In many respects, Kerala’s health status is almost on a par with that of developed economies. The state has succeeded in increasing life expectancy as well as reducing infant and maternal mortalities. The implementation of land reforms improved the standard of living of the rural poor.
The effective implementation of the public distribution of food played an important role in improving nutritional status.Kerala’s publicly funded healthcare system has helped in providing treatment facilities to people of all strata of society. The high literacy rate, especially among the females, also played a major role in improving the health scenario. The Kerala Model of Health is often described as “good health based on social justice and equity”.
The health sector had begun to face crises by early the 1980s. Communicable diseases like malaria which were once eradicated came back and new viral diseases like dengue and chikungunya emerged. The incidence of non-communicable diseases (NCD) like diabetes, hypertension and cancer also increased.
The society started to bear the double burden of resurgent epidemics and emergent lifestyle diseases. The spread of epidemics is due to failures in implementation of waste management, mosquito eradication and provision of potable water. Changes in food habits, lack of physical exercise and increased mental stress are behind the surge in NCDs. The incidence of suicides and death and disability due to road accidents are also high in the state. The severity of health crises faced by marginalised groups (like Adivasis and the fisherfolk) is greater than that faced by ‘mainstream’ society.
Since the stagnant government hospitals could not manage the increasing patient load, big private hospitals mushroomed across the state. Excessive privatisation and commercialisation of health sector lead to an escalation in healthcare expenses.The state should now formulate a health policy taking note of the spread of epidemics and NCDs, rising health expenditure, health problems of the aged, the marginalised and women. It must give equal importance to preventive health and curative care. Improving the facilities and services provided by the government hospitals catering to the needs of the poor must be the sheet anchor of such a policy. Corporate private hospitals must be subjected to social control.
(Public health activist and academician)
