Here is a consolidation of several links on Kerala's efforts at combatting Covid 19.
1. The Economist has a very good summary,
But Kerala tamed Nipah within a month, adopting an all-hands approach that included district-wide curfews, relentless contact-tracing and the quarantine of thousands of potential carriers. Kerala has used the same simple, cheap tools to fight covid-19, with similarly stellar results... Vietnam and Kerala both benefit from a long legacy of investment in public health and particularly in primary care, with strong, centralised management, an institutional reach from city wards to remote villages and an abundance of skilled personnel... Kerala’s state government has been similarly energetic, from the chief minister, its top elected official, giving nightly pep talks to village-level committees working to set up public hand-washing stations. Aside from showing logistical efficiency in monitoring cases and equipping its health system, it has also emphasised sympathy and compassion for people affected by the pandemic. The state has mobilised some 16,000 teams to man call centres and to look after as many as 100,000 quarantined people, ensuring they do not lack food, medical care or simply someone to talk to. Free meals have been delivered to thousands of homes, as well as to migrant workers stranded by a national lockdown.
And this from the Washington Post,
Even though Kerala was the first state to report a coronavirus case in late January, the number of new cases in the first week of April dropped 30 percent from the previous week... The success in Kerala could prove instructive for the Indian government, which has largely shut down the country to stop the spread of the contagion... The state faced a potentially disastrous challenge: a disproportionately high number of foreign arrivals... Its challenges are plenty — from high population density to poor health care facilities — but experts say Kerala’s proactive measures like early detection and broad social support measures could serve as a model for the rest of the country... Kerala’s approach was effective because it was “both strict and humane,” said Shahid Jameel, a virologist and infectious disease expert... Henk Bekedam, the World Health Organization’s representative in India, attributed Kerala’s “prompt response” to its past “experience and investment” in emergency preparedness and pointed to measures such as district monitoring, risk communication and community engagement.
This is a very good narrative of the Covid management in Kerala - plain simple and detailed monitoring. This, this, this, and this are good summaries of the Kerala government's response. More on the Kerala's Covid 19 response here and here. This is a very good and comprehensive post.
At the core of the Kerala model is its simplicity and doing the basic stuff, and getting execution right. And this, as we know from elsewhere in India and abroad, is very hard and rare.
2. History. But Kerala's success has been built on a very strong foundation of investments in primary health and education since the 19th century made by the combined efforts of its maharajahs, social reformers, missionaries. In an excellent article, V Ramankutty writes,
Both Travancore and Kochi had strong public health traditions. Travancore popularised vaccination in the 19th Century by royal edict. The Maharaja of Travancore is known to have publicly accepted vaccination for his family members and advised his people to follow his example so that their fears may be allayed. They also had strong departments of modern medicine, with general hospitals in Trivandrum and Ernakulam, and Women and Children’s Hospital in Trivandrum. Travancore appointed Dr Mary Punnen Lukose as the Durbar Physician — one of the highest posts under princely rule. A woman raised to such a position of eminence was a first for India. Dr Lukose, a Syrian Christian, had studied medicine in England, when few women had the opportunity to do so even in western countries.
This about how Kerala was able to avoid the trap of falling into the prevailing late-nineties ideological dominance of private sector,
Around this time, the World Bank and other lending institutions increasingly provided loans for health system development, and Kerala was one of the Indian states to make use of them. At the same time, the World Bank, in line with its philosophy of encouraging private initiative, tried to restructure the government health system, significantly pressing for the introduction of user fees. In Kerala, this was resisted by a strong coalition of civil society. One important piece of legislation at the time was instrumental in changing the face of healthcare again: the decentralisation of power to the panchayats and other local bodies. This brought health institutions under the direct administration of local bodies, and also provided them more funds. Many local bodies utilised this opportunity to improve the facilities in hospitals. This was the beginning of revival of the public sector in health in Kerala. Recent years have seen many initiatives in the government health sector, and 10-20 per cent of people have moved back to the public sector. More sophisticated care is available at taluka and district hospitals as well as government medical colleges. Successive governments have provided improved funding at different tiers of government institutions.
3. Strong public health system. This is a very good article on the important role played by the 26000 community health workers or ASHAs.
4. Governance. Several elements of plain simple good bureaucratic actions and political leaderships have contributed to the state's success so far.
This is the Kerala government's supply chain and inventory management system which lists over 19000 GST registered traders. This is the Government's monitoring Dashboard, which has granular information on Covid status. This is the state government's services portal, Jagratha.
4. The state's response has been characterised by getting several small things right and a space for decentralised district-level initiatives.
Sample this on the use of low cost technology innovations like automated telephone calls to those under isolation.
4. Another feature of the Kerala government's work has been its transparency, constant communication, and painstaking field work and political leadership. Sample this,
... state's decentralised community-level task force, devised to lend a helping hand for those who are quarantined. Kerala has structured a three-member team in each village, comprising a village's elected representative, a public health worker and a police officer, for monitoring and assisting any need for those in home quarantine.
This interview of the Kerala Chief Minister is as statesmanly an interview as any. It also clearly indicates the reasons for Kerala's success - being transparent with details, and doing the simple things right. This is another interview of the Kerala CM which pretty much captures the essence of what the state is doing right.
5. It also was the earliest, by weeks, of any government in India to step in with economic support measures. This is a good description of its economic rescue package.
6. Another notable feature was the humane nature of the response by the state, both the government and especially civil society organisations. This describes the state's community kitchens and home delivery which have now been established across all villages and towns. This article highlights how the state has mobilised Kudumbashree women's self help groups to run community kitchens to prepare food for the poor.
7. Kerala's bigger long-term challenge would be to accommodate its returning Gulf emigrants. They brought in Rs 1 trillion, or one-third of the state's total income.
No comments:
Post a Comment