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The purpose of this paper is to evaluate the effectiveness of the intervention program for dengue fever prevention among people in rural communities.

A quasi-experimental study was designed for two groups. The intervention group received five weeks of dengue hemorrhagic prevention program consisted of knowledge broadcast, campaign, model house contest and group education. The control group received only the usual care of health promoting hospitals. The primary expected outcomes were changes in knowledge, perceived susceptibility, perceived severity, perceived benefit, perceived barriers and preventive action from baseline data, post-intervention and three-month follow-up, along with a comparison between the two groups. The secondary expected outcomes were changes in house index (HI) from baseline to post-intervention and three-month follow-up, along with a comparison between the two groups.

From the total of 64 participants, 32 were randomly assigned to the control group and 32 were randomly assigned to the intervention group. There were significant differences in knowledge, perceived susceptibility, perceived severity, perceived benefit, perceived barriers, preventive action and HI in the intervention group after received the five-week intervention program and at three-month follow-up (p<0.05).

Dengue hemorrhagic prevention program based on the Health Belief Model was effective in lowering HI and improving knowledge, perceived susceptibility, perceived severity, perceived benefit, perceived barriers and preventive action among people in rural communities. The intervention program may be beneficial in primary care in such a rural community.

The substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.

A systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.

Chronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.

The present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.

Given the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.