Changing families and its effect on the health of family members in Kerala: A qualitative exploration

Abstract

Problem consideredThe study of changing families and the effect on changes in the health of family members is important for planning health policy and programs. Kerala is in fast epidemiological transition and the ‘Kerala model of development’ is famous. The state had the matrilineal family system and now has a social milieu maintaining a high burden of non-communicable diseases for which lifestyle modification through family-level interventions is a suggested solution.The specific objectives were to explore the changes in families, understand the health effects of changing families on family members, and describe stakeholder's perspectives on access and utilization of health services. Methods92 in-depth interviews and 17 focus group discussions were conducted in three representative districts in Kerala. Participants from different age groups from urban and rural settings were separately studied. ResultsThe reported changes were, related to nuclearization, role functions of women, elderly care, food habits, parenting styles, type of marriage, household-level decision making, and health service utilization. The linkages of these changes to the perceived health status were also explored. ConclusionsThe reports of stakeholders threw light on poor social penetration of health programs, explanations for new parenting styles, elderly care, and changing behavior of adolescents. The study revealed intergenerational conflicts and gives recommendations for better health care in the community.