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Kerala’s Family Health Centres Proving Revolutionary: International Webinar

In Health, Kerala
February 19, 2021

Kerala has been among the world’s first to invest effectively in primary healthcare to achieve the standards of Universal Health Coverage laid down by WHO, a global summit noted.

Kerala’s focus on integrated services enables its welfare system to nullify conventional socio-economic inequities owing to urban-rural and elite-poor divides. The development of family health centres (FHCs) in the past four years under Kerala’s Aardram Mission as a pioneering people-friendly project is set to eliminate all such variations, speakers at ‘Kerala Health: Making the SDG A Reality’ said here last evening.

Further, Kerala has succeeded in making communities aware of their entitlements and promoted a healthcare system that is accountable, delegates from within the country and abroad told the virtual event being conducted by the state’s Health and Family Welfare (H&FW) department.

For instance, the incredible transformation of a primary health centre (PHC) in hilly Wayanad into a modern medical facility since 2017 exemplifies the successful profile of Aardram as a pioneering people-friendly project, two top government officials said at a session on ‘Kerala Experience of Universal Health Coverage’.

The FHC in the tribal belt of interior Noolpuzha, with its new OP and in-patient blocks, physiotherapy and antenatal wings, telemedicine facilities and e-rickshaws besides children’s park and an open-air geriatric corner, stands proof to the critical role of community participation in developmental initiatives, according to Dr Rajan Khobragade, Principal Secretary (H&FW) and Dr Dahar Muhammed, Medical Officer of that health centre.

Ability to convince people about the genuineness of welfare schemes leads to build-up of strong teams, more so through a bottom-up approach, they reiterated. The 2017-initiated Aardram has by far upgraded 767 PHCs in Kerala to FHCs as first-level health delivery points of high quality, Dr Khobragade said. The rest of the state’s 200-odd PHCs will be made FHCs by the end of 2022, he informed, explaining the policy perspective.

The process generates 4,000 posts, which are getting filled. Dr Dahar Muhammed, Medical Officer of the Noolpuzha FHC, revealed that the Aardram-triggered enhancement in the centre’s health services has raised OP count from 40-60 a day to close to 250. Daily lab tests have risen by five times from what was 20 four years ago, he added.

The 40-minute session on Wednesday evening highlighted the ways in which Kerala has made major advances in comprehensive primary healthcare through investments in infrastructure, decentralised governance and community engagement. Much of these are in consonance with the guidelines of the Centre’s NHM (National Health Mission).

At a subsequent panel discussion on ‘UHC: Outlook for Developing Countries’, Dr Mala Rao, Senior Clinical Fellow, Imperial College London, said Kerala has an “incredibly committed” primary care staff comprising multi-professional teams trained in new ways of working.

“This makes primary care an attractive specialty choice. It enhances public confidence in that health segment and further strengthens its infrastructure facilities,” she added, emphasising the need for research and evaluation based on areas identified for improvement.

Luigi D’Aquino, UNICEF Chief of Health (India), said the Universal Health Coverage cannot ignore private sector — from regulation to participation to delivery of services. All the same, public financing for health must prioritise PHCs, he added.

At the discussion, moderated by NHM Kerala Mission Director Dr Rathan Kelkar, Dr G.N.V Ramana, Ex Lead Health Specialist, World Bank, spoke on the UHC experiences from the African countries.

Earlier, Dr Viroj Tangcharoensathien, Senior Advisor, Ministry of Health, Thailand, highlighted “sustained commitment” to Universal Health Coverage “despite protracted political conflicts” as a key to the success of the health system that provides a full range of essential medical services to the people of the Southeast Asian country.

The webinar series that began on February 17, with focus on the prospects of achieving sustainable development goals (SDGs) amid an added challenge posed by Covid-19, is being held across five days this month and early March.