Ministry of Health and Family Welfare, Government of Kerala has been doing commendable service and this has been recognised as seen by the many awards it has under its belt in a short period.
“It is health that is the real wealth, and not pieces of gold and silver,” so said Mahatma Gandhi.
Kerala was always on the top in various health indicators, be it infant mortality rate, or in the fight against polio, small pox and various other diseases. It was always way above the national average in all senses.
In 2019, Kerala continued to top the list for the best performing State in the health sector among the 21 large states, according to the second edition of NITI Aayog’s Health Index released in June this year. The state got an overall score of 74.01.
The report has also compared health outcomes of Kerala to that of Argentina or Brazil, with neo-natal mortality rate (NMR) which is the probability of a baby dying in first 28 days of birth, being as low as six per 1,000 live births.
Dr. Harsh Vardhan, Union Minister for Health, in a letter to the Government of Kerala, lauded the achievements of the state in the health sector. In the letter he said that he congratulated the whole team and the government for doing commendable service in public health. In appreciation of the achievement, the Centre will sanction more funds for Kerala in the health sector. This would be disbursed as an incentive that would be 10 percent of the total amount that was sanctioned earlier. And this would come to about Rs.100 crores, according to a press release by the office of the Minister of Health and Social Welfare.
If the state further improves the services in the health sector, next year the state would be sanctioned more incentives, the Minister said.
The Health Index ranks the States and Union Territories based on 23 health-related indicators, including neonatal mortality rate, under-five mortality rate, proportion of low birth weight among new-borns, proportion of districts with functional Cardiac Care Units, full immunisation coverage and proportion of specialist positions vacant at district hospitals.
The report ‘Healthy States, Progressive India: Report on Rank of States and UTs’ has ranking in three categories larger States, smaller States and Union Territories “to ensure comparison among similar entities.”
Early this year, the Kerala health care system crossed a new milestone after seven Primary Health Centres (PHCs) in the state secured the National Quality Assurance Standards (NQAS) certification. Among the seven health centres, the family health centre at Kayyur in the Kasaragod district secured the top position as the best PHC in the country. The NQAS certification is awarded by the National Health Mission, under the Ministry of Health and Family Welfare.
Ms. K.K. Shailaja, Minister of Health and Social Welfare, Kerala, in a statement said that the family health centre at Kayyur obtained a NQAS score of 99 per cent to become the top PHC in the country. The other health centres in the state to receive the NQAS certification are the Valapattanam and Therthally Family Health Centres in Kannur district, Valiyaparamba and Karinthalam Family Health Centres of Kasaragod, Peruvemba family health centre at Palakkad and the Chemmaruthy family health centre at Thiruvananthapuram.
“This achievement is an acknowledgement of the efforts taken by the Kerala government in the field of health care,” said the minister.
The past three years have seen the State’s health sector, especially primary care services, undergo a major transformation in such a way that most primary health centres (PHCs) are now family health centres that offer comprehensive primary care services, right up to early cancer screening and detection.
Another recent national survey by the government had found that India’s healthiest children live in its north-eastern states and Kerala. The Comprehensive National Nutrition Survey (CNNS) collected primary information on the medical health and allied behaviours from over 1.12 lakh children between the ages of 0 and 19 across 30 states. The CNNS expands on the data covered by key past health surveys, including the National Family Health Survey, to give a more rounded and more detailed look into the health and lives of India’s children. It includes an expanded range of anthropometric measures to comprehensively capture malnutrition and previously unstudied micronutrient deficiencies.
Dadra and Nagar Haveli, Haryana, Assam, Kerala and Punjab have emerged as the top five states or Union Territories in the first ever exercise to rate their performance on several parameters of the National Health Mission. Twenty per cent of NHM funds are based on the states’ performance, which means better performing states received a financial incentive — Rs 3,000 crore is set aside for incentive-based payments.
Another interesting fact is that the Health Index also put southern states like Kerala in a fix. Even as it came up trumps in the index, Kerala’s performance had ‘deteriorated’ in 2017-18 as compared to 2015-16, which ranked it 16 out of 21 states in terms of incremental performance. So Kerala has been classified as a “not improved” state despite topping the charts. This was because the Ministry of Health has decided to link funding under India’s Rs 31,745 crore National Health Mission (NHM) to performances of states in this index. States like Kerala and Tamil Nadu make little progress in this index because they have already reached the status of developed nations in healthcare delivery. Kerala achieved the United Nations 2030 Sustainable Development Goals (SDG) on infant mortality rate (12 per 1,000 live births) in 2000 – about 30 years ahead of schedule.
According to the NitiAayog, Kerala has also achieved the SDG 2030 target of under–five mortality rate of 25 per 1,000 live births. These two parameters are crucial components of the health outcome parameters used by the NitiAayog to rank states on its health index. Health outcomes in the index carry half the weight while computing the states performances. So in effect, a state like Kerala which has already achieved SDG targets decades in advance finds itself as showing the least improvement among states in India. By the Government of India’s logic of linking funding to the health index, a high performing state like Kerala or for that matter Tamil Nadu would get the least share of India’s health funding.
