Rarely we see a government sticking close to its manifesto and trying to implement almost all aspects of it within one year of its coming. The people friendly health policy laid down by first Kerala government under EMS has made significant contributions to the Kerala Model of Development, cutting down the mortality and morbidity rates of the population considerably. The trajectory set 60 years ago helped us achieving the health indices as high as those of the rich countries despite the low economic growth of India in general and Kerala in particular.
The LDF manifesto 2016 has broadly laid down the current government’s roadmap to governance. In the healthcare sector the 35 point pre-election manifesto the 21st and 22nd point is directly linked to healthcare. It talks about the need to review the staff pattern and double the number of doctors and nurses. Suggestions to efficiently use existing healthcare infra structure and building new ones to fill the gaps. Manifesto promised to bring facilities for Heart surgery and cath lab to the level of Taluk hospital and cancer check up facility at Taluk hospitals. On this first anniversary let us take a stock of what we had happened so far.
The government has decided to address the socio-economic developmental challenges faced by Kerala by launching four mission based projects. Ardram mission is the component that deals with challenges in the health care segment. Key governmental activities related to health is woven around the vision of Ardram mission which has the poorest of the poor at its centre.
Ardram: Upping the Bar; Humility and Compassion
The flagship project Ardram mission aims a total overhaul of public health sector making it people friendly, affordable for poorest and provide substantial state of the art infrastructure facilities. State has a wide network of Healthcare Institutions, ranging from Sub-Centres to Medical College Hospitals (MCH), both in Modern medicine and AYUSH streams. Specialist treatments are mostly given by MCH and institutions like Regional Cancer Centre. Ardram aims to extend give the super speciality facilities now limited to medical colleges, to district and taluk hospitals.
The specialist institutions are currently not able to manage the large volume of patients who approach them for treatments directly, without any reference from the lower hospitals. Although many of the ailments they are suffering from can be treated at lower level hospitals, they are forced to approach the Medical Colleges etc., at the first instance itself due to inadequate facilities. To resolve this problem it is the lower level hospitals that are to be strengthened where the health issues of majority of the population can be effectively addressed.
Primary health centres will get a makeover as family health centres with focus on health coverage for all members. This will ensure preventive and rehabilitative healthcare interventions in local community. The MCH and the Specialist Centres should function only as referral hospitals. This will go a long way in re-orienting the institutions with proper distribution of duties and responsibilities.
Employing IT for Health Care
Introduction of Electronic Health Card for each individual, which has all vital details of a person, aliment history and the treatment given from time to time is being implemented all over the state. When any person approaches the hospital with a health related issue, this data will be of immense help for the speedy and proper diagnosis of the disease. Thus the patients get precise treatment. Similarly, when a patient is referred to a higher level hospital it will be helpful to alert the referral hospital and also transfer the vital details of the referred patient. Registrations in hospitals is already online in few MCHs and will go online soon in all hospitals, the rush in OP wings and inpatient departments can be brought down using e-health cards.
Electronic display boards for each consultant, patient waiting area with proper facilities and local maps will make hospitals people friendly. Our government is committed to regulate treatment costs, provide free medicines for life style diseases. The facilities at the casualty wing, IP wing, diagnostic laboratories, pharmacy, labour room, operation theatre are being upgraded as per the norms laid down for these services. Treatment protocol will be put in place for major diseases. Universal training to doctors and support staff will keep them updated on the latest developments in their respective fields.
Putting Human Resource on the Vision
There was an acute shortage of staff in the health care system, within the past one year government has created as many as 1897 posts in the Health and Social Welfare Departments. Among that the orders sanctioning 721 posts of staff nurses is worthy of special mention, it is one-third of the total number of existing nurses. This is a record, it is aimed at making a favourable patient-nurse ratio.
Other posts created within the one year were, 47 assistant dental surgeons, 204 lab technicians, 307 staff nurses and doctors in district and taluk hospitals, seven technical staff in the Kerala Health Research and Welfare Society, 19 nursing tutors, 10 posts at the Public Health Lab in Malappuram, 12 posts at the public hospital Ranni and 15 at the public lab in Pathanamthitta. Posts have been created at the directorate of medical education too. As many as 24 posts of teaching staff have been created at the Government Nursing College, Ernakulam, and 12 non-teaching staff. Nine nursing tutors have been posted at the nursing colleges, 24 teaching and non-teaching staff have been posted at dental colleges. The current government has also newly appointed 719 assistant surgeons.
For a healthy society non-Medical Interventions at various levels like proper quality drinking water supply, waste management, encouraging healthy lifestyle by providing play grounds establishing Gyms, Yoga, etc. are also needed. The health of the community can be improved by a comprehensive Primary Health Care involving all line departments spearheaded by Health Department and Panchayats. With the implementation of Ardram Mission, the State is going to make a great leap in the health sector. We expect to confront the maladies of communicable diseases, seasonal health hazards, life style diseases and the new generation health issues through this mission.