Kerala 2005 - of Planning Commission

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Figure 2.8 shows the infant mortality rate across districts
in Kerala. 4 The variability in infant mortality rate is low in
Kerala, if we exclude the two outlier districts of Wayanad
and Idukki. In the districts of Wayanad and Idukki,
1 in 50 newborn babies dies before reaching the first
birthday, whereas in most of the other districts 1 in 100
dies. The estimated infant mortality rate is lowest in the
districts of Pathnamthitta, Kollam and Alappuzha.
2.7 Maternal Health Care
and Child Immunisation
Some of the favourable outcomes discussed above are
primarily dependent on the utilisation of maternal health
care services, which is the highest in Kerala among all
Indian States due to better availability and accessibility of
such services (Navaneetham and Dharmalingam, 2002).
For instance, antenatal check up is almost universal
(99 per cent) in Kerala as compared to India
(65 per cent), as per NFHS-II (1998-99). However, the
use of full antenatal services (at least three ANC visits
and at least one TT taken and IFA tablets taken during
pregnancy) in Kerala is 86 per cent. Although there was
little variation across districts, the use of full antenatal
services is below the State average in the districts
of Thiruvananthapuram (71.8 per cent), Kasaragod
(75.4 per cent), Malappuram (78.8 per cent), Idukki
(82.1 per cent) and Pathanamthitta (84.8 per cent).
Nevertheless, almost all deliveries (97 per cent) took
place at the medical institutions in Kerala, except
in Malappuram district (88 per cent). Among these,
59 per cent of the deliveries were in private and only
38 per cent were in public medical institutions. This raises
the question about the cost involved in delivery care and
the likely impact of this economically on the family in the
absence of regulatory mechanisms in private hospitals.
Like use of maternal health care services, the coverage of
complete child immunisation (child given BCG, three doses
of DPT, three doses of polio and measles vaccines) is the
highest in Kerala (84 per cent). However, the coverage of
complete immunisation is the lowest in Malappuram district
(60 per cent) followed by Palakkad (75 per cent). These
districts need special attention in providing preventive care
services.
It goes without saying that in addition to increased
availability that helps people’s access to health care
facilities, it has been the increasing levels of awareness that
has led to better utilisation of these services. This increasing
Table 2.6: Use of Maternal Health Care Services by Districts
District Full ANC (%) Institutional Deliveries (%)
All Public Private
Thiruvananthapuram 71.8 99.5 67.3 32.6
Kollam 90.2 99.0 48.3 51.6
Pathanamthitta 84.8 99.4 27.5 72.4
Alappuzha 93.1 100.0 54.4 45.5
Kottayam 91.9 99.4 40.7 59.2
Idukki 82.1 93.3 25.4 74.5
Ernakulam 89.6 99.4 29.1 70.8
Thrissur 89.3 99.2 28.5 71.4
Palakkad 86.2 93.4 30.6 69.3
Malappuram 78.8 88.0 31.4 68.5
Kozhikode 93.1 98.9 54.3 45.6
Wayanad 90.4 97.7 54.2 45.7
Kannur 90.2 98.4 35.9 64.0
Kasaragod 75.4 96.7 11.1 88.8
Kerala 86.1 97.0 38.0 58.9
Coefficient of Variation (%) 7.6 3.4 38.2 23.9
Source: Reproductive and Child Health Project, Rapid Household Survey, 1998-99, ISEC, Bangalore, IIPS, Mumbai, 2001.
Note: Full ANC = At least 3 ANC visits+ at least one TT+ IFA given.
4 See Technical Note at the end of the Report for estimation procedure.