The State Cabinet approved Kerala’s new health policy on 24th January 2019. The draft report was prepared by a 17-member expert committee headed by Dr. B. Ekbal. The Draft report had been approved by the Cabinet last year. The final version was approved by Cabinet after incorporating suggestions received from the public as well as other stakeholders. Read more about the Policy here:
- The new Kerala Health Policy 2018 aims to provide universal, affordable and quality health care for everyone.
- Only 3% of India’s population lives in Kerala, but people in the state consume 10% of the medicines produced in the country.
- The long-term goals set in this new policy are:
- Establish a universal, free and comprehensive healthcare system
- Bring Infant, Child and Maternity Mortality rates to levels of developed countries
- To increase healthy life expectancy of people
- The short term goals of policy are:
- Reduce Maternity Mortality Rate from the current 66 to 30
- Reduce Infant Mortality Rate from the current 12 to 8
- Reduce Neonatal Mortality Rate from the current 7 to 5
- Reduce Under-5 Mortality Rate from the current 14 to 9
- Reduce the occurrence of Infectious disease by 50%
- The government will aim at raising its current expenditure on health from the current 0.6% of GSDP to at least 5% by increasing it by 1% every year.
- The state spends between Rs 6,000 crores and Rs 8,000 crores on medicines every year. High medicine prices result in higher overall cost of healthcare. The policy points out that the biggest public health problem is enormous out-of-pocket expenditure on healthcare
- The policy has prepared basic guidelines for human resources required for the next 25 years in the health sector.
- It has proposed strict enforcement of norms for infrastructure facilities and faculty in medical college hospitals.
- The new policy envisages a three tier healthcare system:
- Primary Health Centers – for primary level health care
- Community Health Centers, Taluk Hospitals, District-General Hospitals – for secondary care
- Medical Colleges – for tertiary care
Focus on Primary Health care
- The new health policy focuses on comprehensive primary care services in grassroot level. The strengthening of primary care services will help the prevention, early detection, and management of non-communicable diseases.
- The policy proposes a Primary Health Center (PHC) in each panchayat with facilities which include OP clinics, minor OT, labor room, basic pharmacy, laboratory services, health information collection mechanism and health education system.
- Under E-Health, the medical details of all families residing within the limits of the PHC will be collected. This is to map the health profile of the population and take steps accordingly.
- Tertiary hospitals will have basic specialties such as medicine, general surgery, women-child diseases, Skin, Orthopedic, Ophthalmology and ENT.
- The medical colleges will be strictly maintained as referral centres.
- It also advocates ‘better organic linkages’ between medical colleges and the Health Services hospitals.
- The Health Department has been bifurcated into Modern Medicine and Ayush departments under the new policy.
- The modern medicine will have three directorates. The doctors will be divided into three cadres for serving under the new directorates.
- Directorate of clinical services – covering all hospitals
- Directorate of public health – which will take care of administration of hospitals and work related to public health
- Directorate of medical education – covering medical education and colleges.
- These will be under the Director General Health (Modern Medicine).
- Public health activities will be brought under the District Medical Officer (Health).
- A separate public health directorate will help in tackling public health issues including prevention and control of the infectious diseases effectively.
- The immunisation programmes, disease control and prevention programmes which are now being carried out by the directorate of health services, will be transferred to public health directorate once it is formed.
- The Kerala Clinical Establishments (Registration and Regulation) Act, 2018 was already passed by Kerala Legislative assembly and came to existence on January 1, 2019. The objective of the Act is to provide for the registration and regulation of clinical establishments (public and private) to ensure that minimum standards of facilities and services provided by such establishments.
- The Government will bring a comprehensive Kerala Public Health Act which take into account environmental, lifestyle and other issues faced by Kerala. It will replace Travancore-Cochin Public Health Act and Malabar Public Health Act.
- As of now, the registration of medical practitioners in Travancore-Cochin region is under Travancore-Cochin Medical Practitioners Act (1953) and those in Malabar region are under Madras Medical Practitioners Act (1914). While the former allow medical practitioners in all medicine systems, the latter allow only modern medicine. The Government will bring Kerala Unified Medical Practitioners Act to tackle this problem.
- Nurses and Midwives Act 1953 will be modified to allow nursing teachers to participate in health care and treatments. This will make them more qualified teachers.
- Multi Disciplinary Research Units (DRU) will be established in all government medical colleges with the help of Department of Health Research, Government of India.
- The appointment of nurses, technicians and pharmacists would be regulated in a transparent manner.
- Special ambulances will be deployed with trained staff in potential accident-prone zones.
- Comprehensive trauma care facilities will be provided by pooling resources of government, private and cooperative hospitals in every 10 km area.
- The ongoing Mrithasanjeevni programme (deceased organ donor programme) will be strengthened. Organ transplant facilities will be extended to other medical college hospitals.
- Many of the things outlined in the policy, aimed at improving public health delivery, focussing on preventive and primary care, were already being implemented by the government through Aardram Mission.