Kerala 2005 - of Planning Commission

CHAPTER 2
ASSESSING DEVELOPMENT: SOME NON- INCOME DIMENSIONS
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Table 2.7: Coverage of Child Immunisation and Low Birth Weight Babies by Districts, 1998-99
Districts
Immunisation
(%)
BCG 3 Doses 3 Doses Measles Complete
of DPT of Polio
Immunisation
Low Birth
Weight (%)
Thiruvananthapuram 99.3 90.8 94.3 85.9 81.6 11
Kollam 99.4 95.9 95.9 93.5 90.6 12
Pathanamthitta 100.0 97.1 96.4 97.1 91.4 18
Alappuzha 100.0 98.6 98.6 99.3 97.4 12
Kottayam 99.2 91.0 88.8 90.3 79.1 18
Idukki 98.3 96.7 95.7 92.4 90.8 15
Ernakulam 100.0 98.0 96.7 95.4 93.4 18
Thrissur 99.0 96.0 94.0 93.5 90.5 13
Palakkad 95.1 85.8 82.9 85.3 75.1 16
Malappuram 87.7 72.9 76.4 65.5 59.8 17
Kozhikode 98.4 96.4 93.9 94.9 90.9 17
Wayanad 97.6 90.5 90.5 85.5 82.3 30
Kannur 97.5 91.3 90.9 87.6 84.7 15
Kasaragod 97.9 94.1 93.2 90.3 87.4 15
Kerala 97.3 91.4 91.3 88.6 84.0 16.0
Coefficient of Variation (%) 3.1 7.0 6.2 8.9 10.7 27.8
Source: Reproductive and Child Health Survey, 1998-99.
Note: Complete Immunisation = BCG + 3 doses of DPT + 3 doses of polio drops + measles.
awareness, in turn, perhaps owes to the disappearance of
disparities in literacy in the wake of a series of adult and
non-formal education activities, culminating in the Total
Literacy Programme (1989-91), which sought to address
the problem of ‘residual literacy’ in the districts.
Marring these achievements are some emerging areas
of concern that appear to be contradictions in human
development in the State and which also need to be noted.
2.8 Morbidity
While Kerala had been hailed for its very low levels
of mortality, the National Sample Survey conducted in
1973-74 reported a startling finding that Kerala’s morbidity
was one of the highest in India, 71 per 1,000 persons
in the case of acute illness and 83 per 1,000 persons
in the case of chronic illness. Subsequently, surveys
conducted by KSSP (Kannan et al, 1990; Kunhikannan
and Aravindan, 2000), National Council of Applied
Economic Research in 1992-93 at the all-India level and
the 52nd round of NSS data collected during 1995-96
confirmed high levels of acute and chronic morbidity
in Kerala. All these estimates were based on surveys of
illnesses as perceived by the respondents.
Although the different sources threw up substantially
different rates of morbidity, they all indicated that Kerala
had the highest rates of morbidity among the major Indian
States. This led to an interesting debate on whether the
reported high rates of morbidity were ‘real’ or due to
better reporting given the higher levels of education and
awareness among the people about health care services.
However, the KSSP study of 1987 based on a survey of
10,000 households argued that Kerala’s high morbidity
was to a large extent real due to two reasons: First,
infections constitute a large share of morbidity, which can
hardly be attributed to perception alone. Second, poor
people reported more illness than the rich, which also
goes against the argument that the perception factor is the
major contributor of high reported morbidity in the State
(Kannan et al, 1990).
It is difficult to refute the observation that the reported
prevalence rates of some acute illnesses like asthma
and tuberculosis seem to be higher in Kerala than in
many other States. For example, according to NFHS II
(1998-99), the prevalence rate of tuberculosis is 5 per
1,000 population in Kerala, which is significantly higher
than many other States such as Tamil Nadu, Karnataka,
Maharashtra, Rajasthan, Punjab and Haryana. The KSSP