Unravelling the Contextual Factors Mediating Illness Response Using Mixed Methodology
The re-emergence of infectious diseases has been a rampant public health challenge in the state of Kerala over the past one decade with high rates of mortality and morbidity. In an exploration of the contextual factors determining illness response associated with these diseases, this study employed a mixed methodology including a cross sectional survey of 430 respondents and 30 in-depth interviews. Individuals having one or more cases of selected re-emerging infectious diseases (Chikungunya, Dengue, Malaria and Leptospirosis) from various socio-spatial locations were included in the study to understand the patterns and determinants of illness response across different categories. The findings demonstrated that respondents’ response to illness is jointly determined by individual and household level factors such as gender, parenthood, illness context and spatiality. The article explains the ways in which these factors have interacted and intersected at varying points to create and reinforce multiple layers of vulnerability. Results are pertinent in understanding the pathways and mechanisms through which health inequities are created and sustained among different categories in the population. The findings demonstrate that only interventions concomitantly dealing with these factors and their interactions will produce more equitable results in improving access to health services and management of morbidity associated with re-emerging infectious diseases.