Beyond describing patterns: A methodological critique of health equity research in India

Abstract

India’s capacity for public health research is growing and within this health inequity research too is finding its place. The evidence that scheduled tribe communities (and among them those who self-identify as Adivasi ) experience worse nutrition, higher infant mortality, and lower healthcare access than the general population is well documented, as are analogous inequities along dimensions of caste, poverty, gender, and geography. What is less well established is why these inequities persist despite decades of targeted programmes, what mechanisms sustain them, and what kinds of action can mitigate them. This article argues that Indian public health research is constrained by a dominant methodological pattern that describes inequity at the level of population statistics but systematically fails to explain it at the depth needed to generate evidence for structural and institutional action. This pattern produces evidence of associations without causal mechanisms, recommendations which lack analysis of the systemic and institutional structures, and a research culture in which the choice of method (the ‘tools’) take precedence over the research question (inequities). Drawing on work in health policy and systems research, on Adivasi health as an illustrative case, and on recent institutional shifts within the ICMR where implementation research has found a new impetus, and the uncertainties in the global health research ecosystem, this article identifies four specific methodological deficits. It argues for an urgent reorientation of the Indian public health research ecosystem (grants and fellowships, peer review, and Indian journal priorities) to fund and publish the kind of inquiry that health justice demands.

The authors' abstract, as published at the source. The Indian Journal of Medical Research, 2026 · DOI ↗