KERALA: The budget clearly stated the objective to develop Kerala as a medical hub in the country building upon the state’s past achievements in health care. While funds were allotted from the budget, another plausible strategy specified was mobilisation of public funding for developing government medical facilities the feasibility of which needs to be seen. Varied related dimensions of health care that found mention and allotment in the budget included overall development of medical education in the state - ( Rs 401 cr) , development of specific medical colleges (Rs 217 cr for select institutions in Thiruvananthapuram and Rs 11.50 cr for KUHS) , development of dental colleges (Rs 22 .79 cr ), nursing colleges (Rs 13. 78 cr) etc.
Funds have also been allotted for specific activities such as developing robotic surgery (Rs 29 cr), Cancer care (Rs 28 cr for Malabar Cancer Centre and Rs 14.50 cr for Cochin Cancer Research Centre) mental health and neuro sciences, dialysis centres, setting up stroke centres, stem cell/ marrow transplantation, sports injury treatment, deaddiction centres etc.
Health needs of specific segments of population were covered through schemes for tribal health care- (Rs 32 crore) health care for deserving patients and elders belonging to SC community (Rs 65 cr), medical insurance to government staff through Medisep, Karunya Scheme for poor families including disabled and transgenders ( Rs 678.54 cr), journalists (Rs 75 lakh), migrant workers through AAWAZ scheme (Rs 1.25 cr ) etc.
The interlinkage of sports and health was emphasised through Healthy Kids – Play for health project and the development of playgrounds in rural areas. Certain interesting gender specific health schemes included are Amma Manasu to address post partum depression among new mothers, Aswasakiranam for financial assistance to care givers for physically and intellectually challenged persons, Bhoomika- for providing medical care to victims of violence etc.
Another distinguishing feature which has indirect implication for public health is this year’s environment budget which has an outlay of Rs 765 crore spread over 81 schemes covering nine sectors -agriculture, livestock, fisheries, forests and wildlife, environment, water resources, co-operation, soil survey and energy.
The mechanism of CEMS- Concurrent Evaluation and Monitoring of Schemes introduced for real-time assessment of progress and impact of schemes unfortunately is restricted to merely assessing project progress and utilisation of allotted funds. Bringing these within the specific ambit of measurable output indicators will enhance accountability, streamline effectiveness of public funds that are spent and facilitate faster movements towards realisation of underlying objectives.
Dr Nirmala Padmanabhan
Professor (retd), PG dept and advance research centre in economics, St Teresa’s College, Ernakulam, and independent director, Dhanlaxmi Bank