Civil Society Involvement and Resultant Health Care Utilization: A Study of Sickle Cell Disease Patients Across Communities in Kerala

Civil society initiatives have helped in attempts to bring equity and efficiency in health systems by providing direct health services to vulnerable sections in society and indulging in health promotion and information exchange. Kerala, despite the presence of civil society in the health sector shows a pattern of ‘health divide’, with tribal communities experiencing a higher health burden than non-tribal communities. This becomes problematic in the case of some peculiar diseases, particularly genetic diseases such as Sickle Cell Disease (SCD). The article explores the involvement of civil society in health systems with a special focus on SCD and enquires into links between socio-economic position and health care utilization patterns. The study identifies the existence of inter-community differences in health care utilization across social classes, depicting the fact that even after the involvement of civil society organizations, socio-economic stratifiers still remain an important impediment in uplifting the health status of SCD patients.