Niti Aayog health index: Kerala on top but slips

THIRUVANANTHAPURAM: Kerala may have topped Niti Aayog’s  health index, but the overall score has dropped from 80/100 in 2014-15 to76.55 during  2015-16 indicating that there is a slight decline in the growth rate.

While it is not surprising to find Kerala on the top of the list, there is certainly cause for  concern over the way some of the important health indicators and social indices have declined to some extent.

Kerala is at 11th place in low birth weight which needs detailed examination. Sex ratio too has shown a drop from 974 girls /1000 boys in 2012-14 to 967/1000.  However, Kerala continues to top in the male-female ratio.

According to  the 2011 census,  the male-female ratio was 1084 females per 1000 males. Experts say if the figures are to be believed then there is certainly a decline in female population and male population is overtaking females. This trend needs to be studied in detail.

While there have been no reports about female foeticide in Kerala like  other states, experts say there is no room for complacency especially in view of the fresh data.

The state’s hospital deliveries or institutional deliveries have also declined from 96 percent to 92.6 which is a cause for  concern. The declining trend should be seen along with the instances of unscientific deliveries taking place in the state.
But what is more alarming is the decline in vaccination coverage of children below one year. In Kerala the vaccination coverage in 2014-15 was 95.5 percent and now it is 94.6 percent.   The state had faced stiff resistance from anti-vaccine campaigners during the recent MR vaccination programme.

Kerala now stands at eighth position in vaccination coverage. Experts say it is important to study the reasons behind the decline. J & K tops in this category with 100 per cent coverage. In 2014-15,  J & K vaccination coverage was 89.9 and now it is 100 percent.

“If the statistics are true and even if there is one  per cent decline in coverage then it is an alarming situation. We cannot brush these figures under the carpet. 

The state needs to counter the anti-vaccine campaigners strongly to prevent further decline in vaccination coverage. The state could not achieve its 100 per cent target in MR vaccination owing to the resistance in some districts,  especially Malappuram,” said Dr  P.S. Jinesh, health activist.

It may be recalled that the hi-tech cell of police had registered cases against those running campaigns against MR vaccine in the state. Info Clinic team member Dr Jithin T Joseph had submitted a complaint to the chief minister referring to the misleading messages appearing on the WhatsApp and other social media networks and how these had adversely affected MR vaccination campaign in many parts of the state.

IMA state president Dr N. Sulphi says while the Niti Aayog statistics are on the expected lines as Kerala had achieved high indicators compared to other states long back, the fresh challenge is to deal with the emerging diseases. Many types of fevers are coming back, non-communicable diseases are on the rise and some of the cancers have also shown an upward trend.

“While maintaining our present status, Kerala will have to  come up with long-term plan for the next 15 – 20 years. We will be able to sustain the Kerala model only through such initiatives. The actual impact of the resistance to vaccination will be seen on the ground after 10 – 15 years. So the government and health agencies need to take up the issue on priority and launch a counter offensive against those spreading lies about vaccination,” he added.

Experts say waste problem needs to be tackled on a war-footing as it has also contributed to diseases like leptospirosis, chikungunya and dengue. The increasing population of rats has led to rise in rat fever or leptospirosis cases in many parts of the state. This should set alarm bells ringing for health officials.
Kerala Government Medical Officers Association which represents doctors of 1200-odd health department institutions believes that Kerala’s growth in health sector is comparatively low. “Our growth is less compared to some other states which have improved considerably from their previous status. We seem to have become stagnant in many areas. The increase in the number of migrant workers  has also brought enormous challenge before the health department. The state needs to provide better hygienic and living conditions for workers,” said Dr K.A. Raoof, newly-elected president of KGMOA.

He said the propaganda being unleashed by various sections against modern medicine has  misguided people. The huge campaign unleashed against MR vaccine was a case in point.

The social media is being effectively used to run a series of campaigns against modern medicine. While the chief minister and health minister have expressed happiness over Kerala being ranked first in  the Niti Aayog index, experts say the state cannot rest on its past laurels any longer. The government, health officials, planners, policy makers and  society at large need  to come together to check the unhealthy trends which are setting in and  prepare an effective long-term action plan to keep the state and its people healthy.