State health policy Kerala

1. STATE HEALTH POLICY,2013

2. Components
• Information
• Financing
• Service delivery
• Human resources
• Medicines and technologies
• governance

3. Guidance for the development of
State health policy
• National level expert committee reports like
ICMR/ICSSR committee report,
• Swaminathan Committee Report on
Population Control
• Commission on Macro economics and health
• Reports are significant documents

4. Objectives
• To position good health as the product of development agenda including
water supply, nutrition, sanitation, prevention of ecological degradation,
respect for citizens’ rights and gender sensitivity.
• To ensure availability of the needed financial, technical and human
resources to meet health needs of the state.
• To effectively organize provision of health care from primary to tertiary
levels through referral networks managed by primary care providers to
maximize efficiency and reduce costs.
• To regulate practice in health sector to ensure quality and patient protection

5. Need for the Development of health
policy
• To achieve the targets set out in the 12th plan
document it is important to develop a policy to
guide our efforts in this direction.

6. Kerala statistics
Sl Category Numbers
1 Districts 14
2 Taluks 75
3. Panchayaths 978
4. Blocks 152
5. City Corporations 5
6. Muncipalities 1060

7. Kerala statistics
Sl
No
Category Numbers
1 Population 33387677
2 Sex ratio 1084
3. Density 859
4. Literacy rate 93.91
5. Sex ratio child 959

8. Current Scenario- Social
determinants
• Water supply
Decreased water availability due to
increased reclammation of land and water
bodies
and pollution of drinking water sources.

9. Current Scenario- Social determinants
Sanitation
• Problems of toilet
construction in water
logged areas and areas
below sea level.
• Absence of appropriate
models

10. Current Scenario- Social determinants
Solid and liquid waste
management system
• Accumulation of plastic waste
and issue of thin plastic carry
bags
• Unscientific use and misuse of
pesticides

11. Current Scenario- Social determinants
Climate change
• Infectious diseases
• Reduction in availability of fresh
water
• Regional drops in food
production
• Rising sea levels

12. Current Scenario- Social determinants
Others
• Food and nutrition
• Regular employment
• Housing
• Women empowerment

13. Current Scenario
• Managing emerging and remerging diseases
Presence of migrant labourers from different
states might introduce/ reintroduce diseases
that are not prevalent here.

14. Current Scenario
Non communicable diseases
• 50% of deaths occurring age group between 30
and 60.
• The state NCD Control programme
(Amruthum Arogyam)

15. Current Scenario
Cancer care
• Kerala reports 35,000 new registrations and
around 1 lakh patients are under treatment every
year.
• Treatment in governemnt sector
Regional Cancer Centre, Trivandrum and
Malabar Cancer Centre, Thalassery.

16. Current Scenario
Women's health
• Domestic violence
• Health problems of elderly women and
women in traditional industries
• Female feticide
• Child sex selection

17. Current Scenario
• Maternal mortality rate
• 66 as per SRS(2010)

18. Current Scenario
Child health
IMR-12 as per 2011 census
• Neonatal intensive care unit
• Special new born care unit
• New born Care Croner

19. Current Scenario
Adolescent health
• Weekly Iron and folic acid supplementation
programme
• Hospital Based Adolescent Friendly Health
Clinics

20. Current Scenario
School health
• Modified school health programme
• Aim
• To provide school based health support services to all
students by working collaboratively with different
agencies, school teachers, parents and community
members.

21. Current Scenario
Health problems of elderly
• Geriatric care wards at district hospital
• Geraiatric health programme
• Palliative care policy

22. Current Scenario
• Mental health problems
• District mental health programmes
• To incorporate the mental health
services with the general health
services up to the primary health centre
level.

23. Current Scenario
• Health of vulnerable section and health
infrastructure
• Unequal distribution

24. PLAN OF ACTION

25. PLAN OF ACTION
• Determinants of health care
• Enforcement of regulations for
good health
• Reorganization of government
system
• Other specialized services

26. 1. Determinants of health care
• Clean drinking water
• Sanitation facilities
• Solid waste management policy and plan
of action
• Poverty

27. 1. Determinants of health care
Clean drinking water
• Responsibility is shared between Kerala
water authority . Water resources
department, local self government and
community based water supply schemes.
• Access the technologies to test the quality
of water

28. 1. Determinants of health care
Sanitation facilities
• Providing sanitary latrines
• Access and implement technologies to treat
septic tank sludge in water logged areas and
high density residential areas.

29. 1. Determinants of health care
Solid waste management policy and plan of
action
• Legal measures and education of the public
• Participate in decentralized scientific system of
management
• Banning of plastic bags

30. 1. Determinants of health care
Poverty
• RSBY
• Karunya Benevolent fund
• Janani Sishu Suraksha Programme
• Free distribution of generic drugs

31. 2. Enforcement of regulations for good
health
• Food safety
Food safety and security act
• Public health act
Proposes to enact a unified Kerala Public health act by
combining existing Travancore cochin public health
act,1955 and Madras Public health Act,1939

32. 3. Reorganization of government
health system
Primary
health
centres
Community
health
centres
Taluk head
quarters
hospital
District or
General
Hospital
Medical
college
hospitals

33. 3. Reorganization of government
health system
Primary health centres
• Staffing of Primary health centres will be reworked with
three teams of a doctor and a nurse managing a population
of 10,000 each.
• Only OP and field activities will be discharged in PHCs
• The job responsibility of nurses will be revised to assign
more patient care responsibilities to them.
• Laboratory services will be available at all PHCs.

34. 3. Reorganization of government
health system
• Community Health Centers
Facilities at the CHC would be utilized as
Coordinating Centres of Pain and Palliative
Care, terminal care and Community Mental
Health Programme.

35. 3. Reorganization of government
health system
Taluk Head Quarters Hospital
• Average bed strength of 300
• Supporting services as emergency services,
laboratories, blood bank/blood storage centres,
units for maintenance dialysis, physiotherapy
and rehabilitation and deaddiction centres.

36. 3. Reorganization of government
health system
District/ General Hospital
• All major and minor specialities (Cardiology,
Neurology, Nephrology and Urology)
• To ensure adequate attention to the needs of
mothers and children Kerala will have a
Women and Child Hospital in every district

37. 3. Reorganization of government
health system
Medical colleges Hospitals
• Providing specialist consultation services to
other hospitals in the districts
• Training and quality control of services in
other hospitals.

38. 4. Other specialized services
• Public health cadre and health protection agency
• Communicable disease surveillance and execution of
control measures
• Non communicable disease control
• Community mental health services
• Measures for reducing Road traffic accidents other
trauma and developing systematic trauma care services
• Strengthening Laboratory network in the state