Kerala Model: A Legacy of Progress

Veena George Minister for Health and Woman and Child Development

Kerala’s health and welfare sectors have witnessed transformative progress under the second Pinarayi Vijayan government, setting national benchmarks in healthcare, medical education, and women’s empowerment.

The second Pinarayi Vijayan government took office amid the onset of the second wave of COVID-19. T he preparedness and response mechanisms we established to combat the pandemic are now part of history. Alongside COVID-19, Kerala faced outbreaks of Nipah, Monkeypox, and Zika, as well as a surge in non-communicable diseases, which together posed unprecedented challenges for public health. Yet, the state’s health department tackled these crises effectively, achieving remarkable progress. The government initiated transformative changes across the health sector, with over Rs. 10,000 crore worth of development projects underway in various hospitals, funded by KIIFB. As a testimony to our excellence, the Health and Women and Child Development Department has received over 28 national and international awards during this period.

Leading the Nation in Free Healthcare

Kerala continues to lead the country in providing free medical care. Over the past four years, around 30 lakh patients have received free treatments worth Rs. 7,000 crore. This achievement has been consistently recognised with the ‘Ayushman Bharat Arogya Manthan’ award for three consecutive years. According to NITI Aayog, Kerala remains at the forefront in achieving sustainable health goals and continues to hold the top position in the country.

Expanding High-End Surgeries in Government Hospitals

Kerala has made a major breakthrough by launching liver transplantation surgeries—a procedure that costs over Rs. 40 lakh in private hospitals—at government medical colleges. This facility is offered at affordable rates or even free. The first successful liver transplant in a state-run hospital was performed at Kottayam Medical College in February 2022, followed by procedures at T hiruvananthapuram Medical College. Soon, Kozhikode Medical College will also begin liver transplants. For the f irst time in the government sector, robotic surgeries too have been introduced at RCC and MCC. Ernakulam General Hospital has achieved a national milestone, becoming the first district-level hospital in India to perform heart surgeries, valve replacement without open-heart surgery, and kidney transplants. Plans are also underway to make it the first district hospital in the country capable of performing heart transplants. India’s first AI-assisted rehabilitation technology, JIGGAITER, which helps stroke and paralysis patients regain mobility, was introduced at Thiruvananthapuram General Hospital. T he government also launched Karunya Sparsham Zero Profit Anti-Cancer Drug Counters, providing cancer medications at the lowest possible cost. Drugs worth over Rs. 3 crore have been distributed under the scheme so far. T he state has also introduced the ‘Kerala United Against Rare Diseases’ (KARE) project and launched a pioneering initiative to provide medicines for lysosomal storage disorders.

Modernising Healthcare Institutions with National Recognition

T he Emergency Medicine Department of T hiruvananthapuram Medical College has been designated a Centre of Excellence by the central government. Similarly, S.A.T. Hospital has been upgraded as a Centre of Excellence for rare diseases. For the first time, Kerala’s medical and dental colleges have made it to the national rankings, which reflected the improvements in both treatment quality and academics. Another major highlight was the establishment of the Neuro-Intervention Centre at Thiruvananthapuram Medical College. The state has set up Cath Labs across government hospitals to ensure timely treatment for heart attacks. India’s first government-sector Neuro Cath Lab, along with a Rs. 14.3 crore Comprehensive Stroke Centre, was inaugurated at Thiruvananthapuram Medical College, which now offers a fellowship programme in neuro-intervention. Kerala has implemented India’s first ‘One Health’ project and established the Kerala One Health Centre for Nipah Research at Kozhikode Medical College. Other national firsts include a government-sector Neuro Cath Lab-equipped Stroke Unit at Thiruvananthapuram Medical College and the state’s first Skin Bank. A hub and spoke model lab network for diagnosis will soon be established. Kerala is also launching the Kerala Centre for Disease Control (K-CDC) for communicable and non communicable disease control and has implemented an advanced blood bag traceability system. In paediatric healthcare, the Paediatric Cardiology Division at S.A.T. Hospital now offers state-of-the-art cardiac surgery facilities, and the first government-run Spinal Muscular Atrophy (SMA) Clinic has been set up there. Kerala has also introduced a Fatty Liver Clinic for early liver disease detection and treatment. T he state has established Critical Care, Genetics, Geriatrics, Interventional Radiology, Rheumatology, Paediatric Gastroenterology, and Foetal Medicine departments for the first time. New government medical colleges have been opened in Konni and Idukki. In another milestone, the government sector has allocated 1,020 new B.Sc. Nursing seats. So far, 202 healthcare institutions in Kerala have received National Quality Assurance Standards (NQAS) accreditation, and 12 hospitals have achieved National Target Certification.

Expanding E-Health and Strengthening Public Health Infrastructure

T he E-Health project has been expanded to 684 hospitals across the state. The government has transformed 5,415 health sub-centres into Janakeeya Arogyam Centres and upgraded 711 primary health centres into Family Health Centres. Under the Aardram Mission, taluk and district general hospitals are being modernised with enhanced outpatient services, speciality care, labour rooms, and dialysis units. Super speciality services, trauma care, cath labs, and cancer units are being set up at district hospitals. Outpatient facilities in medical colleges are also being upgraded for a more patient-friendly experience. To better manage pandemics like COVID-19, isolation wards with at least 10 beds are being set up in every constituency, with 55 already completed.

Transforming Cancer Care

Kerala has made significant progress in cancer treatment. India’s first government-sector Surface-Guided Radiation Therapy (SGRT) has been introduced at T hiruvananthapuram RCC. A new ‘CerviScan’ device for early cervical cancer detection has been developed. Breast cancer screening, including mammography, biopsy, and Pap smear tests, is now available at district and taluk hospitals.At Malabar Cancer Centre, a Bone Marrow Donor Registry has been launched to support transplant procedures. The state has integrated cancer screening across all government hospitals and established a Cancer Care Grid for streamlined treatment. The ‘Aarogyam Anandam’—’Akkattam Arbudam’ campaign has been initiated as a community-driven cancer prevention initiative.

Leading in Palliative Care

Kerala’s commitment to palliative care has led to the establishment of a state-wide Palliative Care Grid, earning recognition from the World Health Organization. A free Peritoneal Dialysis programme has been introduced in all 14 districts, and free stroke treatment is now available in 12 districts. Plans are underway to set up Cath Lab facilities in every district. T he state is advancing towards becoming a health hub, with the second phase of the lifestyle disease screening programme covering 1.2 crore people. Kerala has also been a national leader in antimicrobial resistance (AMR) prevention and was the first state to launch an Anti Biogram to curb excessive antibiotic use by 30%.

Strengthening Medical Education and Ayurveda

Eight new nursing colleges have been established under the government sector, and seven additional colleges have opened under SIMET. A ‘Code Grey’ protocol has been implemented for the safety of healthcare workers. NITI Aayog has lauded Kerala’s progress in AYUSH healthcare. As many as 150 government AYUSH institutions have received NABH accreditation. The government has also created 116 new posts to strengthen Ayurvedic healthcare. The research hospital and Manuscript Centre, which constitute the first phase of the International Ayurveda Research Centre in Kannur, is nearing completion. The Sneha Dhara programme, which provides palliative Ayurvedic care, has been expanded across all districts. A project has been launched to upgrade the Poojappura Government Panchakarma Hospital to international standards. Similarly, a Rs. 16.65 crore project is set to elevate the Varkala Government Naturopathy Hospital to global standards. For the first time, the Homoeopathy Department has signed an agreement with the Central Council of Research in Homoeopathy for a research study. In response to the long-standing demand of patients, the Kidney Care Project has commenced operations at Kozhikode Government Homoeopathic Medical College.

Women First and Child-Friendly Always

T his has been a period of remarkable achievements and recognitions for the Women and Child Development Department, which works tirelessly for the welfare and advancement of women and children. UN Women, the United Nations entity for gender equality and women’s empowerment, has applauded Kerala’s efforts in women’s empowerment. A memorandum of understanding has been signed to provide technical support to the department’s Gender Park. T hrough the Kerala State Women’s Development Corporation, 1,42,450 women have been provided employment over the past three years. The Digital Pathshala initiative has been launched to enhance women’s presence on digital platforms. A re-skilling programme has been implemented specifically for women, along with a special training initiative for nurses preparing to work abroad. The Women’s Development Corporation has also set a record in loan distribution. For women’s safety, the Kanal campaign was launched and successfully executed, along with the introduction of a new Nirbhaya policy. The state also launched the f irst-ever POSH Compliance Portal, enabling online complaints against workplace sexual harassment. To instil confidence and courage in young girls from an early age, the Dheera initiative was introduced. An e-learning portal featuring all child safety-related training modules has also been rolled out. T he Supreme Court has commended Kaval and Kaval Plus, two state government programmes designed to ensure the mental, physical, and social well-being of children who cannot be reintegrated into traditional family settings. A gender audit of Anganwadi books has been conducted across the state. Efforts have been made to achieve full electrification of Anganwadis and approval has been granted for 204 Smart Anganwadis.