The Impact of General Strike on Government Healthcare Delivery in Kerala State in India

Abstract EN

General strike (also known as hartal) is used as a mode of protest by organizations and political parties in India.

It is generally thought that hartals negatively impact the healthcare delivery in a society.

We used the Right to Information Act to obtain data from government health centers in Kerala state in India for four hartal days (H-day) and two control days (A-day and B-day) for each H-day, from sixteen health centers including 6 Community Health Center (CHC), 6 Secondary Health Center (SHC), and 4 Tertiary Health Center (THC).

Data on emergency room visits was available for six HCs.

15 HCs had a statistically significant decrease in the number of outpatient visits on H-day.

There was no difference in the number of outpatient visits between the two control days (A and B) in 15 HCs, suggesting the lack of a posthartal surge in visits.

Median decrease in outpatient visits in CHCs, SHCs, and THCs was 50.4%, 59.5%, and 47.4%, respectively.

Hartal did not impact the number of emergency room visits in 6 out of 7 health centers assessed.

Our study identified a significant harmful impact on government healthcare delivery due to hartals in Kerala.

These findings have major public health implications.