The World Bank has approved a $280 million program aimed at improving health coverage and building more resilient health systems for 11 million elderly and vulnerable people in Kerala, India. The initiative, called the Kerala Health System Improvement Program, seeks to address the challenges posed by an aging population and the increasing prevalence of non-communicable diseases such as hypertension, diabetes, and cancer.
Kerala has seen significant improvements in health outcomes over the past two decades. The state reports low neonatal, infant, under-five mortality rates, and maternal mortality rates compared to national averages. These gains are attributed to high literacy rates, strong public health awareness, and decentralized governance. However, the state’s healthcare system is under pressure due to its rapidly aging population—over 20 percent are elderly—and rising cases of chronic illnesses. Additionally, emergency and trauma care services face challenges with more than 4,000 road traffic deaths reported annually.
The new program will focus on strengthening Kerala’s digital health infrastructure by expanding eHealth services and integrating data platforms with enhanced cybersecurity measures. One of its goals is to ensure that over 90 percent of patients registered for hypertension and diabetes receive support through electronic tracking mechanisms. It also plans to introduce a home-based care model for bedbound or vulnerable elderly individuals.
Paul Procee, Acting Country Director for India at the World Bank, said: “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. 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.”
Local government bodies such as gram panchayats and municipal corporations will be involved in adopting standard protocols for antibiotic use and managing zoonotic disease outbreaks by speeding up laboratory information delivery for patients. Primary healthcare facilities across several districts—including Wayanad, Kozhikode, Kasaragod, Palakkad, and Alappuzha—will implement climate-resilient solutions like improved energy efficiency measures to better handle extreme heat waves or floods.
Deepika Chaudhery and Hikuepi Katjiuongua—Task Team Leaders of the program—noted: “Kerala has adopted One Health approaches, and experiences from ongoing World Bank support have been tapped to establish a sound system of community surveillance. 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 funding comes as a loan from the International Bank of Reconstruction and Development (IBRD), part of the World Bank Group; it carries a final maturity period of 25 years with a five-year grace period.