The World Bank’s Board of Executive Directors has approved a new $280 million program aimed at improving life expectancy and quality of life for 11 million elderly and vulnerable people in Kerala. The initiative seeks to expand health coverage, enhance resilience against climate-related shocks, and strengthen the state’s overall healthcare infrastructure.
Kerala has achieved remarkable progress in public health over the past two decades, recording significant improvements in neonatal (3.4 per 1,000 live births), infant (4.4 per 1,000 live births), under-five mortality (5.2 per 1,000 live births), and maternal mortality (19 per 100,000 live births) rates. These achievements are attributed to high literacy levels, widespread health awareness, and effective decentralized governance. However, the state now faces growing challenges from non-communicable diseases (NCDs) such as hypertension, diabetes, and cancer, along with an aging population — with the elderly accounting for more than 20% of residents. Additionally, Kerala continues to report over 4,000 annual deaths due to road accidents, exposing gaps in emergency and trauma care.
The newly launched Kerala Health System Improvement Program aims to create a comprehensive, climate-resilient healthcare model. It will strengthen Kerala’s digital health ecosystem through enhanced eHealth services, integrated data platforms, and robust cybersecurity frameworks. The Program will also enable electronic tracking for over 90% of patients registered with hypertension and diabetes, and establish a home-based care model for bedbound, homebound, and vulnerable elderly individuals.
“Good health empowers people, creates jobs and drives economic growth. Strong, resilient health systems also help economies prevent and better respond to health emergencies and pandemics,” said Paul Procee, the World Bank’s Acting Country Director for India. “In Kerala, women have one of the highest educational attainments in the country and can contribute more to the state’s economic growth with optimum health. The Program will ensure a 40 percent increase in patients whose hypertension is controlled and 60 percent increase in cervical and breast cancer screening for women to accelerate efforts to end preventable deaths.”
The Program will work with local government bodies, including gram panchayats and municipal corporations, to implement standard antibiotic-use protocols and improve responses to zoonotic disease outbreaks through faster laboratory data integration. Districts such as Wayanad, Kozhikode, Kasaragod, Palakkad, and Alappuzha will pilot climate-resilient healthcare practices, including energy-efficient facilities and systems to manage heatwaves and floods.
“Kerala has adopted One Health approaches, and experiences from ongoing World Bank support have been tapped to establish a sound system of community surveillance,” said Deepika Chaudhery and Hikuepi Katjiuongua, the Program’s Task Team Leaders. “This Program will ensure elderly people in Kerala receive wider access to health coverage through innovative initiatives. The Program will also support a multilevel trauma and emergency care system to ensure that 8.5 million people receive timely and high-quality service.”
The $280 million loan from the International Bank for Reconstruction and Development (IBRD) carries a 25-year maturity period, including a five-year grace period, reflecting the World Bank’s continued commitment to supporting Kerala’s efforts toward building a robust, inclusive, and sustainable healthcare system.
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