Kerala has some of the best health indicators in India like low infant mortality and birth rates. However, it also has the highest reported morbidity rates. The paper examines issues in Kerala's health sector like high rates of infections and non-communicable diseases. It finds declining investment in public health as a percentage of GDP. To improve health status, the paper recommends increasing access to safe drinking water, sanitation, and healthcare for vulnerable groups as well as augmenting budgets for medicines and supplies.

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KERALA’S HEALTH STATUS: SOME ISSUES
Gangadharan K
Department of Applied Economics, Kannur University
Introduction
Though 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 both
from urban and rural areas and Kerala has been identified as the state with highest morbidity
prevalence in India with urban Kerala records the highest male morbidity prevalence rate.Thus
the paradox is that on the one side, Kerala stands as the state with all the indicators of better
health care development in terms of infant mortality rate, perinatal mortality rate, neonatal
mortality rate, birth rate, death rate etc. On the other it outstrips all other states in India in terms
of 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 in
morbidity 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 of
liberalization programme of the economy since 1991.
Objectives
1. 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 in
Kerala.
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2. Materials and Methods
The study is based on the secondary data collected from the published records of National
Research institutions, and from various government departments of both centre and state
governments. Thus the methodology of the study is based on the analysis of secondary data
related to health care development in Kerala. The materials for the study is also developed on
the basis of analysis and interpretation of secondary data collected from the published records of
National Research Institutions and from various central and state government departments.
Importance of the Study
The study has great relevance in the present socio-economic and environmental context. The
state, Kerala which has been considered as a state with advanced human development index and
better health status is now ailing from acute morbidity of different communicable and chronic
illness. 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 of
India was forced to provide a health package for protecting the state from the clutches of
chickengunya and from other communicable illness. Coupled with this, the problem of drinking
water and sanitation, low utilization of government health facilities, ageing of population etc also
accounts for the changing health profile of Kerala which has vital significance at the national and
international level.
Morbidity Issues
Kerala has shown best results with regard to most of the health status indicators, but the biggest
paradox 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
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3. due to any of the illness prevalence and urban Kerala records the highest male morbidity
prevalence rate of 185 per thousand populations in India.
Table 1 Morbidity prevalence in Kerala
Morbidity indicators Kerala Bihar India
Morbidity prevalence rate per 1000 persons Rural
Total 183 98 104
Male 185 98 102
Female 181 98 105
Morbidity indicators Kerala Bihar India
Morbidity prevalence rate per 1000 persons Urban
Total 175 102 101
Male 185 106 96
Female 166 98 106
III Overall morbidity prevalence rateby type ofpersons (rural)
Percentage distribution of morbidity per 1000 sickness
All
Infections 181
16.8 99
40.7 103
33.8
Male– infections
Non 185
43.7 99
20.0 101
25.9
Female
Fevers 177
39.5 98
39.2 105
40.3
Prevalence of illness by type (urban)
Infections 29.5 41.3 31.4
Non – infections 42.3 23.9 31.8
Fevers 28.2 34.9 33.8
Source : 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
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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, Trivandrum
Investment on health sector in Kerala is also steadily diminishing especially in the liberalized
context of the economy. Table 2 reveals the declining trend in investment on medical and public
health in Kerala which is also an important reason for the declining utilization of public health
medical institutions in Kerala.
Results and Conclusions
The analysis of data related to morbidity, investment and other variables reveals that greater
attention is needed to improve and sustain the health status of the people of Kerala. The state is
suffering from acute shortage of investment in medical and public health, better infrastructural
facilities including good drinking water, sanitation and it also suffers from maintaining better
environmental quality and better environmental facilities. Better provisions of safe drinking
water and sanitation are to be provided to the urban and rural community and thrust should be
provided to better drainage and environmental facilities in urban areas. To improve the
utilization of government health facility more medicines and supplies is to be provided to the
government hospitals and health centres and for this budget allocation should be augmented to
the medicines and supplies in the health budget of the government. To attain the status of health
for all, the aged population has to be properly rehabilitated and measures have to be devised for
their health and happiness. Since majority of them are under acute loneliness and in the stage of
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5. negligence effort should also be made to increase the utilization of material and child health
services among the marginal, deprived and vulnerable sections in the country.
References
Government of India (2003). Health Information of India, New Delhi : Director General of
Health services.
Government of Kerala (2003). Economic Review Thiruvananthapuram, State Planning Board
Hema 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.
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