023
Decentralisation, health and Sustainable Development Goal 3.
Article in Public health action, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- "Differentiated care is not a matter of feasibility but a necessity"- service providers' perception on initiating a comprehensive tuberculosis care package (CCp-K) to reduce deaths in Kerala, India.BMC health services research · 2025Article
- Palliative care policy and practice in Kerala, India: Implications for Sustainable Development Goal 3-Health and well-being.Palliative care and social practice · 2025Article
- When policy-makers have your back: the Kerala experience with state-wide antimicrobial resistance mitigation efforts.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Understanding caregiver burden and quality of life in Kerala's primary palliative care program: a mixed methods study from caregivers and providers' perspectives.International journal for equity in health · 2024Article
- Procedural fairness in decision-making for financing a National Health Insurance Scheme: a case study from The Gambia.Health policy and planning · 2023Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
settingKerala State, India, implemented decentralising reforms of healthcare institutions 25 years ago through transfer of administrative control and a sizeable share of the financial allocation.
objectiveTo describe the main impacts of decentralisation in Kerala on local policy formulation, programme implementation and service delivery for sustainable health systems.
designThis was part of a broader qualitative study on decentralisation and health in Kerala. We conducted 25 in-depth interviews and reviewed 31 government orders or policy documents, five related transcripts and five thematic reports from the main study.
resultsLiaising between health system and local governments has improved over time. A shift from welfare-centric projects to infrastructure, human resources and services was evident. Considerable heterogeneity existed due to varying degrees of involvement, capacity, resources and needs of the community. State-level discourse and recent augmentation efforts for moving towards the UN Sustainable Development Goals (SDGs) strongly uphold the role of local governments in planning, financing and implementation.
conclusionThe 25-year history of decentralised healthcare administration in Kerala indicates both successes and failures. Central support without disempowering the local governments can be a viable option to allow flexible decision-making consistent with broader system goals.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.