Kerala 2005 - of Planning Commission

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In fact, as in the case of education, private provision
far exceeds public provision in health care. A recent
study conducted by the Department of Economics and
Statistics (in 1995) found that there were in the private
sector of Kerala 12,328 medical institutions with 70,506
hospital beds. This included 4,288 allopathic medical
institutions with 67,517 beds (against 1,227 public
sector allopathic institutions with 37,905 beds), 4,922
ayurvedic institutions with 2,595 beds and 3,118
homoeopathic institutions with 394 beds; 10 an earlier
survey (in 1986) brings out the continuing growth in
private health care sector. 11 It goes without saying that a
sizeable proportion of demand for health care provision
is directed towards the private sector in Kerala, which
explains to a significant extent the development of health
care in the State.
The tremendous growth of the private sector in the health
care provision system of Kerala has, however, raised a
number of problems of both governance and equity.
There has never been an effective regulatory mechanism
in force, and a good section of the sector has grown into
a medical elite of ‘super speciality’ centres, with little
access for commoners. Here the poor stand disadvantaged
on two counts: They cannot afford to access medical care
facilities of a wide range in the private sector, and at the
same time, the ‘brain drain’ from the public to the private
sector leaves the poor deprived of better medical attention
in Government hospitals.
4.2 Potable Water
One of the key factors that contribute to the health status
of a population is protected (piped) drinking water supply.
It should be noted that Keralites in general have been in the
habit of drinking boiled water (often with some medicinal
leaves or roots or seeds) and this has generally helped
them avert the attack of water-borne diseases, despite
their drawing water from open wells or ponds or streams.
Though this persistent good health habit renders protected
drinking water supply somewhat irrelevant in its mission of
health protection, its public provision has been on the rise.
As in July 2003, 64 per cent of the population in Kerala,
with 59 per cent in the rural and 79 per cent in the urban
areas, received piped water supply.
4.3 Sanitation
Sanitation is another critical factor in health status
determination that has earned Keralites a reputation
for personal cleanliness. That Keralites attach a high
premium to the significance of having a sanitary latrine is
Table 2.14: Percentage of Households having Latrine and Electricity Connections by Districts, 2001
State/Districts
Percentage of Households having
Latrine
Electricity
Total Rural Urban Total Rural Urban
Thiruvananthapuram 82.56 78.60 90.86 74.94 69.46 86.38
Kollam 82.63 80.97 90.78 73.00 70.30 86.26
Pathanamthitta 81.73 81.22 86.57 71.58 70.46 82.21
Alappuzha 80.00 76.93 87.81 74.60 72.56 79.77
Kottayam 85.33 84.23 91.61 77.71 75.78 88.78
Idukki 75.99 75.24 91.12 56.78 55.60 80.50
Ernakulam 91.95 89.45 94.81 84.90 80.12 90.38
Thrissur 90.91 89.46 94.63 77.30 74.19 85.27
Palakkad 68.40 66.11 82.72 60.27 57.19 79.55
Malappuram 87.37 86.84 92.28 63.84 62.67 74.68
Kozhikode 91.97 90.28 95.09 64.15 55.71 79.66
Wayanad 85.15 85.06 87.54 41.96 41.23 60.77
Kannur 87.21 82.17 92.76 66.99 51.28 84.26
Kasaragod 68.43 64.12 86.42 57.20 52.40 77.21
Kerala 84.01 81.33 92.02 70.24 65.53 84.34
Source: Estimated from Census 2001.
10 Government of Kerala (2002: 250).
11 Government of Kerala (1987).