While Kerala’s health system is on the right track to achieving universal health care and coverage, the State will have to devise renewed strategies and focus on preventive and primary care, so as to meet the healthcare requirements of a rapidly aging population and the high cost of care of chronic illnesses.
Public health in the State continues to focus on clinical care and has gone away from preventive care, public health measures and health promotion activities, all of which are crucial for improving primary care. The focus on setting up high-end hospital infrastructure should not be at the cost of primary and preventive care, which alone can help the State bring down its high out of pocket expenditure on health, health experts pointed out at a seminar on Public Health sector here on Friday, organised as part of Keraleeyam.
Speaking on the occasion, the president of Public Health Foundation of India, K. Srinath Reddy, said that Kerala had developed an equitable and empathetic public health system which looked beyond delivery of healthcare services and that the continuum of clinical medicine and public health had been achieved remarkably well by the State. He said that the State should invest heavily in multidisciplinary research to meet the challenges of growing non communicable diseases and health issues linked to environment and climate change.
M.V. Pillai, renowned medical oncologist from Jefferson University in the US, pointed out that Kerala was trapped in its own success in health care. The longevity of the population and the stabilisation of population growth to replacement level fertility meant that there were no youngsters to take care of the huge proportion of the elderly in the State. Preventive health was where Kerala had to focus now, especially when it came to tackling chronic non-communicable diseases like cancers. He pointed out that the State also needed to focus on digitalising its data and keeping it safe. Kerala’s investments in setting up the Institute of Advanced Virology, One Health policies, microbiome research will pay rich dividends, Dr. Pillai said.
V. Ramankutty, renowned public health analyst and epidemiologist, pointed out that the high cost of healthcare and impoverishment following catastrophic health expenditure, the high and life-long cost of managing non-communicable diseases and the struggle to find increased resources for health were real challenges for the State. Despite the huge improvements in public health system, why a chunk of the population preferred to go to the private health sector institutions was a question that Kerala had to ask itself. He pointed out that despite 25 years of decentralisation, the healthcare needs of the marginalised sections of society like tribals and coastal folk continued to be neglected.
T. Sundararaman, independent consultant, Health Systems and Health Policy Studies, was all praise for Kerala’s new Public Health Act, the quality of community engagement in healthcare activities and intersectoral convergence in health. He advised the State to build on health system data consolidation and to open up the data sets for scrutiny by the academic community and public health experts.
Health Minister Veena George, expounded on the remarkably long history and development of the State’s public health system and its new achievements
Principal Secretary (Health), A.P.M. Mohammed Hanish, former Health Minister P.K. Sreemathy, chairman of Pallium India M.R. Rajagopal and former Director of Health Services and Planning Board member, P.K. Jameela, also spoke at the seminar.
