Kerala and the Astana declaration

2019 January 4
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“Kerala tried to provide [primary care services as described by the Astana declaration] and more with mixed results. These services cannot be provided without adequate human resources. It is nearly impossible to provide them with the current Indian norm of one primary care team for a population of 30,000. Kerala tried to reduce the target population to 10,000. Even the reduced target turned out to be too high to be effective,” writes Shri Rajeev Sadanandan IAS, Additional Chief Secretary, MoH&FW, Kerala, in this Op Ed titled “Lessons from Kerala“, published in The Hindu on 3 Jan 2019. Shri Rajeev Sadanandan was also the keynote speaker at a recent workshop on “Palliative Care & Universal Health Coverage in Kerala“, organized in Trivandrum by Pallium India and Govt Medical College, to commemorate Universal Health Coverage (UHC) day.

We agree; Kerala could indeed provide good primary care, if only each primary health care team was expected to perform a job that it could realistically handle. Currently, one team has to care for a population of at least 10,000. More than 3,000 is not realistic to achieve. Obviously, the manpower needs would be huge.

Is this a realistic dream? We would say: Yes – if as a nation, we decide to give due importance to health. Any civilised country allocates at least 5% of its GDP to health, whereas India spends an abysmal 1.25%.

While we are busy making money, will we not end up creating a society with the majority of its members in ill health?

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