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04 13

  1. 1. 04-13 KERALA’S HEALTH STATUS: SOME ISSUES Gangadharan K Department of Applied Economics, Kannur UniversityIntroductionThough the health status of Kerala is comparatively far better compared to other Indian states,Kerala still ails in the health front. The vital issue is the problem of high morbidity reported bothfrom urban and rural areas and Kerala has been identified as the state with highest morbidityprevalence in India with urban Kerala records the highest male morbidity prevalence rate.Thusthe paradox is that on the one side, Kerala stands as the state with all the indicators of betterhealth care development in terms of infant mortality rate, perinatal mortality rate, neonatalmortality rate, birth rate, death rate etc. On the other it outstrips all other states in India in termsof morbidity, Since high morbidity prevalence is the basic issue of the Kerala’s health sector,greater attention is needed to reduce the intensity of morbidity prevalence. This hike inmorbidity ultimately culminated in declaring a health package for the state.The present paper examines the basic issues in the health sector of Kerala especially in the eve ofliberalization programme of the economy since 1991.Objectives1. To examine the success indicators of health in Kerala with that of the national health.2. To examine the basic issues connected with the health care investments and morbidity inKerala. 1
  2. 2. Materials and MethodsThe study is based on the secondary data collected from the published records of NationalResearch institutions, and from various government departments of both centre and stategovernments. Thus the methodology of the study is based on the analysis of secondary datarelated to health care development in Kerala. The materials for the study is also developed onthe basis of analysis and interpretation of secondary data collected from the published records ofNational Research Institutions and from various central and state government departments.Importance of the StudyThe study has great relevance in the present socio-economic and environmental context. Thestate, Kerala which has been considered as a state with advanced human development index andbetter health status is now ailing from acute morbidity of different communicable and chronicillness. The state is trailing in sustaining the health status which it has retained in the last decade.It is very unfortunate that for a model state for better health status like Kerala, the Government ofIndia was forced to provide a health package for protecting the state from the clutches ofchickengunya and from other communicable illness. Coupled with this, the problem of drinkingwater and sanitation, low utilization of government health facilities, ageing of population etc alsoaccounts for the changing health profile of Kerala which has vital significance at the national andinternational level.Morbidity IssuesKerala has shown best results with regard to most of the health status indicators, but the biggestparadox is that, Kerala has been identified as the state with highest morbidity prevalence in India(Sherri,1995). It has been estimated that 181 out of every thousand people in Kerala are morbid 2
  3. 3. due to any of the illness prevalence and urban Kerala records the highest male morbidityprevalence rate of 185 per thousand populations in India. Table 1 Morbidity prevalence in KeralaMorbidity indicators Kerala Bihar IndiaMorbidity prevalence rate per 1000 persons RuralTotal 183 98 104Male 185 98 102Female 181 98 105Morbidity indicators Kerala Bihar IndiaMorbidity prevalence rate per 1000 persons UrbanTotal 175 102 101Male 185 106 96Female 166 98 106III Overall morbidity prevalence rateby type ofpersons (rural)Percentage distribution of morbidity per 1000 sicknessAllInfections 181 16.8 99 40.7 103 33.8Male– infectionsNon 185 43.7 99 20.0 101 25.9FemaleFevers 177 39.5 98 39.2 105 40.3Prevalence of illness by type (urban)Infections 29.5 41.3 31.4Non – infections 42.3 23.9 31.8Fevers 28.2 34.9 33.8Source : Sheriff, NCAER Survey, New Delhi Table 2 .Plan and non-plan expenditure on medical and public health including family welfare in Kerala Year Expenditure on Expenditure on Total Percentage of medical of family welfare GSDP 3
  4. 4. public health (plan & non- plan) 2001-02 65587.79 16270.57 77858.36 1.05 2002-03 71214.24 9459.40 84974.02 1.04 2003-04 74572.39 11324.98 85897.37 0.96 2004-05 919833.33 9270.00 101203.33 1.01 Source: Directorate of Health Services, TrivandrumInvestment on health sector in Kerala is also steadily diminishing especially in the liberalizedcontext of the economy. Table 2 reveals the declining trend in investment on medical and publichealth in Kerala which is also an important reason for the declining utilization of public healthmedical institutions in Kerala.Results and ConclusionsThe analysis of data related to morbidity, investment and other variables reveals that greaterattention is needed to improve and sustain the health status of the people of Kerala. The state issuffering from acute shortage of investment in medical and public health, better infrastructuralfacilities including good drinking water, sanitation and it also suffers from maintaining betterenvironmental quality and better environmental facilities. Better provisions of safe drinkingwater and sanitation are to be provided to the urban and rural community and thrust should beprovided to better drainage and environmental facilities in urban areas. To improve theutilization of government health facility more medicines and supplies is to be provided to thegovernment hospitals and health centres and for this budget allocation should be augmented tothe medicines and supplies in the health budget of the government. To attain the status of healthfor all, the aged population has to be properly rehabilitated and measures have to be devised fortheir health and happiness. Since majority of them are under acute loneliness and in the stage of 4
  5. 5. negligence effort should also be made to increase the utilization of material and child healthservices among the marginal, deprived and vulnerable sections in the country.ReferencesGovernment of India (2003). Health Information of India, New Delhi : Director General of Health services.Government of Kerala (2003). Economic Review Thiruvananthapuram, State Planning BoardHema R and Muraleedharan U.R (1993). Health and Human Resources Development, Economic and Political Weekly, 28: 2328-30 PP.Rajendran R (2006). Dengipani, Vijbana Kairali, Kerala Langugage Institute,37(4)Registrar General of India (2004). Sample Registration System, Statistical Report 2003, New Delhi ,Office of the Registrar General of India.Sheriff Abusaleh (1995). Health Transition in India, Differentials and Determinants of morbidity in India, Disaggregated analysis, working paper no. 57, New Delhi, NCAER.. 5