Does Data Protect Health? Reflections from District-Level Assessments in Kerala

Kerala has been a state to watch in the context of health equity, whether in the popularisation of the “Kerala model” for health in the 1980s, the identification of various “outliers” of this model in the decades following, or the introduction of programmes and reforms to bridge equity gaps in health and its antecedents in the 2000s.

Late 2014 saw the launch of Kerala’s Public Health Protection Agency, spearheaded by the Department of Health, involving Departments of Social Justice, Social Security, Water/ Sanitation, Rural and Urban Development, as well as Planning and Local Self Government Institutions. This was a unique, not uncontroversial effort to address the challenges of convergence for health equity and its social determinants, which we supported through an 8 month long baseline mapping exercise in two districts of the state. We analysed secondary data on 168 schemes and programmes from over two dozen different departments, triangulating this with in-person consultations at state and district levels.

We found stark linkages in data (on water and sanitation and communicable disease prevalence) as well as gaping lacunae (on data from the private sector, both within health and related to health harming industries). Vulnerable populations prioritised by social sector programmes (like the elderly, and indigenous persons) continued to have the poorest health and development outcomes, suggesting a troublingly iniquitous form of “dispossession by welfare.” Given the larger political scenario, the time is ripe to both advocate not just for more or better data, but its meaningful use to improve population health.