The Health Care System in Kerala - Its Past Accomplishments and New Challenges -

Abstract

Since the 1970s the Indian state of Kerala has been internationally praised for its health achievements despite its economic backwardness. The ‘Kerala Model for Development’ is often referred to as an example for other countries to follow. These achievements are said to be based on the good performance of its health sector as well as its non‑health sector. However the sluggish economy in the past decade has caused fiscal problems and mixed with the burden of an aging society and the expense of technology advancement Kerala’s health care system is facing new challenges. Increasingly the public sector is unable to meet the demands for health care and the people of Kerala have responded to these inadequacies by increasing private sector use. This trend is not something to welcome. The burgeoning private sector raises household health care expenditures making health a commodity purchased by ‘ability to pay.’ Many public facilities remain underutilized. Lack of regulations over the private sector does not guarantee the quality of care. Many medical graduates are enticed to work at the private sector where no systematic training exists. Three major suggestions may overcome these challenges. First Kerala must invest in the public sector to revitalize the system. To achieve this tax revenue must be increased. The government of Kerala is in the process of transforming its economic structure from cash crops to a more industrialized society by attracting new investments. Second Kerala must streamline the system through decentralization. Kerala launched a radical decentralization policy in 1996 by which the health care system would be responsive to the local people. Third Kerala must take a step to revamp the health care system in a way that the public and private sectors effectively cooperate and complement each other to meet the needs of the people. Faced by these new challenges the once‑praised state is struggling to sustain the past achievements under the current economic climate while concentrating on achieving the growth through development in the age of globalization. (Accepted for publication June 27 2003

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