The World Bank has approved a $280 million program to enhance health coverage and strengthen health systems for 11 million elderly and vulnerable people in Kerala, India. The initiative aims to improve life expectancy and quality of life by building a more resilient, climate-adaptive health system and expanding access to essential services. Kerala has achieved notable health gains over the past two decades, including low neonatal, infant, under-five, and maternal mortality rates, driven by high literacy, public health awareness, and decentralized governance. However, rising non-communicable diseases and a rapidly aging population have strained the state’s health infrastructure, alongside gaps in emergency and trauma care.
The Kerala Health System Improvement Program will expand digital health systems, including eHealth services, integrated data platforms, and enhanced cybersecurity. It plans to track and treat over 90 percent of registered patients with hypertension and diabetes through electronic monitoring. A home-based care model will be established for bedbound and vulnerable elderly populations to ensure comprehensive access to health services. The program also targets a 40 percent increase in patients achieving controlled hypertension and a 60 percent increase in cervical and breast cancer screening for women, aiming to reduce preventable deaths.
Local governments, including gram panchayats and municipal corporations, will implement standard protocols for antibiotic use and zoonotic disease outbreak management, supported by rapid laboratory information systems. Primary health facilities in districts such as Wayanad, Kozhikode, Kasaragod, Palakkad, and Alappuzha will adopt climate-responsive solutions to enhance energy efficiency and manage extreme heat and floods. The program will also strengthen multilevel trauma and emergency care to ensure timely, high-quality services for an estimated 8.5 million people.
Paul Procee, Acting World Bank Country Director for India, emphasized that strong health systems empower people, boost economic growth, and enhance resilience against health emergencies. Task Team Leaders Deepika Chaudhery and Hikuepi Katjiuongua highlighted the integration of Kerala’s One Health approach and previous World Bank experience to establish robust community surveillance systems. The program is financed through a $280 million loan from the International Bank for Reconstruction and Development (IBRD) with a 25-year maturity and a five-year grace period.







