PUBLIC HEALTH 3pages APA not including title and min 5 references reference page

Kerala

Health

Kerala's remarkable achievements in health in spite of its economic backwardness has provoked many analysts to talk about the unique "Kerala Model of Health" worth emulating by other developed countries. The hall mark of Kerala model is low cost of health care, universal accessibility and availability even to the poor sections of the society.

There are many socio-economic conditions unique to the state which have been postulated to make this health model possible. The high female literacy rate (87.72%) of the state is worth mentioning in the regard. The widely accepted health indication viz death rate, Infant Mortality Rate (IMR) and expectation of life at birth too are far advanced than the rest of the states in India and are even comparable with developed countries. Such that in Kerala, the expectation of life has increased, infant mortality rate is very low and there is decline in death rate. Also the health awareness among the citizens of the state maintains to be at a very high level.

Source: Directorate of Health Services

* Refers to the period 2001-03

Kerala's achievement of TFR inspite of low per capita income disproves the theory that economic development is an essential prerequisite for reduction in fertility. High status of women, female literacy, age at marriage and low infant mortality were thought to be the factors behind the rapid fall in the fertility rate in Kerala.

It is also to be noted that Kerala has nurtured a progressive policies, social reform movements that had succeeded in awakening a collective consciousness to principles of equity, equality, public policies that involves land reform, welfare schemes, public distribution system and investments in social sectors such as health and education. Apart from the socio-economic factors, the universally available public health system in Kerala has also contributed to this much acclaimed health system of the people. The state has a three-tier-system of health care - the Primary Health Centres (PHC), Community Health care Centre (CHC), Taluk & District hospital and Medical Colleges evenly distributed in the rural and urban areas. Apart from this, there is an extensive network of medical care institutions practicing homeopathy and ayurveda in government, voluntary and private sectors.

The contributions of Kerala in the field of ayurveda are unique. Kerala has a fairly ancient ayurvedic medicinal system, which is a treasure house of knowledge about natural medicine. Kerala has sensed the potential for fitness holiday packages and is trying to tap this market. Kerala's ayurvedic system is not fundamentally different from the main stream. Along with Charaka Samhitha and Sushruta Samhita, Ashtanga Hridaya and Ashtanga Sangraha written by Vagbhata are also used by the proponents of ayurveda in Kerala. Various types of ayurvedic treatments designed in Kerala have enriched ayurveda as a system of medicine. Dhara, Pizhichil, Njavarakizhi, Thalam, etc. and its numerous types are Kerala's traditional ayurvedic treatment methods. The state's equable climate, natural abundance of forests with a wealth of herbs and medical plants are a key to the success of ayurvedic treatments of Kerala. The new tourists who seeks adventure and the unknown including different culture, cuisine, lifestyle, health systems etc has popularised the Ayurvedic health holidays of Kerala all over the world.

In the state, there exist 7831 public health institutions, comprising of all the three disciplines. Of this, 71.8% are PHCs (including sub centres), 8.2% are CHCs and 11% are hospitals (censes 2001). Apart from this there are 81 co-operative hospitals functioning effectively in Kerala. The number of sub-centres continuous to be 5074 for the last 12 years and there is a sub-centres for every 6.16 sq.km and a primary health centres for every 33.3 sq.km there by assuring the accessibility of health care to the downtrodden section of the society. In terms of health personnel, there are 25225 medical and para medical personnel and there is one medical officer for every 8244 population in Kerala.

Despite, better health outcomes, the much-proclaimed Kerala model of health have started showing a number of disturbing trends. Although mortality is low, the morbidity (those suffering from diseases) both from urban and rural Kerala is high in Kerala compared to other Indian states. Thus the paradox is that on the one side Kerala stands as the state with all indicators of better health care development in terms of IMR,MMR, birth rate, death rate etc. on the other it outstrips all other Indian states in terms of morbidity especially the chronic illness

The morbidity analysis of Kerala reveals that the attack of acute diarrhoeal diseases, measles, pneumonia, pulmonary tuberculosis, dengue fever etc is the major diseases dominating the health profile of the state. The attack and death of a mammoth of population due to vital illness - chikungunya compelled the state to declare a health package to the state to liberate its people from this vital illness. Moreover, many epidemics that were supposed to be eliminated from kerala are staging a come back. Higher prevalence of mental health problems including higher suicide rates, health problems and death due to road traffic accidents and other traumas are worth mentioning in this regard.

Ageing is another area of concern of Kerala health that accounts for hike in morbidity. As life expectancy increases there is high incidence of disease associated with aging and life style diseases. Sedentary life styles, lack of physical activities and obesity increases the risk of chronic and life style diseases.

Though Kerala spends fairly substantial amount on medical and public health compared to other Indian states {Rs. 96049.66/- (2005-06)}, public health system is getting alienated from the common man due lack of medicines and sophisticated infrastructure facilities in the government hospitals. Thus, public health centers are being utilised mostly for maternal and child health care programmes especially for immunisation schemes. This has led to the impetus growth of the private medical care set up in the state and the dependence on private health care is quite high even among the lower expenditure classes and rural areas. In the changing scenario, the private sector reigns supremacy in the infrastructure and health manpower development than public sector in the state.

As the state is moving into a consumeristic society, the commercialization and the commodification of health care are rampant in the state. Thus the state's health scenario is slowly drifting towards the decay of public health system, uncontrolled growth of private sector, escalation of health care cost and the presence of communicable, non-communicable and life-style diseases. In such a situation the state has to go a long way for improving the key health care indicators of health.

Courtesy : Human Development Report - 2005, Centre for Development Studies,Thiruvananthapuram

Gender profile in Kerala, prepared by Integrated Rural Technology Centre, Palakkad, Kerala.

People's Campaign for Decentralized and the Health Sector in Kerala, People's Health Assembly-Issue paper, B. Ekbal.

Source: IT Department, Government of Kerala