P K Sreemathi Teacher
HEALTH and education are two of the key areas which have helped Kerala to be counted among the best in the country. Health status is generally measured in terms of mortality indicators like death rate, infant mortality rate and expectation of life at birth among others. Mortality indicators show that the health status of Kerala is far advanced and higher than the all-India average and is even comparable with developed countries. This outstanding progress of health status is achieved through widespread growth of the three systems of medicine in public, private and cooperative sectors, combined with people's health awareness. It is also a result of a development path adopted by the state, since its formation, which gave importance to the social sectors by investing in public health and education.
IN FOREFRONT OF INDIAN STATES
Students of Kerala society and history know that it is the social reform movements dating back to the nineteenth century and running through the first half of the twentieth century and culminating in the formation of the first elected communist government in the state led by Comrade EMS Namboodiripad in 1957 and the land reforms initiated by that government, which gave ownership of land and along with it, dignity to the millions, that have formed the basis for the achievements in social sectors in later years.
The health seeking behaviour of the people is very high in the state, and therefore, improving the quality of healthcare is of utmost importance as well as challenging. In this context, the initiatives rolled out by the Left Democratic Front (LDF) government with the support of National Rural Health Mission are pioneering as well as result oriented. The state has been able to initiate many programmes suiting its specific requirements and taking into account the health issues that need immediate intervention.
Kerala is in the forefront of Indian states in effective implementation of decentralisation as envisaged in our Constitution, including in the health sector. Even though we have progressed a lot in terms of providing quality healthcare to our people, there are still a lot of issues that retard our achievements. One of these issues is the emergence and resurgence of vector borne diseases and increase in lifestyle related diseases liked diabetes, hypertension, cancer etc. Kerala has been able to contain the spread of the virus fever which created havoc in the first two years of the present LDF government. State and local level programmes have also been launched to tackle the lifestyle related diseases.
Introduction of ASHA workers in the state is a revolutionary step towards intensifying field level intervention. ASHA scheme was extended to the state of Kerala, only after a detailed assessment on the special needs of the state by the government of India. Around 30,000 ASHA volunteers have been deployed in the state after the induction training. Drug kits have been procured and distributed to all the ASHA workers. In this year’s state budget, a monthly honorarium of Rs 300 has been announced for ASHA workers.
KINDS OF SERVICES
Kerala is one of the few states to adopt a Pain and Palliative Care Policy. The pain and palliative programme aims at the development of community based care services for the bed ridden, elderly, chronically and incurably ill people in the state. This unique initiative has resulted in positive improvement in the care of marginalised groups of people in the state and has won international acclaim.
Life expectancy in Kerala is much higher than the national average. The state has the highest segment of elderly persons in the whole country. To meet the increasing needs of geriatric population, a two-pronged strategy is proposed to be implemented in the state through community level and institution based interventions. A Vayomitram scheme has been launched under which a help desk for elderly has been set up in urban centres and mobile clinics have been deployed to reach healthcare to the needy old aged people at their homes.
The LDF government has initiated steps for upgradation and standardisation of services including diagnostic facilities in the government hospitals and the government’s efforts have paid off, with the general hospital of Eranakulam receiving NABH accreditation recently. It is only the third public sector hospital in the country to have attained this status.
The LDF government has adopted a unique policy regarding women. It has constituted a Gender Advisory Board to coordinate and monitor the implementation of gender empowerment and women’s development programmes of various agencies under the government. It also appointed 14 women protection officers to deal with the complaints regarding domestic violence. The government has decided to form a separate Department for Women’s Development.
The Kudumbasree Mission, which covers 37 lakh families in the state, is one of the major programmes for women’s development and empowerment in the state. The women’s self-help groups have ventured into many income generating activities, including in agriculture, micro enterprises etc, which have brought change in their life.
The Kerala Social Security Mission was formed with a corpus of Rs 65 crore with the objective of providing care and support for the destitute, chronically ill and elderly people. Two novel schemes launched by the mission are free treatment for cancer and major surgeries in case of ailments affecting children under the age of 18, and providing monthly assistance of Rs 300 for those taking care of the physically and mentally challenged persons. Hundreds of children from poor families have benefited from the scheme.
TOWARDS HEALTH FOR ALL
The state has implemented a Kerala Emergency Medical Services project under which advanced life support ambulances have been deployed along the main roads at a distance of 20-30 km each, from where emergency relief will be provided to victims of road accidents and other medical emergencies within a span of 10-15 minutes and victims will be transported to the nearest tertiary care hospital. Hundreds of lives have been saved through this scheme that initially started in the capital district. It is now being extended to all other districts.
The Comprehensive Health Insurance Scheme, implemented in the state during the past two years, is expected to cover 40 lakh families under both below-poverty-line (BPL) and above-poverty-line (APL) categories this year. Insurance premium is borne by the state government for all the families, with the central government providing 75 per cent subsidy for only one-fourth of the families in the BPL list. Treatment up to Rs 30,000 is free for all card holders with an additional support for Rs 70,000 for heart, kidney and cancer diseases and surgeries.
Medical education has received tremendous boost under the LDF government with starting of new medical postgraduate courses, increase in MBBS seats, starting of 5 nursing colleges in the government sector and hundreds of nursing, paramedical and other colleges in the private sector. Under an agreement with the majority of the private professional colleges, the LDF government was able to provide admission to students from weaker sections and SC/ST communities in 50 per cent seats in these colleges based on merit.
Ayurveda is the traditional healthcare system of Kerala, practised over thousands of years. Also, ayurveda and homeopathy sectors have got equal attention from the state government in the matter of upgradation of hospitals, posting of doctors, opening of new dispensaries etc. A most modern Panchakarma Research and Development Centre has been completed in the Thiruvananthapuram Ayurveda College.
In short, the last five years have seen the commitment of the LDF government of the state of Kerala to rejuvenate the public healthcare sector in the state. This is all the more significant in view of the fact that the healthcare system in Kerala was in a morbid state, to which it had been plummeted by the previous UDF government. The LDF government’s efforts have led to a steady improvement in the facilities and human resources in the health institutions, thus regaining the lost confidence of the people in the system as well as glory for the state. The best state award for health sector, which Kerala received recently after a national level assessment by IBN7 TV channel, is a recognition of these achievements.
Courtesy: www.pd.cpim.org/
