Consequences of the epidemiologic transition in Kerala, India – A public–private-partnership model of health care: A critical analysis

The state of Kerala stands out as having the highest prevalence of diabetes and coronary artery disease in comparison to other states within India. This observation positions India as the global epicenter for noncommunicable diseases (NCDs), specifically diabetes, and cardiovascular ailments. Kerala is in a highly advanced stage of epidemiological transition, surpassing other states in India. This transition is characterized by factors such as an aging population, a high incidence of NCDs, and elevated levels of morbidity. Kerala boasts a robust health-care system encompassing a strong public sector, further reinforced by a network of private hospitals spread across the state. Moreover, the population of Kerala possesses a high literacy rate. It is well-informed about their rights, while local self-governance and nongovernmental organizations (NGOs) actively collaborate to promote community health. These factors have collectively contributed to the state’s proactive approach toward addressing NCDs. In the domains of surveillance, monitoring, and prevention of NCDs, as well as the prevention of complications arising from these diseases, Kerala has implemented various schemes across the public, private, and NGO sectors. These initiatives encompass activities to raise awareness about NCDs, provide treatment options, and focus on preventive measures. By documenting and highlighting these schemes, Kerala’s health-care system and its achievements can serve as a roadmap for the rest of the country, outlining strategies for prevention, monitoring, and therapeutic interventions. It is imperative that other states within India, as well as low- and middle-income countries (LMICs) at large, adopt and adapt the processes and practices established by Kerala to effectively combat the NCDs pandemic. By following this path, the nation and other LMICs can effectively confront the challenges posed by NCDs and work toward improving their populations’ overall health and well-being.