ArticleInternational journal for equity in health2024
Kerala's progress towards universal health coverage: the road travelled and beyond.
Article in International journal for equity in health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Strengthening Primary Health Care for Improved Population Health and Health Equity in Somalia: A Narrative Review.Public health challenges · 2026Review
- Knowledge and Attitude Related to Stroke and Factors Associated with them Among Adults Aged 18 Years and Above in Kerala, India: A Community-Based Cross-Sectional Study.Annals of Indian Academy of Neurology · 2026Article
- Pathways to Care, Out- of- Pocket Expenditure, and Associated Factors Among Breast Cancer Patients in Kerala, India: A Hospital-Based Cross- Sectional Study.Asian Pacific journal of cancer prevention : APJCP · 2026Article
- Understanding Roadblocks to Heart Failure Care (UNLOCK-HF): A Convergent Parallel Mixed-Methods Study in Kerala.Tropical medicine & international health : TM & IH · 2026Article
- Kerala's Aardram Mission and universal health coverage: integrated time series evidence on mortality reduction and assessment of financial protection and equity gaps.Frontiers in public health · 2026Article
- Recurrent myocardial infarction and adherence to secondary prevention strategies among adults with coronary artery disease in rural Aluva, South India: a nested case-control study.BMC public health · 2025Article
- Awareness of Antibiotic Resistance Among Medical Professionals in Kerala, India: A Cross-Sectional Study.Cureus · 2025Article
- Health in Kerala: exploring achievements and remaining challenges of health systems reform using an equity lens.International journal for equity in health · 2025Article
- Scrub Typhus in Kerala: Demographic, Clinical, and Laboratory Predictors of ICU Admission in a Tertiary Care Setting.Le infezioni in medicina · 2025Article
- Transforming neonatal nursing in India: challenges, opportunities, and the way forward.The Lancet regional health. Southeast Asia · 2025Review
- Predictors of mortality among critically ill SARS-CoV-2 infected patients-a retrospective cohort study, Kerala, India.Frontiers in public health · 2025Article
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Abstract
backgroundKerala has initiated many Universal Health Coverage (UHC) reforms in the last decade. The Aardram Mission launched in 2017 stands out owing to its scope, objectives, and commitments for strengthening Primary Health Care (PHC) in the State. The current study proposes to explore access and financial protection through the lens of equity in Kerala especially in the context of major UHC reforms carried out during the last decade. This paper will also highlight the key lessons from Kerala's approach towards UHC and health systems strengthening through a political economy approach.
methodsData from the Kerala state sample of 75th Round (2017-18) National Sample Survey is used for this study. Comparison is also drawn from the 71st Round Sample Survey, 2014, to measure the state's progress in terms of access and financial protection. Logistic regression was used for the calculation. The findings were further explored through a political economy approach.
resultsThe share of public facilities for outpatient care is 47.5%, which is a significant increase from 34.0% (in 2014) in the state. The share of public sector for out-patient care has increased for the lower socio-economic population in the state. The share of public sector for in-patient care has also increased to 37.3% in 2017-18 from 33.9% in 2014, but not to the extent as the increase shown in outpatient care. The average out-of-pocket-expenditure during hospitalization has increased more in private facilities as compared to public for both outpatient care and hospitalization.
conclusionsOverall increase in the share of public facilities for both outpatient care and hospitalization is indicative of the enhanced trust among the people at large of the public healthcare delivery system in Kerala, post the launch of UHC reforms in the State. The insurance linked UHC reforms would be insufficient for the State to progress further towards UHC. Kerala with a long and successful history in 'public provisioning' should focus more on strengthening PHC through Aardram Mission in its journey towards pursuit of UHC.
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